Treatment overview

How CML is treated depends on:

  • the phase of the illness
  • your general health
  • how fit you are.

Your doctor will discuss the possible treatment options with you, and their advantages and disadvantages.

Chronic phase

In the chronic phase, the aim of treatment is for your blood count to return to normal, and for you to keep feeling well. This may be for many years – possibly for your normal lifespan.

You will usually be treated with a tablet called imatinib. This is a type of targeted therapy called a tyrosine kinase (TK) inhibitor. TK inhibitors have greatly improved the outlook for people with CML. Many people have been taking imatinib for 10 years or longer without any problems from their leukaemia. If imatinib doesn’t work or if you can’t take it because you have side effects, other TK inhibitors can be used. These include nilotinib and dasatinib.

If you have CML that hasn’t responded to TK inhibitor treatment, stem cell transplants (sometimes called bone marrow transplants) may be used.

Accelerated phase

If imatinib or another TK inhibitor hasn’t been used in the chronic phase, it can be used in the accelerated phase.

If you don’t have a TK inhibitor, you’ll usually be treated with a combination of chemotherapy drugs. These are given by injection into a vein (intravenously). Some people may have a stem cell transplant if they are fit enough.

Blast phase

In the blast phase, the aim of treatment is to reduce symptoms and to try to put your leukaemia back into a second chronic phase. If you’ve not had TK inhibitors before, you may be given them. Blast-phase CML is like an acute leukaemia, so you will usually be treated with combinations of chemotherapy drugs used to treat acute leukaemia. If your leukaemia responds well to either TK inhibitors or chemotherapy and you are fit enough, your doctors may recommend a stem cell transplant.

Supportive treatments

Some people have a very high number of white blood cells in their blood when they’re diagnosed with CML. The cells can clog up blood vessels and cause physical problems. Doctors may treat this by removing the excess cells from the blood using a machine called a cell separator. This process is called leukapheresis.

You lie on a bed or reclining chair with a plastic tube (cannula) in each arm. Each cannula is connected by a tube to the cell separator. Your blood is removed through one tube and circulated through the cell separator. This removes the white blood cells. The rest of your blood is then returned to your body through the cannula in your other arm. The whole procedure takes a few hours and is not painful.

Back to Understanding your diagnosis

Phases of CML

There are three phases of CML. Most people are diagnosed in the chronic phase.