The treatment plan is based on the phase of CML.
Chronic Phase
Single agent chemotherapy with busulphan or hydroxyurea is the traditional approach to chronic phase CML.
Treatment goal for chronic phase patients is to provide symptomatic relief of leukocytosis and organlomegaly.
Single-Agent Chemotherapy
- Busulfan or hydroxyurea is standard treatment for chronic phase
- lower white blood cell count
- reduce liver and spleen size
- normalizes hematologic parameters and clinical findings
- provide symptomatic relief but does not delay progression to blast phase or improve survival.
Splenectomy can be used for CML but is a palliatiive and not a curative treatment.
The goal for accelerated and blast phase is reversion to chronic phase.
Interferon-ά (INF-ά)
- Antiproliferative effect against normal and CML myeloid precursors
- Effective for Ph+ CML patients during early phase
- Reverse splenomegaly
- Normalize white blood cell and platelet count
- Interferon-ά in combination with low dose cytarabine
- Higher hematologic response rate
- Rapid disease control
- Low incidence of side effects
- Longer duration of disease control
Side effects of INF-ά include flu-like syndrome, neurologic/psychiatric and dermatologic symptoms.
Hematopoietic stem cell transplantation (HSCT) is the curative treatment for the majority of CML patients.
Chronic Myeloid leukemia: Treatment options at the National Cancer Institute
