Other types of treatment for CML

If your white blood cell count is very high, or you have a lot of symptoms and feel unwell, your doctor may give you a tablet called hydroxycarbamide. This will help to control your symptoms and stabilise your blood counts until you can switch to a different treatment.

You can take hydroxycarbamide at home, and most people only have to have a small dose for a short period of time. It is classed as a form of chemotherapy, so there may be some warnings on the label that seem alarming if you aren’t expecting to see them.

There is a chance that hydroxycarbamide may affect your fertility and increase your risk of skin cancer, so always follow sun-safety advice and speak to your hospital team if you plan to have a family.

If your white blood cell count is very high, and particularly if you have certain symptoms such as blurred vision, your doctor may recommend something called leukapheresis. This is a procedure which removes some of your white blood cells from your body in order to get the CML under control.

Most people won't need to have leukapheresis, but if your doctor does recommend it you will be treated by a specially trained nurse in hospital. Your team will explain more about what’s involved if necessary.

If you become pregnant whilst on treatment for CML, or you are pregnant at the time of diagnosis, you may be recommended interferon as a temporary alternative to TKIs. This is because it is safe to take during pregnancy.

Interferon is an injection given under the skin. It can be done by you or someone else at home, or by your district nurse at your GP surgery if you prefer.

Some people notice that they become depressed whilst on interferon. Tell your hospital team if you notice any changes in your mood.

Stem cell transplants are usually only recommended for people who haven’t responded to multiple TKIs. Doctors will also take into account things like your age, fitness levels, lifestyle and any other conditions you might have.

If you are diagnosed with blast phase CML, or you progress into the blast phase, your hospital team may consider recommending intensive chemotherapy followed by a stem cell transplant.

If you do need a transplant and wish to go ahead, your hospital team will try to find a matching donor.

People who have a stem cell transplant may not need to take any more medication for CML, but might need treatment for side effects of the transplant either straight away or later in life. Your doctor will talk to you about the benefits and risks of a transplant if you need one.

Very few people will be in the blast phase when they’re diagnosed with CML, but this can happen. You may also progress to the blast phase from the chronic or high risk phases if your treatment doesn’t work properly.

If you do reach the blast phase, you will be recommended stronger treatments, which is similar to how acute (fast-growing) leukaemia is treated. This usually involves chemotherapy, and sometimes TKIs as well.

It is likely that stronger treatments may affect your ability to have children, so it’s important to speak to your hospital team if you think you might want to start a family or add to one.

If the treatment at the blast phase is successful and you return to the chronic phase, your doctor may recommend that you have a stem cell transplant. If this applies to you, you will have the chance to ask lots of questions before deciding what to do.