Chronic myeloid leukaemia (CML) treatment and side effects

Most people with CML are diagnosed in the chronic phase and are prescribed tyrosine kinase inhibitor (TKI) treatment. There are a number of different TKIs available.

If you’re diagnosed in the chronic phase, your first treatment will usually be a regular standard dose of one of three types of TKI: imatinib, dasatinib or nilotinib. In general, people cope well with these drugs, and can return to a relatively normal lifestyle, such as continuing to work and study. Most people start on imatinib, which is taken once a day, after food.

If the first TKI that you try stops working for you or you struggle to cope with its side effects, your doctor may suggest you try another TKI. This is known as second-line treatment. This will be either imatinib, nilotinib, dasatinib, bosutinib or ponatinib, depending on which TKI you tried first. Nilotinib is taken twice a day with a ‘fasting regimen’, meaning no food two hours before or one hour after taking the tablet. Dasatinib and ponatinib are taken once a day (with or without food). Bosutinib is taken once a day after food.

If you don’t respond to second-line treatment, you may be able to try a third TKI. Some people may also be able to have a stem cell transplant if TKIs don’t work for them.

If you’re diagnosed in the blast phase, your CML will be treated with stronger treatments, in a similar way to an acute (fast-growing) leukaemia. This usually includes chemotherapy, and sometimes TKIs.

If treatment for blast phase CML is successful and you return to the chronic phase, your doctor may recommend a stem cell transplant.

Our pioneering research into chronic myeloid leukaemia (CML) has played a dramatic role in improving treatment and survival rates for CML.