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Treatment of Chronic Myeloid Leukemia

General

Chronic myeloid leukemia often starts with an indolent chronic phase which, before treatment with imatinib was introduced, progressed in 4–6 years via an accelerated phase to acute leukemia.

In the accelerated phase, the number of blasts and basophilic granulocytes increase in peripheral blood. The symptoms also increase in parallel and the condition is then more difficult to treat. This phase can last up to one year and then evolve into the blast phase (transformation). The disease profile is then acute leukemia where the immunophenotype can be lymphoblastic or myeloblastic. The prognosis is poor in these cases.

The tyrosine kinase inhibitor imatinib is the most effective medication for treatment of chronic myeloid leukemia. An allogeneic stem cell transplantation (myeloablative/non-myeloablative) is the only treatment method which, with assurance, can cure the disease.

Treatment with hydroxy urea (HU) gives longer survival than busulfan. Treatment with interferon-a gives approximately 6 months average extended survival compared to hydroxyl urea (HU) if administered at the disease debut.

Indication

  • Chronic myeloid leukemia

Goal

  • Control the disease on hematological, cytogenetic, and molecular levels.
  • Maintain good quality of life.

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