Treatment Cancer

Chronic Myelogenous Leukemia

Tyrosine Kinase Inhibitors

The mainstay treatment for chronic phase CML is tyrosine kinase inhibitors (TKIs), such as imatinib (Gleevec), dasatinib (Sprycel) or nilotinib (Tasigna). TKIs are oral medications that shut down the abnormal protein produced by the BCR/ABL gene.

With TKIs, 80 percent of CML patients will have complete disappearance of the Philadelphia chromosome and restoration of normal blood counts. The life expectancy of chronic phase CML patients taking TKIs has improved from four to six years to well over a decade. In most patients, TKIs prevent conversion to the accelerated or blast phase. Dasatinib or nilotinib works for most patients who are resistant to imatinib.

Side effects of TKIs include rash, upset stomach, swelling of the eyelids, mild lowering of the blood counts and rare episodes of fluid build-up around the lungs and/or heart.

Patients survive a long time with TKIs, but it is still unknown if patients are cured by these drugs. The disease is monitored by a blood test for BCR/ABL every three months, and an annual bone marrow aspiration and biopsy.

Stem Cell Transplantation

The only proven cure for CML is allogeneic blood and marrow transplantation. Before TKIs were available, all chronic phase patients with tissue-matched donors received allogeneic transplantation. Cure rates were 70 to 80 percent. Because of treatment-related mortality of 15 to 20 percent, however, allogeneic transplantation is now reserved for patients failing TKIs.

Investigational Therapies

UCSF is dedicated to improving outcomes of CML patients through the use of investigational therapies and clinical research trials. We currently have new TKIs and related drugs available to treat patients failing the approved TKIs. A world leader in understanding the mechanisms of BCR/ABL resistance to standard TKIs, Dr. Neil Shah, is at UCSF. His laboratory is developing new and better TKIs.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

Recommended reading

Matched Unrelated Donor Transplantation

Bone marrow transplantation can be performed using one's own bone marrow or by using another person's bone marrow. Learn more here.

Hematology and BMT Resource Guide

This hematology and bone marrow transplant (BMT) resource guide provides information about diseases and treatments, employment, insurance and more.

Self-Care for Caregivers

Caregiver fatigue can be brought on by the physical and emotional demands of caring for a loved one with a serious illness. Learn tips to combat caregiver fatigue here.

Communicating with Your Doctor

The relationship with a doctor is a very personal one, built on communication and trust. In choosing a doctor, the "chemistry" between the two of you must work.

Coping with Chemotherapy

Each person experiences side effects from chemotherapy differently, and different chemotherapy drugs cause different side effects. Learn more here.

Delegation to Help with Fatigue

Fatigue caused by cancer treatment can make it difficult to accomplish even the smallest of tasks. Learn how task delegation can help with this fatigue.

Diet for Cancer Treatment Side Effects

Nausea is a common side effect of chemotherapy and radiation therapy. Find practical tips and suggested foods to help with nausea here.

FAQ: Cancer Pathology Tissue Slides

Find frequently asked questions regarding cancer pathology tissue slides, such as how to obtain the slides and what to do with them once you do.

FAQ: Cancer Radiology Scans and Reports

Learn the difference between a radiology report and radiology films or scans as well as why your doctor may be requesting these scans and more.

Managing Your Treatment

Living with or caring for someone with cancer can be a full-time job. Here are some tips to reduce stress and help navigate the disease more effectively.

Nutrition and Coping with Cancer Symptoms

Side effects of cancer treatment may affect your eating pattern, requiring new ways to get the calories, protein and nutrients that you need. Learn more.

Questions to Ask Your Doctor

Your time with the doctor is limited, thus it's helpful to prepare for the visit in advance by prioritizing the questions that are important to you. Learn more.

Resources for End of Life

The UCSF Cancer Resource Center has a list of bereavement support groups, counselors, hospice and others dealing with end-of-life issues. Learn more.

Tips for Conserving Your Energy

Cancer and cancer therapy can be accompanied by feelings of extreme fatigue. To help you deal with this fatigue, follow these easy tips help conserve energy.

Using a Medical Calendar and Symptom Log

Take time at the end of each day or each week to reflect back on the symptoms you've had. You can use a calendar to track your symptoms. Learn more here.

Seeking care at UCSF Health

Expand Map