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Doctor and Patient Teamwork: Management of CML Leukemia Explained

Leukemia Leukemia Treatment

Facts to Know While Undergoing Therapy for CML

Summary & Participants

In treating Chronic Myeloid Leukemia (CML), doctors admit: they don't have all the answers. So patients must learn enough about CML to help make good treatment decisions. That means understanding the natural course of the disease and how his or her own body responds to therapy. Tune in as doctors describe what CML patients need to know.

Medically Reviewed On: June 30, 2008

Webcast Transcript

ANNOUNCER: Patients with Chronic Myeloid Leukemia or CML face many decisions over the course of their treatment. Doctors don't have all the answers. So CML patients must collaborate in decision-making. That means patients must become well-educated about their disease and understand how their body responds to therapy.

STEPHEN O'BRIEN, MD, PhD: It's very important for patients to know the nature or the natural history of chronic myeloid leukemia because that must inform decision-making.

ANNOUNCER: First off, a patient must understand how CML , a cancer of the white blood cells may progress. In the early, or chronic phase of CML, the disease is stable, and the patient may experience no, or only mild symptoms, like fatigue. But later, low platelet counts may lead to uncontrolled bleeding. Too few normal white blood cells may lead to serious infection.

STEPHEN NIMER, MD: As the disease progresses, it becomes more difficult to treat and ultimately becomes untreatable. And so patients die not in the chronic phase of their disease, but from accelerated phase or blast phase disease.

STEPHEN O'BRIEN, MD: Well, clearly the most desirable treatment goal is to cure the patient with Chronic Myeloid Leukemia. At the moment, the only know curative therapy is a bone marrow transplant.

ANNOUNCER: CML patients must learn the factors that determine eligibility. For transplant. Age, overall health, tolerance for risk and the quality of a potential donor match.

STEPHEN NIMER, MD: And really, only about a third of patients will have a suitable donor for the transplant, which leaves the other two-thirds of the patients for whom transplantation is not really an option.

ANNOUNCER: So most patients discover their best goal in therapy falls short of "cure."

RICHARD STONE, MD: In general the goal of treatment of CML should be to lengthen life, lengthen good quality of life. In other words, the idea is to prolong the stable phase as long as possible.

ANNOUNCER: A patient undergoing drug therapy for CML must understand how his body's response is measured. There are three different kinds of tests, tracking hematologic, cytogenetic and molecular responses.

GWEN NICHOLS, MD: When we see that that the medicine treats the blood counts, we call this a hematologic response. When it returns the blood counts to what we consider a normal range.

ANNOUNCER: Some drugs, like interferon, have a deeper impact, reducing the number of cancerous cells containing the abnormal chromosome at the heart of the disease, the so-called Philadelphia chromosome.

STEPHEN NIMER, MD: And if more than two-thirds of the bone marrow, or the peripheral blood are in fact normal cells and not the CML cells, we would call that a major cytogenetic response. Now if we find no CML cells when we do the chromosome analysis, that's call a complete cytogenetic response.

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