Chronic Myelogenous
Leukemia Treatment Update

fact sheet

800-813-HOPE (4673)
info@cancercare.org
www.cancercare.org

Chronic myelogenous leukemia (CML), also known as chronic myeloid
leukemia, is a type of blood cancer. CML occurs from genetic changes ina person’s bone marrow cells. Human cells contain 46 chromosomes(packets of genetic material). CML results from a mistaken “swap”
between two chromosomes (9 and 22) during the division of cells. The
swap creates what is known as thePhiladelphia (Ph) chromosome.
This chromosome causes twogenes to become one gene called
BCR-ABL, which acts like a switchthat can’t be turned off, leading
to a build up of blood cells in thepatient’s body. Almost everyone
who gets CML has this genetic
alteration. It’s a change that happens
gradually during your lifetime—you
do not inherit it from your parents
or pass it on to your children.

CML has three phases:
Chronic: The leukemia is slow growing
and responds more easily to treatment.
Accelerated: The cancer cells start togrow more quickly.
Blast crisis: The leukemia is fast
growing and treatment is neededurgently.
Targeted Drugs for CML:
Tyrosine Kinase Inhibitors
People coping with CML have seen
great progress in managing theirdiagnosis over the last decade due
to a class of drugs called tyrosine
kinase inhibitors. These drugs target asubstance produced by the BCR-ABLgene, preventing the growth of cancer
cells and killing them without harminga person’s normal, healthy cells.
The current standard of treatment
for someone who is newly diagnosed
with CML is to consider a group oftherapies. It’s important that patients
work with their health care team inchoosing therapies that are bestfor them, and weigh the benefitsof different treatment options withpotential side effects. To learn
about managing side effects ofCML treatments, read CancerCare’s
fact sheet, “Coping With Side
Effects of Chronic Myelogenous
Leukemia (CML).”
Imatinib (Gleevec) was the firsttargeted drug for CML approvedby the U.S. Food and Drug
Administration, revolutionizing
the treatment of CML. A daily pill,
imatinib is the standard treatment
for people newly diagnosed withCML. It’s able to put the majority ofpatients into remission (cancer stopsgrowing) and has an excellent trackrecord. But some patients develop
resistance to treatment and needmore options.
Dasatinib (Sprycel) and nilotinib(Tasigna) are two FDA-approved
drugs that, like imatinib, are taken inpill form and treat CML by blocking(over)the gene that causes cells to grow and divide.
These two drugs are used to treat patients whose
CML has developed resistance against imatinib
or who cannot continue to tolerate imatinib’s sideeffects. Recent data has suggested that thesenewer drugs may be used as a first choice rather
than as a second choice because of the benefitsof putting people into remission faster without
significant side effects.
Bosutinib (Bosulif) is an option for people who
did not respond to imatinib, dasatinib or nilotinib.
Patients should speak with their doctor about
managing side effects of this drug.
Ponatinib (Iclusig) is being tested for patients
who have highly specific mutations (geneticchanges) and who have had multiple previous
therapies. Patients should speak with their doctor
about any side effects of this drug.
Omacetaxine mepesuccinate (Synribo) wasdeveloped for patients whose CML has developed
resistance to two or more tyrosine kinase
inhibitors. It is unique from the other targeteddrugs for CML in that it is injected under theskin twice a day. Patients should speak with theirdoctor about any side effects of this drug.

What is the Future of
CML Treatment?
As more and more people continue to manage
their CML as a chronic illness, researchers arelooking for ways to deepen remission and lower
the risk of relapse (cancer comes back). Noneof the advances in CML treatment would bepossible without clinical trials. People who takepart in these studies receive state-of-the-art careand often gain access to and benefit from new
medicines, which are being developed every year.
Your doctor can guide you in making a decision
about whether a clinical trial is right for you.
Here are a few things you should know:• Before you take part in a clinical trial, you will
be fully informed as to the risks and benefitsof the trial.
• No patient receives a placebo (a look-alikecontaining no active ingredient) unless there
is an effective standard treatment available.
Most clinical trials are designed to compare
a new treatment to a standard treatment tofind out whether the new treatment has any
added benefit.
• You can stop taking part in a clinical trial at
any time for any reason.

CancerCare Can Help
If you or a loved one has been diagnosed with
CML, contact CancerCare. We are a national
nonprofit organization providing free, professional
support services for anyone affected by cancer.
Our services include individual counseling, support
groups, education, financial help and referrals
to other resources. To learn more, call us at
800-813-HOPE (4673) or visit www.cancercare.org.

This fact sheet has been made possible by a grant from Teva Pharmaceuticals.

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