A bone marrow or cord blood transplant is the only known cure for chronic myelogenous leukemia (CML) L at this time. A transplant begins with chemotherapy, with or without radiation, to destroy the diseased cells and marrow. The transplant replaces diseased blood forming cells with healthy ones.
Allogeneic transplants are used to treat patients with CML. An allogeneic transplant uses healthy blood-forming cells from a family member, unrelated donor, or umbilical cord blood unit.
If transplant is an option for you, your doctor can talk with you about your risks and your chances of remaining disease-free with transplant. Drugs that can keep CML in remission for most patients are also available and are almost always used first. Remission means that tests cannot find any leukemia cells and a patient is symptom-free. Transplant is not the first treatment tried, but is only used if the drugs stop working or cannot be tolerated by the patient.
Understanding if transplant would help your CML
Our patient services coordinators can answer your questions and provide support and education to help you navigate your transplant journey.
Whether a transplant is right for you depends on several things, such as your overall health, and what phase your disease is in. In the past, the chronic phase typically lasted two to five years before turning into the accelerated phase.
This has improved since the development of medications called tyrosine kinase inhibitors (TKIs). These medicines control CML by interfering with the action of the Philadelphia chromosome. Now, a large number of patients who are treated with TKIs are stable (getting neither better nor worse) five years after starting the drug.
If TKIs or related medicines don’t work, stop working, or you cannot tolerate them, then you should be referred to a transplant doctor. A transplant doctor can discuss treating your CML with a transplant.
There are medical guidelines for when someone should be referred for a transplant consultation, whether or not you might need a transplant at that time. Talking to a transplant doctor is especially recommended if you cannot take TKIs because of severe side effects, allergies, or if any of the following are true1:
- Poor response to TKIs
- Disease progression
- Intolerance to TKIs
- CML in accelerated phase at any point
- CML in blast phase at any point
1Recommended Timing for Transplant Consultation. Guidelines developed jointly by National Marrow Donor Program/Be The Match and the American Society for Blood and Marrow Transplantation (ASBMT). Available at: marrow.org/md-guidelines