Medications for CML directly destroy cancer cells or help the body’s immune system attack cancer cells to prevent them from growing. Medications may not cure CML, so people may need to continue taking them throughout their life to manage the condition.
The aim of CML medications is to control CML and prevent the growth of cancer cells.
Some CML medications may help to lower very high white blood cell counts.
This article looks at the different CML medications available, as well as possible side effects.
The first-line treatment for CML is tyrosine kinase inhibitors (TKIs), a type of targeted therapy drug. TKIs
The latest medication for CML is asciminib (Scemblix). The Food and Drug Administration (FDA) approved asciminib in October 2021.
Asciminib is a TKI for people with CML who have been resistant or intolerant to two previous TKIs or have the T315I mutation.
Targeted therapy uses drugs that specifically target cancer cells. They may cause
TKIs treat CML by blocking the enzyme that leads to an excess of white blood cells. Fibroblast growth factor receptor (FGFR) inhibitors, such as ponatinib, are a type of TKI that help to block the growth of cancerous cells.
The following table outlines targeted therapy medications for CML:
| Generic name | Brand name | Medication type | Dose | Common side effects |
|---|---|---|---|---|
| imatinib mesylate | Gleevec | oral | 400–600 milligrams (mg) once daily, or 800 mg in two doses of 400 mg daily | • diarrhea • nausea • muscle pain • fatigue • itchy skin rashes |
| dasatinib | Sprycel | oral | 100 mg daily for adults | • fluid buildup • lowered blood cell counts • nausea • diarrhea • skin rashes |
| nilotinib | Tasigna | oral | 300 mg for adults, twice a day | • fluid buildup • lowered blood cell counts • nausea • diarrhea • rash • low potassium levels • low magnesium levels • high blood sugar in rare cases • pancreatitis in rare cases |
| bosutinib | Bosulif | oral | 400 mg once daily | • diarrhea • nausea • vomiting • abdominal pain • rash • fever • fatigue • low blood cell counts • fluid retention • liver damage |
| ponatinib | Iclusig | oral | 45 mg once daily | • diarrhea • nausea • vomiting • abdominal pain • rash • fever • fatigue • low blood cell counts • fluid retention • liver damage |
| asciminib | Scemblix | oral | 80 mg once daily or 40 mg twice daily | • tiredness • nausea • diarrhea • joint pain • muscle pain • skin rash • upper airway infection |
Chemotherapy drugs work to destroy cancer cells or prevent them from dividing in order to stop the cancer growing.
This treatment may include antineoplastic agents, such as cytarabine, in combination with TKIs.
According to the
| Generic name | Brand name | Medication type | Dose |
|---|---|---|---|
| hydroxyurea | Hydrea | oral | according to actual or ideal weight |
| omacetaxine mepesuccinate | Synribo | injection | starting dose of 1.25 mg per square meter of body area (m2) twice daily |
| cytarabine | Ara-C | injection or intravenous (IV) infusion | depends on medication type |
| busulfan | Myleran | oral | 4–8 mg daily for adults |
| cyclophosphamide | Cytoxan | oral | 1–5 mg per kilogram (kg) daily for adults and children |
| vincristine sulfate | Oncovin | injection | 1.4 mg/m2 once weekly for adults |
Side effects
Side effects can include:
- hair loss
- oral sores
- nausea
- vomiting
- appetite loss
- low white blood cell counts
- low platelet counts
- anemia, or low red blood cell counts
The ACS states that different chemotherapy drugs can cause different side effects.
Immunotherapy medications support the body’s own immune system to better attack cancer cells.
Interferons are a type of substance the immune system makes naturally. Interferon drugs mimic this natural substance.
Doctors
The following table outlines the immunotherapy drugs to treat CML:
| Generic name | Brand name | Medication type | Dose |
|---|---|---|---|
| Peginterferon alfa 2a | Pegasys | injection | once weekly |
| Interferon-alpha | Intron A | injection into a muscle or vein |
Side effects
Side effects include:
Most people receive a diagnosis of CML when the disease is in the chronic phase. For the majority of people with chronic-phase CML, treatment is very effective.
People with CML usually take oral medication daily to help control the condition. In most cases, people are able to treat CML as a chronic but manageable condition.
CML medications, in particular TKIs, may help people with CML live longer and experience fewer side effects.
The outlook for CML
CML medications may help people to effectively control and manage CML. The outcome of treatment can depend on the phase of CML.
These medications include targeted therapy, chemotherapy, and immunotherapy drugs.
People may need to take CML medications throughout their life in order to control CML. New advances in medications have led to better outcomes for CML.