Chemotherapy and Drug Therapy
If you're being treated for chronic myelomonocytic leukemia (CMML), your first line of defense may be chemotherapy. During chemotherapy, you'll be given potent drugs that must be toxic enough to damage or kill leukemic cells. At the same time, they take aim at normal cells and cause side effects. Yet, not everyone experiences side effects and people react differently.
Chemotherapy Drugs Used for CMML
Doctors sometimes combine two or more chemotherapy drugs to treat CMML. Each drug type works in a different way to kill the cancerous cells. Combining drug types can strengthen their effectiveness.
Some drugs used to treat CMML, combined or separately, are:
- cytarabine (Cytosar-U®)
- etoposide (VePesid®)
- hydroxyurea (Hydrea®)
- azacitidine (Vidaza®)
- decitabine (Dacogen®)
Azacitidine and decitabine have both been approved for treating myelodysplastic syndromes, but more studies are needed to determine their effectiveness against CMML.
Some drugs are swallowed in pill form. Others are given through a catheter (a thin, flexible tube or intravenous line) surgically placed in a vein, normally in your upper chest.
For the 1 percent to 4 percent of CMML patients who have the PDGFR-? and TEL gene mutation, imatinib mesylate (brand name: Gleevec®) can be an effective treatment. Gleevec has been used successfully to control chronic myeloid leukemia. The drug is swallowed in tablet form.
Targeted drugs are designed to interfere with functions or growth of specific cancer cells. For CMML, this treatment usually leads to:
- a return to normal blood counts
- cytogenetic remission (no leukemia cells can be detected in the blood or marrow by a fluorescence in situ hybridization [FISH] test)
- molecular remission (no leukemia cells can be detected in the blood or marrow by a polymerase chain reaction [PCR] test)
If you would like to read about these drugs individually, including information about side effects, click here.