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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65740_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65740_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65740_"><span class="title" itemprop="name">Chronic Myelogenous Leukemia Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: November 17, 2023.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000258006__204">This PDQ cancer information summary has current information about the treatment of chronic myelogenous leukemia. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000258006__205">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000258006__1"><h2 id="_CDR0000258006__1_">General Information About Chronic Myelogenous Leukemia</h2><div id="CDR0000258006__1.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258006__2">Chronic myelogenous leukemia is a disease in which the bone marrow makes too many white blood cells.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__193">Leukemia may affect red blood cells, white blood cells, and platelets.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__16">Signs and symptoms of chronic myelogenous leukemia include
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weight loss and tiredness. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__120">Most people with CML have a gene mutation (change) called the Philadelphia chromosome.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__20">Tests that examine the blood and bone marrow are used to diagnose chronic myelogenous leukemia.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__25">Certain factors affect prognosis (chance
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of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000258006__2"><h3>Chronic myelogenous leukemia is a disease in which the bone marrow makes too many white blood cells.</h3><p id="CDR0000258006__4"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044901/" class="def">Chronic myelogenous leukemia</a> (also called CML or
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046754/" class="def">chronic granulocytic leukemia</a>) is a
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slowly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045850/" class="def">progressing blood and bone marrow disease</a> that usually occurs during or after middle age, and rarely occurs in children. </p><div id="CDR0000258006__201" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20bone&p=BOOKS&id=597535_CDR0000755927.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65740/bin/CDR0000755927.jpg" alt="Anatomy of the bone; drawing shows spongy bone, red marrow, and yellow marrow. A cross section of the bone shows compact bone and blood vessels in the bone marrow. Also shown are red blood cells, white blood cells, platelets, and a blood stem cell." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the bone. The bone is made up of compact bone, spongy bone, and bone marrow. Compact bone makes up the outer layer of the bone. Spongy bone is found mostly at the ends of bones and contains red marrow. Bone marrow is found in the center of most bones and has many blood vessels. There are two types of bone marrow: red and yellow. Red marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Yellow marrow is made mostly of fat.</p></div></div></div><div id="CDR0000258006__193"><h3>Leukemia may affect red blood cells, white blood cells, and platelets.</h3><p id="CDR0000258006__195">Normally, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> makes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000765906/" class="def">blood stem cells</a> (immature <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>) that become mature <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> cells over time. A blood stem cell may become a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046279/" class="def">myeloid</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">stem cell</a> or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046298/" class="def">lymphoid</a> stem cell. A lymphoid stem cell becomes a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cell</a>. </p><p id="CDR0000258006__200">A myeloid stem cell becomes one of three types of mature blood cells:</p><ul id="CDR0000258006__196"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">Red blood cells</a> that carry <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000538149/" class="def">oxygen</a> and other substances to all
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> of the body.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">Platelets</a> that form <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476017/" class="def">blood clots</a> to stop bleeding.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046374/" class="def">Granulocytes</a> (white blood cells) that fight <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a> and disease.</div></li></ul><div id="CDR0000258006__202" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Blood%20cell%20development&p=BOOKS&id=597535_CDR0000526538.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65740/bin/CDR0000526538.jpg" alt="Blood cell development; drawing shows the steps a blood stem cell goes through to become a red blood cell, platelet, or white blood cell. A myeloid stem cell becomes a red blood cell, a platelet, or a myeloblast, which then becomes a granulocyte (the types of granulocytes are eosinophils, basophils, and neutrophils). A lymphoid stem cell becomes a lymphoblast and then becomes a B-lymphocyte, T-lymphocyte, or natural killer cell." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Blood cell development. A blood stem cell goes through several steps to become a red blood cell, platelet, or white blood cell. </p></div></div><p id="CDR0000258006__197">In CML, too many blood stem cells become a type of white blood cell called granulocytes. These granulocytes are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> and do not become healthy white blood cells. They are also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045343/" class="def">leukemia</a> cells. The leukemia cells can build up in the blood and bone marrow so there is less room for healthy white blood cells, red blood cells, and platelets. When this happens, infection, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045360/" class="def">anemia</a>, or easy bleeding may occur.</p><p id="CDR0000258006__198">This summary is about chronic myelogenous leukemia. See the
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following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information about leukemia:</p><ul id="CDR0000258006__199"><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000257989/">Adult Acute Lymphoblastic
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Leukemia Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000258001/">Childhood Acute Lymphoblastic
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Leukemia Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000257990/">Acute Myeloid Leukemia Treatment</a>
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258000/">Childhood Acute Myeloid
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Leukemia/Other Myeloid Malignancies Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000258005/">Chronic Lymphocytic Leukemia Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000258013/">Hairy Cell Leukemia Treatment</a>
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</div></li></ul></div><div id="CDR0000258006__16"><h3>Signs and symptoms of chronic myelogenous leukemia include
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weight loss and tiredness. </h3><p id="CDR0000258006__18">These and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may be caused by CML or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>.
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Check with your doctor if you have any of the following:</p><ul id="CDR0000258006__19"><li class="half_rhythm"><div>Feeling very tired.</div></li><li class="half_rhythm"><div>Weight loss for no known reason.</div></li><li class="half_rhythm"><div>Drenching <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454810/" class="def">night sweats</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">Fever</a>.</div></li><li class="half_rhythm"><div>Pain or a feeling of fullness below the ribs on the left side.</div></li></ul><p id="CDR0000258006__119">Sometimes CML does not cause any symptoms at all.</p></div><div id="CDR0000258006__120"><h3>Most people with CML have a gene mutation (change) called the Philadelphia chromosome.</h3><p id="CDR0000258006__122">Every cell in the body contains <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a> material) that determines how the cell looks and acts. DNA is contained inside <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosomes</a>. In CML, part of the DNA from one chromosome moves to another chromosome. This change is called the “<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044179/" class="def">Philadelphia chromosome</a>.” It results in the bone marrow making a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, called tyrosine <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000641114/" class="def">kinase</a>, that causes too many stem cells to become white blood cells (granulocytes or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blasts</a>).</p><p id="CDR0000258006__123">The Philadelphia chromosome is not passed from parent to child. <div id="CDR0000258006__158" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=The%20Philadelphia%20(Ph)%20chromosome%20is%20an%20abnormal%20chromosome%20that%20is%20made%20when%20pieces%20of%20chromosomes%209%20and%2022%20break%20off%20and%20trade%20places&p=BOOKS&id=597535_CDR0000533336.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65740/bin/CDR0000533336.jpg" alt="Philadelphia chromosome; three-panel drawing shows a piece of chromosome 9 and a piece of chromosome 22 breaking off and trading places, creating a changed chromosome 22 called the Philadelphia chromosome. In the left panel, the drawing shows a normal chromosome 9 with the ABL1 gene and a normal chromosome 22 with the BCR gene. In the center panel, the drawing shows part of the ABL1 gene breaking off from chromosome 9 and a piece of chromosome 22 breaking off, below the BCR gene. In the right panel, the drawing shows chromosome 9 with the piece from chromosome 22 attached. It also shows a shortened version of chromosome 22 with the piece from chromosome 9 containing part of the ABL1 gene attached. The ABL1 gene joins to the BCR gene on chromosome 22 to form the BCR::ABL1 fusion gene. The changed chromosome 22 with the BCR::ABL1 fusion gene on it is called the Philadelphia chromosome." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>The Philadelphia (Ph) chromosome is an abnormal chromosome that is made when pieces of chromosomes 9 and 22 break off and trade places. The <i>ABL1</i> gene from chromosome 9 joins to the <i>BCR</i> gene on chromosome 22 to form the <i>BCR</i>::<i>ABL1</i> fusion gene. The changed chromosome 22 with the fusion gene on it is called the Ph chromosome. </p></div></div></p></div><div id="CDR0000258006__20"><h3>Tests that examine the blood and bone marrow are used to diagnose chronic myelogenous leukemia.</h3><p id="CDR0000258006__22">The following tests and procedures may be used:</p><ul id="CDR0000258006__23"><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease such as an enlarged <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000729979/" class="def">Complete blood
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count (CBC) with differential</a></b>: A procedure in which a sample of blood is drawn and
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checked for the following:
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<dl id="CDR0000258006__24" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">
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The number of red blood cells and platelets.</p></dd><dt>-</dt><dd><p class="no_top_margin">The number and type of white blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin">The amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045108/" class="def">hemoglobin</a> (the protein that carries oxygen) in the red blood cells.</p></dd><dt>-</dt><dd><p class="no_top_margin">The portion of the blood sample made up of red blood cells.
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</p></dd></dl><div id="CDR0000258006__157" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Complete%20blood%20count%20(CBC)&p=BOOKS&id=597535_CDR0000526546.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65740/bin/CDR0000526546.jpg" alt="Complete blood count (CBC); left panel shows blood being drawn from a vein on the inside of the elbow using a tube attached to a syringe; right panel shows a laboratory test tube with blood cells separated into layers: plasma, white blood cells, platelets, and red blood cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions.</p></div></div></div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304685/" class="def">Blood chemistry studies</a></b>: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
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</div></li><li class="half_rhythm"><div class="half_rhythm"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000669655/" class="def">Bone marrow aspiration and biopsy</a></b>: The removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000549425/" class="def">breastbone</a>. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> views the bone marrow, blood, and bone under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> to look for abnormal cells.<div id="CDR0000258006__169" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Bone%20marrow%20aspiration%20and%20biopsy&p=BOOKS&id=597535_CDR0000554337.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65740/bin/CDR0000554337.jpg" alt="Bone marrow aspiration and biopsy; drawing shows a patient lying face down on a table and a bone marrow needle being inserted into the hip bone. An inset shows a close up of the needle being inserted through the skin and hip bone into the bone marrow." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Bone marrow aspiration and biopsy. After a small area of skin is numbed, a long, hollow needle is inserted through the patient's skin and hip bone into the bone marrow. A sample of bone marrow and a small piece of bone are removed for examination under a microscope.</p></div></div></div><div class="half_rhythm">One of the following tests may be done on the samples of blood or bone marrow tissue that are removed:
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<dl id="CDR0000258006__192" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270737/" class="def">Cytogenetic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390238/" class="def">analysis</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> in which the chromosomes of cells in a sample of blood or bone marrow are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes, such as the Philadelphia chromosome, may be a sign of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. Cytogenetic analysis is used to help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> cancer, plan treatment, or find out how well treatment is working.</p></dd><dt>-</dt><dd><p class="no_top_margin"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000460228/" class="def">FISH</a> (fluorescence in situ hybridization)</b>: A laboratory test used to look at and count <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> or chromosomes in cells and tissues. Pieces of DNA that contain fluorescent dyes are made in the laboratory and added to a sample of a patient’s cells or tissues. When these dyed pieces of DNA attach to certain genes or areas of chromosomes in the sample, they light up when viewed under a fluorescent microscope. The FISH test is used to help diagnose cancer and help plan treatment.</p></dd><dt>-</dt><dd><p class="no_top_margin"><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000783668/" class="def">Reverse transcription–polymerase chain reaction</a> test (RT–PCR)</b>: A laboratory test in which the amount of a genetic substance called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000662001/" class="def">mRNA</a> made by a specific gene is measured. An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzyme</a> called reverse transcriptase is used to convert a specific piece of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046568/" class="def">RNA</a> into a matching piece of DNA, which can be amplified (made in large numbers) by another enzyme called DNA polymerase. The amplified DNA copies help tell whether a specific mRNA is being made by a gene. RT-PCR can be used to check the activation of certain genes that may indicate the presence of cancer cells. This test may be used to look for certain changes in a gene or chromosome, which may help diagnose cancer.</p></dd></dl></div></li></ul></div><div id="CDR0000258006__25"><h3>Certain factors affect prognosis (chance
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of recovery) and treatment options.</h3><p id="CDR0000258006__149">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> and treatment options depend on the following:</p><ul id="CDR0000258006__150"><li class="half_rhythm"><div>The patient’s age.</div></li><li class="half_rhythm"><div>The phase of CML.</div></li><li class="half_rhythm"><div>The amount of blasts in the blood or bone marrow.</div></li><li class="half_rhythm"><div>The patient’s general health.</div></li></ul></div></div><div id="CDR0000258006__31"><h2 id="_CDR0000258006__31_">Stages of Chronic Myelogenous Leukemia</h2><div id="CDR0000258006__31.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258006__117">After chronic myelogenous leukemia has been diagnosed, tests are done to find out if the cancer has spread.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__32">Chronic myelogenous leukemia has 3 phases.</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258006__125">Chronic phase</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__109">Accelerated phase</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__111">Blastic phase</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258006__228">Chronic myelogenous leukemia can relapse (return) after it has been treated.</a></div></li></ul></div><div id="CDR0000258006__117"><h3>After chronic myelogenous leukemia has been diagnosed, tests are done to find out if the cancer has spread.</h3><p id="CDR0000258006__33">The extent or spread of cancer is usually described as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a>. In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044901/" class="def">chronic myelogenous leukemia</a> (CML), the disease is
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classified by phase: <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045160/" class="def">chronic phase</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046212/" class="def">accelerated phase</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046113/" class="def">blastic phase</a>. It
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is important to know the phase in order to plan treatment. The information from <a href="#CDR0000258006__20">tests and procedures</a> done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> chronic myelogenous leukemia is also used to plan treatment.</p></div><div id="CDR0000258006__32"><h3>Chronic myelogenous leukemia has 3 phases.</h3><p id="CDR0000258006__124">As the amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blast cells</a> increases in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a>, there is less room for healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045840/" class="def">platelets</a>. This may result in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infections</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045360/" class="def">anemia</a>, and easy bleeding, as well as bone pain and pain or a feeling of fullness below the ribs on the left side. The number of blast cells in the blood and bone marrow and the severity of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> determine the phase of the disease.</p><div id="CDR0000258006__125"><h4>Chronic phase</h4><p id="CDR0000258006__127">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045160/" class="def">chronic phase CML</a>, fewer than 10% of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blast cells</a>.</p></div><div id="CDR0000258006__109"><h4>Accelerated phase</h4><p id="CDR0000258006__41">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046212/" class="def">accelerated phase CML</a>, 10% to 19% of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blast cells</a>.</p></div><div id="CDR0000258006__111"><h4>Blastic phase</h4><p id="CDR0000258006__44">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046113/" class="def">blastic phase CML</a>, 20% or more of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blast cells</a>. When tiredness, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">fever</a>, and an enlarged <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a> occur during the blastic phase, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046502/" class="def">blast crisis</a>.</p></div></div><div id="CDR0000258006__228"><h3>Chronic myelogenous leukemia can relapse (return) after it has been treated.</h3><p id="CDR0000258006__230">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045866/" class="def">relapsed</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044382/" class="def">CML</a>, the number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blast cells</a> increases after a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045867/" class="def">remission</a>.</p></div></div><div id="CDR0000258006__48"><h2 id="_CDR0000258006__48_">Treatment Option Overview</h2><div id="CDR0000258006__48.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000258006__49">There are different types of treatment for patients with
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chronic myelogenous leukemia. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__53">Six types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000258006__151">Targeted therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__58">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__131">Immunotherapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__55">High-dose chemotherapy with stem cell transplant </a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__143">Donor lymphocyte infusion (DLI)</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__70">Surgery </a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000258006__79">New types of treatment are being tested in clinical trials.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__206">Treatment for chronic myelogenous leukemia may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__163">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__165">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000258006__167">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000258006__49"><h3>There are different types of treatment for patients with
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chronic myelogenous leukemia. </h3><p id="CDR0000258006__51">Different types of treatment are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044901/" class="def">chronic myelogenous leukemia</a> (CML).
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Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being
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tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve
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current treatments or obtain information about new treatments for patients with
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the
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standard treatment, the new
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treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000258006__53"><h3>Six types of standard treatment are used:</h3><div id="CDR0000258006__151"><h4>Targeted therapy</h4><p id="CDR0000258006__173"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> or other substances to identify and attack specific cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. </p><ul id="CDR0000258006__210"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">Tyrosine kinase inhibitor therapy</a>: This treatment blocks the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046081/" class="def">enzyme</a>, tyrosine kinase, that causes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">stem cells</a> to develop into more <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blasts</a>) than the body needs. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044893/" class="def">Imatinib mesylate</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484435/" class="def">dasatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000575396/" class="def">nilotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000744185/" class="def">ponatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000739953/" class="def">bosutinib</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000806347/" class="def">asciminib</a> are tyrosine kinase inhibitors used to treat CML. </div></li></ul><p id="CDR0000258006__175">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Myelogenous Leukemia</a> for more information.</p></div><div id="CDR0000258006__58"><h4>Chemotherapy </h4><p id="CDR0000258006__60"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>).</p><p id="CDR0000258006__176">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Myelogenous Leukemia</a> for more information.</p></div><div id="CDR0000258006__131"><h4>Immunotherapy</h4><p id="CDR0000258006__133"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. </p><ul id="CDR0000258006__211"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">Interferon</a>: Interferon affects the division of cancer cells and can slow <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> growth.</div></li></ul><p id="CDR0000258006__177">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Myelogenous Leukemia</a> for more information.</p></div><div id="CDR0000258006__55"><h4>High-dose chemotherapy with stem cell transplant </h4><p id="CDR0000258006__209">High doses of chemotherapy are given to kill cancer cells. Healthy cells, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>-forming cells, are also destroyed by the cancer treatment. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">Stem cell transplant</a> is a treatment to replace the blood-forming cells. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046598/" class="def">Stem cells</a> (immature blood cells) are removed from the blood or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045622/" class="def">bone marrow</a> of the patient or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donor</a> and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. These reinfused stem cells grow into (and restore) the body's blood cells.</p><p id="CDR0000258006__178">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Myelogenous Leukemia</a> for more information.</p><div id="CDR0000258006__203" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Donor%20stem%20cell%20transplant&p=BOOKS&id=597535_CDR0000765030.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65740/bin/CDR0000765030.jpg" alt="Donor stem cell transplant; (Panel 1): Drawing of stem cells being collected from a donor's bloodstream using an apheresis machine. Blood is removed from a vein in the donor's arm and flows through the machine where the stem cells are removed. The rest of the blood is then returned to the donor through a vein in their other arm. (Panel 2): Drawing of a health care provider giving a patient an infusion of chemotherapy through a catheter in the patient's chest. The chemotherapy is given to kill cancer cells and prepare the patient's body for the donor stem cells. (Panel 3): Drawing of a patient receiving an infusion of the donor stem cells through a catheter in the chest." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Donor stem cell transplant. (Step 1): Four to five days before donor stem cell collection, the donor receives a medicine to increase the number of stem cells circulating through their bloodstream (not shown). The blood-forming stem cells are then collected from the donor through a large vein in their arm. The blood flows through an apheresis machine that removes the stem cells. The rest of the blood is returned to the donor through a vein in their other arm. (Step 2): The patient receives chemotherapy to kill cancer cells and prepare their body for the donor stem cells. The patient may also receive radiation therapy (not shown). (Step 3): The patient receives an infusion of the donor stem cells.</p></div></div></div><div id="CDR0000258006__143"><h4>Donor lymphocyte infusion (DLI)</h4><p id="CDR0000258006__145"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000524215/" class="def">Donor lymphocyte infusion</a> (DLI) is a cancer treatment that may be used after stem cell transplant. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045765/" class="def">Lymphocytes</a> (a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cell</a>) from the stem cell transplant donor are removed from the donor’s blood and may be frozen for storage. The donor’s lymphocytes are thawed if they were frozen and then given to the patient through one or more infusions. The lymphocytes see the patient’s cancer cells as not belonging to the body and attack them.</p></div><div id="CDR0000258006__70"><h4>Surgery </h4><p id="CDR0000258006__72"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046594/" class="def">Splenectomy</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>
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to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>.</p></div></div><div id="CDR0000258006__79"><h3>New types of treatment are being tested in clinical trials.
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</h3><p id="CDR0000258006__104">Information about clinical trials is available from the
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<a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000258006__206"><h3>Treatment for chronic myelogenous leukemia may cause side effects.</h3><p id="CDR0000258006__206_md_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, visit our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000258006__163"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000258006__163_md_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000258006__163_md_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000258006__163_md_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000258006__165"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000258006__165_md_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000258006__165_md_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000258006__167"><h3>Follow-up tests may be needed.</h3><p id="CDR0000258006__167_md_33">As you go through treatment, you will have follow-up tests or check-ups. Some tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000258006__167_md_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). </p></div></div><div id="CDR0000258006__212"><h2 id="_CDR0000258006__212_">Treatment of Chronic Phase Chronic Myelogenous Leukemia</h2><p id="CDR0000258006__213">For information about the treatments listed below, see the <a href="#CDR0000258006__53">Treatment Option Overview</a> section.</p><p id="CDR0000258006__214">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045160/" class="def">chronic phase chronic myelogenous leukemia</a> may include the
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following:</p><ul id="CDR0000258006__215"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044893/" class="def">imatinib mesylate</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000575396/" class="def">nilotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484435/" class="def">dasatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000739953/" class="def">bosutinib</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High-dose chemotherapy</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">donor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046594/" class="def">Splenectomy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of lower-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> chemotherapy with donor stem cell transplant.</div></li><li class="half_rhythm"><div>A clinical trial of a new treatment.</div></li></ul><p id="CDR0000258006__TrialSearch_212_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258006__216"><h2 id="_CDR0000258006__216_">Treatment of Accelerated Phase Chronic Myelogenous Leukemia</h2><p id="CDR0000258006__217">For information about the treatments listed below, see the <a href="#CDR0000258006__53">Treatment Option Overview</a> section.</p><p id="CDR0000258006__218">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046212/" class="def">accelerated
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phase chronic myelogenous leukemia</a> may include the
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following:</p><ul id="CDR0000258006__219"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">Donor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044893/" class="def">imatinib mesylate</a>).</div></li><li class="half_rhythm"><div>Tyrosine kinase inhibitor <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> followed by a donor stem cell transplant.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">interferon</a>) with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High-dose chemotherapy</a>.</div></li><li class="half_rhythm"><div>Chemotherapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000258006__TrialSearch_216_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258006__220"><h2 id="_CDR0000258006__220_">Treatment of Blastic Phase Chronic Myelogenous Leukemia</h2><p id="CDR0000258006__221">For information about the treatments listed below, see the <a href="#CDR0000258006__53">Treatment Option Overview</a> section.</p><p id="CDR0000258006__222">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046113/" class="def">blastic phase chronic myelogenous leukemia</a> may include the
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following:</p><ul id="CDR0000258006__223"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044893/" class="def">imatinib mesylate</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484435/" class="def">dasatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000575396/" class="def">nilotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000739953/" class="def">bosutinib</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High-dose chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000524215/" class="def">Donor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to relieve
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000258006__TrialSearch_220_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258006__224"><h2 id="_CDR0000258006__224_">Treatment of Relapsed Chronic Myelogenous Leukemia</h2><p id="CDR0000258006__225">For information about the treatments listed below, see the <a href="#CDR0000258006__53">Treatment Option Overview</a> section.</p><p id="CDR0000258006__226">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045866/" class="def">relapsed</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044382/" class="def">CML</a>, the number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046503/" class="def">blast cells</a> increases after a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045867/" class="def">remission</a>. Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045866/" class="def">relapsed</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044901/" class="def">chronic myelogenous leukemia</a> may include the following:</p><ul id="CDR0000258006__227"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484435/" class="def">dasatinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000575396/" class="def">nilotinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000739953/" class="def">bosutinib</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000806347/" class="def">asciminib</a>, or higher <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">doses</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044893/" class="def">imatinib mesylate</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643010/" class="def">Donor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000524215/" class="def">Donor lymphocyte infusion</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">interferon</a>).</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new types or higher <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">doses</a> of targeted therapy or donor stem cell transplant. </div></li></ul><p id="CDR0000258006__TrialSearch_224_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000258006__154"><h2 id="_CDR0000258006__154_">To Learn More About Chronic Myelogenous Leukemia</h2><p id="CDR0000258006__155">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about chronic myelogenous leukemia, see the following: </p><ul id="CDR0000258006__179"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Leukemia Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Therapy to Treat Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Chronic Myelogenous Leukemia</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/myeloproliferative-neoplasms" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Myeloproliferative Neoplasms</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Immunotherapy to Treat Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Stem Cell Transplants to Treat Cancer</a>
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</div></li></ul><p id="CDR0000258006__154_md_40">For general cancer information and other resources from the National Cancer Institute, visit:</p><ul id="CDR0000258006__154_md_41"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors, Caregivers, and Advocates</a>
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</div></li></ul></div><div id="CDR0000258006__AboutThis_1"><h2 id="_CDR0000258006__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000258006__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000258006__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000258006__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000258006__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000258006__AboutThis_6">This PDQ cancer information summary has current information about the treatment of chronic myelogenous leukemia. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000258006__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000258006__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000258006__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000258006__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000258006__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000258006__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000258006__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000258006__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000258006__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000258006__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Chronic Myelogenous Leukemia Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/leukemia/patient/cml-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389183]</p><p id="CDR0000258006__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000258006__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000258006__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000258006__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000258006__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65740</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389183" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389183</a></span></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65740/?report=reader">PubReader</a></li><li><a href="/books/NBK65740/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65740" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65740" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Chronic Myelogenous Leukemia Treatment (PDQ®): Patient Version. 2023 Nov 17. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm">NBK65740.14</span> November 17, 2023 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65740.13/">NBK65740.13</a></span> March 25, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65740.12/">NBK65740.12</a></span> September 20, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65740.11/">NBK65740.11</a></span> April 8, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65740.10/">NBK65740.10</a></span> April 24, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65740.9/">NBK65740.9</a></span> October 30, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65740.8/">NBK65740.8</a></span> August 9, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65740.7/">NBK65740.7</a></span> July 23, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65740.6/">NBK65740.6</a></span> January 30, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65740.5/">NBK65740.5</a></span> May 18, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65740.4/">NBK65740.4</a></span> March 30, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65740.3/">NBK65740.3</a></span> March 6, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65740.2/">NBK65740.2</a></span> September 21, 2015</li><li><span class="bk_col_itm"><a href="/books/NBK65740.1/">NBK65740.1</a></span> March 16, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000258006__1" ref="log$=inpage&link_id=inpage">General Information About Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__31" ref="log$=inpage&link_id=inpage">Stages of Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__48" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000258006__212" ref="log$=inpage&link_id=inpage">Treatment of Chronic Phase Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__216" ref="log$=inpage&link_id=inpage">Treatment of Accelerated Phase Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__220" ref="log$=inpage&link_id=inpage">Treatment of Blastic Phase Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__224" ref="log$=inpage&link_id=inpage">Treatment of Relapsed Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__154" ref="log$=inpage&link_id=inpage">To Learn More About Chronic Myelogenous Leukemia</a></li><li><a href="#CDR0000258006__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul 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