Treatments for Chronic Myelogenous Leukemia in Children

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What is the treatment for CML?

At Children's, we know how difficult a diagnosis can be, both for your child and for your whole family. That's why our physicians are focused on family-centered care: From your first visit, you'll work with a team of professionals who are committed to supporting all of your family's physical and psychosocial needs. We'll work with you to create a care plan that's best for your child. 

Treatment components may include the following (alone or in combination):

Chemotherapy

Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce.

How is chemotherapy given?

Different chemotherapies may be given:

  • as a pill to swallow
  • as an injection into the muscle or fat tissue
  • intravenously (directly to the bloodstream, also called IV)
  • intrathecally (directly into the spinal column with a needle)

How is chemotherapy used?

This depends on many factors. Some things to keep in mind:

  • A number of combinations of chemotherapy drugs are currently being used to stabilize and, in some cases, to shrink the size of the tumor.
  • Depending on the type of cancer, chemotherapy drugs may be given in a specific order.
  • Chemotherapy may be used alone for some types of cancer, or in conjunction with other therapy such as radiation or surgery.

Does chemotherapy come with bad side effects?

While chemotherapy can be quite effective, the agents do not differentiate normal healthy cells from cancer cells. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help your child, family and your child's health care team prepare for and sometimes prevent these symptoms from occurring.

Intrathecal medications/chemotherapy

These are medications inserted through a needle into your child's spinal cord into the area called the subarachnoid space.

Radiation therapy

Radiation therapy uses high-energy rays (radiation) from a specialized machine to damage or kill cancer cells and shrink tumors.

Stem cell transplant

Stem cells are a specific type of cell from which all blood cells develop. They can develop into red blood cells to carry oxygen, white blood cells to fight disease and infection, and platelets to aid in blood clotting. Stem cells are found primarily in the bone marrow, but some also circulate in the blood stream.

When your child's stem cells are replaced with those of a healthy and compatible donor, it is called allogeneic transplantation:

  1. Treatment may begin with high-dose chemotherapy (perhaps combined with radiation therapy) to destroy all of the bone marrow, stem cells and cancerous cells, in your child's body.
  2. Then, healthy stem cells from another person (whose tissue must be the same, or almost the same as your child's) are used to help restore your child's normal blood production.

Biological therapy

Biological therapy refers to a wide range of substances that may be able to involve the body's own immune system to fight cancer or lessen harmful side effects of some treatments.

Other medications

Other medications may be given to prevent or treat damage to other systems of your child's body caused by leukemia treatment, or for nausea and side effects of treatment.

Blood transfusions

A blood transfusion could replace or supplement your child's red blood cells and platelets.

Antibiotics

Your child may be given antibiotics may be given to prevent or treat infections.

Continuous follow-up care

Your child's health will be closely monitored to determine response to treatment, detect recurrent disease and manage late effects of treatment.

What are the various stages of CML?

There are various stages in the treatment of CML, including the following:

  • chronic phase -There may be no symptoms of leukemia, but blast cells are discovered in the blood and bone marrow. This phase can last several months to several years.
  • accelerated phase - an increased number of blast cells are found in the blood and marrow and there is evidence normal cells are decreasing
  • blastic phase - also called a "blast crisis," during this phase more than 30 percent of bone marrow and blood cells are blast cells. Cancerous tumors may form in the bone or lymph nodes, collections of small organs found throughout the lymph system.

What is the long-term outlook for a child with CML?

Your child's prognosis greatly depends on:

  • the extent of the disease
  • the cancer's response to treatment
  • genetic abnormalities of the leukemia
  • his age and overall health
  • his tolerance of specific medications, procedures or therapies
  • new developments in treatment

Relapse can occur during any stage of treatment, even with aggressive therapy, or may occur months or years after treatment has ended.

As with any cancer, prognosis and long-term survival can vary greatly. Prompt medical attention and aggressive therapy are important for the best prognosis, and continuous follow-up care is essential. New methods are continually being discovered to improve treatment and decrease side effects of the treatment for the disease.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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