Chronic Myeloid Leukemia

WHAT YOU SHOULD KNOW:

Chronic myeloid leukemia is also called chronic myelogenous leukemia or CML. It is cancer of the bone marrow and blood cells. With CML, blood cells that should become white blood cells (WBCs) do not fully grow. These cells do not fight infection like a normal WBC should. They crowd the bone marrow and prevent normal blood cells from growing and fighting infection.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Chemotherapy and medicines used to treat CML may cause unpleasant side effects. Some common side effects are nausea, vomiting, and diarrhea. You may feel very tired and have extra body fluid. You could have a bad reaction to a bone marrow transplant or stem cell transplant. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.

  • Treatment of CML may be slow to work, or may not work at all. CML may not go away or it may get worse. If your CML goes into remission, it may return. CML may also spread to other parts of your body. If you do not have treatment, or the treatment does not work, you could die.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Drinking liquids:

Men 19 years old and older should drink about three Liters of liquid each day (about 13 eight-ounce cups). Women 19 years old and older should drink about two Liters of liquid each day (about 9 eight-ounce cups). It is especially important to drink enough liquids if you are vomiting (throwing up) from chemotherapy. Follow your caregiver's advice if you must change the amount of liquids you drink. For most people, healthy liquids to drink are water, juices, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Try to drink enough liquid each day, and not just when you feel thirsty. It may be helpful to drink liquids between your meals instead of with your meals.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

Pulse oximeter:

A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

Reverse isolation:

You may be put on reverse isolation safety measures if your body is having a hard time fighting infections. You are given a private room to protect you from other people's germs. Caregivers and visitors may wear gloves, a face mask, or a gown to keep their germs away from you. Everyone should wash their hands when entering and leaving your room.

Medicines:

You may be given medicines to treat problems caused by your AML. For example, you may be given antibiotics or other medicines to help your body fight infection. You may be given fever or pain medicine. You may take medicines to help you cope with chemotherapy side effects such as upset stomach or diarrhea.

Tests:

You may need many different tests. The following are some common tests that may be done to help caregivers plan your treatment.

  • Blood tests: You may need blood taken for tests. The blood may be taken from your IV, or from a vein in your hand, arm, or the bend in your elbow. Caregivers may do blood tests to count the number of each type of blood cell (RBCs, WBCs, platelets). They may do special test to learn more about the phase of CML that you have.

  • Bone marrow biopsy: This is when a sample of bone marrow is removed and sent to a lab for tests. Bone marrow is the soft, spongy tissue inside the bone. The skin over your upper hipbone is first cleaned. Caregivers put numbing medicine into your skin so you will have little pain. A bandage is put on the biopsy area after the tissue sample is taken.

Treatments:

Caregivers will decide which treatment is best for you. Your treatment may need to be changed one or more times if it is not working. Caregivers may give you some of the following treatments alone or together:

  • Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.

  • CML medicines:

    • Kinase inhibitors: Kinase inhibitors may help decrease the growth of CML cells and increase the growth of normal blood cells.

    • Interferon: This medicine may help to decrease the growth of CML cells.

    • Chemotherapy: Chemotherapy, or chemo, is medicine used to treat cancer. It works by killing cancer cells. It may be used together with other CML medicines. You may need it if the CML has spread. You may need chemo before having a bone marrow stem cell transplant. Chemo can have many side effects. You may be more likely to get infections or have other problems. Caregivers will watch you closely and will work with you to decrease the side effects. Even if the chemo does not cure your cancer, it may help you feel better or live longer.

  • Radiation: This is a treatment that uses x-rays or gamma rays to kill cancer cells. You may have radiation treatments if the CML cells have spread to body organs such as your spleen and liver. They may be used to treat bone pain caused by CML. You may get radiation treatments before having a bone marrow or stem cell transplant.

  • Transplants:

    • Bone marrow transplant (BMT): Your diseased bone marrow is replaced with healthy bone marrow. You are given bone marrow from someone else (a donor). The bone marrow transplant is given to you in an IV while you are in the hospital. A BMT may help cure you, but it can cause other very serious healthy problems. You may be in the hospital for a month or longer for a BMT.

    • Peripheral blood stem cell transplant (PBSCT): Bone marrow has many stem cells in it. The stem cells are the part of the bone marrow that make or change into blood cells. During a PBSCT, stem cells are put into your body. For this process, stem cells are removed from donated blood, and then put into your body through an IV. The stem cells should go into your bone marrow. Once in the bone marrow, stem cells can grow and become blood cells.

Venous access device:

An IV catheter or tube may be placed in a large vein (blood vessel) near your collarbone, in your neck, or in your arm. Some examples of these venous access devices are Hickman. Groshong, and PICC lines. You may also have a port, which is a type of venous access device that is placed under the skin and connected to a large vein. You may need a venous access device to receive chemotherapy, other medicines and fluids that need to be given through a big vein. A venous access device can stay in longer than a regular IV can. You may need this device to receive chemotherapy treatments.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Chronic Myeloid Leukemia (Inpatient Care)

Hide
(web2)