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Chronic Myeloid Leukemia, Ambulatory Care

Chronic myeloid leukemia (CML)

is also called chronic myelogenous leukemia. It is cancer of the bone marrow and blood cells. 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. You may have no signs or symptoms. Many people learn that they have CML after blood is drawn for tests during a regular medical exam.

Common symptoms include the following:

  • Pain or a full feeling in your stomach
  • Tiredness and weakness that does not go away
  • Fever or infections, such as cold or flu, do not get better or keep coming back
  • Weight loss without trying
  • Shortness of breath, or you become easily tired during exercise
  • Night sweats or sweating more than usual
  • Bone pain, or easy bruising and bleeding

Call 911 for any of the following:

  • Warm, tender, swollen, red, and painful arm or leg
  • Suddenly feeling lightheaded and short of breath
  • Chest pain, or pain when you take a deep breath or cough
  • Coughing up blood

Seek immediate care for the following:

  • A headache, stiff neck, or have trouble seeing or thinking clearly
  • A fever in the last 2 weeks after you had chemotherapy

Treatment for CML

may include any of the following:

  • Medicines may be given to decrease the growth of CML cells and increase the growth of normal blood cells.
  • Chemotherapy is used to kill cancer cells. It may be used together with other CML medicines or added as a treatment if your cancer has spread. You may also need it before a stem cell transplant.
  • Radiation is a treatment that kills cancer cells with x-rays or gamma rays. You may need 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 have radiation treatments before a bone marrow transplant or stem cell transplant.
  • A transplant is used to put bone marrow or stem cells in your blood through an IV. The bone marrow or stem cells go to your bone marrow and begin to make healthy, new blood cells.

Manage CML:

  • Prevent infection. Wash your hands often, avoid people who are sick, and clean humidifiers daily. Ask your healthcare provider for more information on preventing infection.
  • Prevent bleeding and bruising. Be careful with sharp or pointed objects, such as knives and toothpicks. Do not play contact sports, such as football. Use a soft toothbrush. Do not floss your teeth while your platelet count is low. Blow your nose gently. Your nose may bleed if you pick it. Do not take NSAIDs or aspirin. NSAIDs and aspirin thin your blood and increase your risk for bleeding.
  • Do not smoke cigarettes or drink alcohol. Alcohol can thin your blood and make it easier to bleed. Smoking increases your risk for new or returning cancer. Smoking can also delay healing after treatment. Ask your healthcare provider for information if you currently smoke or drink and need help quitting.
  • Drink liquids as directed. You may need to drink extra liquids to prevent dehydration, especially if you are vomiting or have diarrhea from cancer treatments. Ask how much liquid you need each day and which liquids are best for you.
  • Exercise as directed. CML or its treatment may make you feel tired. Exercise can help you have more energy.
  • Eat healthy foods. Healthy foods may help you feel better and have more energy. If you have trouble swallowing, you may be given foods that are soft or in liquid form. Ask about any extra nutrition you may need, such as nutrition shakes or vitamins. Tell your healthcare provider if you have problems eating, or if you are nauseated.

Follow up with your healthcare provider as directed:

You will need to see your oncologist for ongoing treatment. Write down your questions so you remember to ask them during your visits.

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. 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.

© 2016 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.

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