Cytotoxic chemotherapy for chronic myeloid leukaemia
Chemotherapy is the treatment of choice for CML to control symptoms, and reduce spleen size and blood counts. The most widely used agents are:
- hydroxyurea
- busulphan - indicated in the elderly, or those who cannot tolerate hydroxyurea
Lymphoid blast crises respond best to standard ALL therapy - prednisolone or vincristine. A second chronic phase may be reached which is managed with ALL maintenance therapy including CNS prophylaxis.
Myeloid blast crises are managed with AML therapy. Remission is less common.
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