Chronic Myeloid Leukemia (CML) is a type of blood cancer. The National Institute of Health (USA) estimates that between 1.2 and 1.5 million people worldwide are living with CML In recent years, India has seen a notable rise in CML cases, with a typical diagnosis occurring in individuals aged 30-40 years. Data from cancer registries shows that CML is the most common type of leukemia diagnosed in India. This disease impacts lives daily and requires long term treatment, presenting a unique set of challenges for patients.
However, with advanced oral medicines, compliance with treatment and regular monitoring of BCR-ABL, patients can achieve long and healthy lives. Effective CML treatment requires proper communication between the patient and the doctor throughout the entire journey. Dr Tulika Seth, Professor Hematology, AIIMS, New Delhi shares ways to manage Chronic Myeloid Leukemia (CML):
The CML Treatment Landscape and its Impact on Quality of Life
One of the most significant breakthroughs in CML treatment has been the development of tyrosine kinase inhibitors (TKIs) and now the STAMP medicines. These targeted medicines act directly on the BCR-ABL protein, a genetic mutation that drives the growth of cancer cells in CML. New generations of TKIs and the newer molecules have better safety and efficacy profiles. These medications have transformed CML from a once lethal condition into a disorder that can be controlled effectively with regular oral pills.
We can now expect improved survival and favorable patients’ quality of life. Despite these advancements, close collaborative communication is required to determine which treatment will work best for the patient. This depends on individual goals, other illnesses, or co-morbid conditions, response to medicines, side effects experienced and plans for family.
Tracking Your BCR-ABL Test Results: A Vital Tool in Treatment Decisions
BCR-ABL is a genetic change that results in the production of a protein that drives the uncontrolled growth of cells in CML. Therefore, monitoring BCR-ABL test results over time provides more than just an initial measure of treatment effectiveness. It helps identify patterns, such as developing resistance or intolerance to therapy, that might otherwise go unnoticed. By regularly reviewing test findings and maintaining open communication with doctors, the patients can ensure their CML is well-managed. This ongoing evaluation is crucial for determining whether the current treatment remains effective or if changes are necessary to prevent further complication. As per ELN guidelines, to keep track of your BCR-ABL levels, it is recommended to monitor every 3,6 and 12 months as per the guidelines and every 3-6 months thereafter.
Disease Progression, and Advanced Management in Later Lines
If the CML is not controlled, it may progress to advanced stage CML this can become increasingly resistant to treatment. This results in a major transformation of the patient’s journey and treatment approach. In these later stages, some therapies may no longer be effective, making continuous monitoring and timely adjustments in treatment crucial. This requires stronger medicines to deal with the resistant disease.
During treatment, having a good support system, remaining positive, focusing on quality of life is essential. Effective symptom management and maintaining a high quality of life are possible in CML care, especially with the success of newer, more refined therapies. Patients should work closely with their doctors to explore the latest treatment options, including advanced medications that may offer improved outcomes and fewer side effects.
Managing Chronic Myeloid Leukemia in India is a dynamic and evolving field. The advancements in treatment offer hope and improved quality of life for many patients. However, the journey requires good compliance with medicines, regular monitoring, effective communication, and timely treatment switches to ensure optimal management. Keeping vigilant ensures patients are on the right track to the best results.
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