Treatment of chronic myeloid leukemia

Most known chemotherapy agents, used singly, may induce remission of CML. Those that best alleviate symptoms (anemia, splenomegaly, etc) do not change either the Ph' chromosome anomaly in the hemopoietic cells nor the median delay of 3--4 years before fatal blastic transformation. A new goal has recently been formulated in CML therapy, namely complete remission, i.e. disappearance of all signs of leukemia including the Ph' abnormality. This can be achieved in certain cases by the use of aggressive (radio)chemotherapy during the chronic phase of CML. Whether or not it means cure of CML awaits further investigation. Encouraging results with these new therapeutic modalities during the chronic phase, and the possibility of rescuing toxic marrow aplasia by autologous cryopreserved blood stem cells, make it less and less defensible to await CML transformation before using aggressive "eradication" therapy.