In the accelerated phase of chronic myelogenous leukemia (CML), the leukemia cells begin to build up more quickly and symptoms appear. New gene mutations are often acquired, which helps the leukemia cells grow and tends to make treatments less effective. The blood cell counts may be abnormal, the spleen may be enlarged and the person does not feel well.
The goal of treatment during this phase is to destroy all the cells that contain the BCR-ABL gene or to return the CML to the chronic phase. The treatment options are similar to those for the chronic phase. However, a long-term response to treatment is less likely.
Response to treatment is important and is closely monitored.
A stem cell transplant may be offered for CML in the accelerated phase.
Targeted therapy with a tyrosine kinase inhibitor may be offered during the accelerated phase of CML. For those already taking targeted therapy, the dose may be increased. The types of targeted therapy used are:
Biological therapy may be offered for CML in the accelerated phase. The most common type of biological therapy used is interferon alfa (Intron A, Roferon A). Interferon alfa may be given in combination with cytarabine (Cytosar, Ara-C).
Chemotherapy may be offered for CML in the accelerated phase. The types of chemotherapy used are:
People with CML may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.
A clinical trial led by the Society’s NCIC Clinical Trials group found that men with prostate cancer who are treated with intermittent courses of hormone therapy live as long as those receiving continuous therapy.