Targeted cancer therapies use drugs to destroy or slow the growth of leukemia cells. One benefit of these drugs is that they leave most healthy cells alone. They do this by targeting a specific gene called BRC-ABL. BRC-ABL makes a protein that causes CML cells to grow and reproduce out of control. Drugs that target BRC-ABL have become the standard treatment for CML. Because they spare healthy tissues, targeted therapies tend to cause fewer and less severe side effects than some other treatments.
Before treatment starts, you meet with a medical oncologist. This is a doctor who specializes in treating cancer with drugs. The doctor talks with you about your treatment and explains what you might expect.
The targeted drugs that can be used to treat CML include imatinib, dasatinib, nilotinib, bosutinib, and ponatinib. These drugs are taken as a pill, usually once or twice daily. If one drug doesn't work, another one may be tried.
It's likely you will need to take these pills indefinitely. You and your doctor should talk about your use of other medicines. Some prescription medications and some over-the-counter ones can interfere with the way these drugs work. So can some dietary and herbal supplements.
The side effects that occur with imatinib and similar drugs are usually mild. Side effects may include the following problems:
Bloating or swelling from fluid retention
Itchy skin rashes
Your doctor will also do blood tests to check for a decrease in your counts of white or red blood cells or platelets. This is more frequent at the beginning of treatment.
Other side effects, such as high blood pressure, are also possible with some of the targeted drugs.