What are Treatments for Chronic Myelomonocytic Leukemia?

Medically Reviewed by: Dr. Douglas Tremblay

The treatment for chronic myelomonocytic leukemia (CMML) typically involves several phases and can include a variety of treatment modalities, including chemotherapy, targeted therapies, stem cell transplant, immunotherapies, and clinical trials. The treatment your CMML specialist will recommend depends on your age, CMML subtype, and if you have any other medical conditions. Explore the different categories below to learn more about treatment options for CMML.

1. Watchful Waiting

Watchful waiting is often recommended for patients with low-risk CMML who do not have any symptoms or only mild symptoms. This approach involves closely monitoring the patient's condition without providing any treatment until symptoms appear or change. The aim is to avoid unnecessary side effects of treatment for patients who may not benefit from immediate intervention.

2. Medications

Medications can be used to manage the symptoms of CMML and slow the progression of the disease. The specific medications used depend on the patient's condition and how the disease is progressing. Some of the medications used include:

• Hydroxyurea: This treatment helps to reduce the number of white blood cells in the blood.
• Azacitidine (Vidaza) and decitabine (Dacogen, Inqovi): These are chemotherapy medications called hypomethylating agents that can help control the growth of cancer cells.
• Immunomodulating medications: Such as lenalidomide (Revlimid), can help regulate the immune system and slow the growth of cancer cells. Or ruxolitinib, a medication that can reduce the inflammation associated with CMML and specifically reduce spleen size. 

3. Stem Cell Transplant

A stem cell transplant, also known as a bone marrow transplant, is the only potential cure for CMML. This procedure involves replacing the patient's diseased bone marrow with healthy bone marrow from a donor. However, this treatment is typically only considered for younger patients and those in good overall health, as it carries significant risks, including life-threatening complications.

4. Clinical Trials

Clinical trials are not just a last resort for treating CMML. They can actually provide access to cutting-edge treatments that are not yet approved but show promise over the years of testing. The choice of a clinical trial depends on a variety of factors, including the patient's age, overall health, the subtype of CMML, and genetic changes in the leukemia cells. It's important to discuss all treatment options, including goals and possible side effects, with your healthcare team to help make the best decision. 

To learn more about your CMML clinical trial options, visit HealthTree's CMML Clinical Trial Finder. Utilize the advanced filter option to locate trials that you are eligible to participate in. You can create a HealthTree account to favorite your top trial options so you can discuss them with your CMML specialist.

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