Leukemia Basics - About Side Effects of Chronic Myelogenous Leukemia Treatments

About Side Effects of Chronic Myelogenous Leukemia Treatments

The following is a list of questions to ask your doctor About Side Effects of Chronic Myelogenous Leukemia Treatments as well as tips for preparing for these conversations.

Will I experience side effects from my treatment?

People receiving treatments for CML sometimes experience side effects, and it is helpful to know what to expect, how to prepare for them and which side effects should raise concern. Medical treatments for CML include targeted therapy such as Gleevec, interferon, standard chemotherapy, and high-dose chemotherapy followed by stem cell transplantation. Each therapy targets the disease in a different way, so each one has different possible side effects. Side effects also depend upon the phase of CML (chronic, accelerated or blast) and how the drug is administered, such as by injection or by mouth.

Experiences with treatments will also vary from person to person. Most people will experience some of the common treatment side effects, while others may experience rare side effects or not have any side effects at all. While most side effects can be managed without having to stop therapy, certain ones can be life threatening.

How will I feel during treatment?

Some of the common side effects associated with CML therapy are listed below. Not all patients will experience these side effects.

Gleevec—Side effects include nausea, acid reflux, vomiting, diarrhea, muscle cramps, skin rashes, and bone and joint pain. Some people may have weight gain and swelling, particularly around the eyes, hands and feet.

Chemotherapy—Side effects vary with the type of chemotherapy and may include mouth and throat sores, nausea and vomiting, diarrhea, hair loss, bruising, infection, fatigue and shortness of breath. Some chemotherapy drugs can cause a loss of libido and/or fertility.

Interferon—Side effects may include flu-like symptoms such as fever, fatigue, muscle aches and headache, as well as numbness, GI disturbances, mood disturbances and skin reactions.

High-dose chemotherapy followed by stem cell transplantation —High dose chemotherapy can destroy healthy blood cells as well as leukemia cells in the marrow and therefore can result in infections (due to low white cell counts), anemia (due to low red cell counts) and bleeding (due to low platlet counts). Stem cells from a donor can result in graft-versus-host disease, which is an immune reaction to the donor's cells.

Hydroxyurea—Side effects may include skin rashes, stool changes and urinary symptoms. People taking the medication long term are at higher risk for skin cancer.

How can the side effects of CML treatments be managed?

All side effects should be reported to your healthcare provider, as there may be a way to minimize your discomfort, often with a medication or with lifestyle approaches such as dietary changes or special exercises. Other strategies include lowering the dose of your CML medication, combining therapies or switching to a different treatment. Serious side effects may require that you stop the treatment temporarily or, in some cases, permanently. Call your doctor immediately if you experience fever, bleeding, bruising, chest pain, vomiting, shortness of breath, breathing difficulties or depression.

Will I need to make changes in my family or social life because of the side effects of treatment?

Stress, treatment schedules and treatment side effects may lead to changes in daily routines that affect your family or social life. You will likely need the support of family and friends to help you adapt to these changes, such as having a friend or family member accompany you to your initial treatments. Treatment can also impact personal relationships by making people feel less confident about their self-worth and attractiveness. Certain treatments may cause low libido. Fortunately, most side effects are temporary, and you should be able to resume your role in your family and social life.

How you can prepare for this discussion?

List past and current experience with medications and note any side effects
Make a list of all the medications, herbal remedies and vitamin supplements you are taking, note any changes in dosages, and keep this information a binder for reference
Collect medical records and make a detailed list of all medical conditions; keep these in a binder for reference
Keep a daily symptom diary
Report any illnesses, including fever
Make a plan before treatment begins about how your family and friends can provide helpful support
Talk to your healthcare professionals about managing lifestyle changes
onsider taking part in support groups, counseling or community programs such as those offered by
Make a list of all treatments and procedures you have had in the past and your experiences with them

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