All treatments have potential risks and benefits, and the decision to treat CML is one that is made by having doctor-patient conversations and evaluating the particular individual patient and his or her disease and overall health. Not every person with CML receives every CML treatment discussed below.

1. Chemotherapy
Omacetaxine is a newer chemotherapy drug that was approved for CML in 2012, in patients with resistance and/or intolerance to two or more tyrosine kinase inhibitors. Resistance is when CML does not respond to a treatment. Intolerance is when treatment with a drug must be stopped due to severe side effects.

Omacetaxine is given as a liquid that is injected under the skin with a needle. Other chemotherapy drugs may be injected into a vein or they may be given as a pill to swallow.

2. Hematopoietic Cell Transplant (HCT)
Before tyrosine kinase inhibitors, this was considered the treatment of choice for CML, but an allogeneic HCT is a complex treatment and can cause very serious side effects. Thus, it may not be a good treatment choice for every patient with CML, and many treatment centers today only consider this treatment option for patients younger than 65 years of age.

High-dose chemotherapy is given first to destroy both normal cells and CML cells in the bone marrow. An HCT is a procedure that replaces the destroyed cells in your bone marrow with new, healthy blood-forming cells.

3. Clinical Trials: Investigational Therapies
New drugs are continuously being researched. Clinical trials of new therapies may be an option for some patients. You can always ask your treatment team if there is an open clinical trial that you can join and whether or not they believe you would be a good candidate for such a clinical trial.