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Cytotoxic chemotherapy for chronic myeloid leukaemia

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Chemotherapy is the treatment of choice for CML to control symptoms, and reduce spleen size and blood counts. The most widely used agents are:

  • hydroxyurea
  • busulphan - indicated in the elderly, or those who cannot tolerate hydroxyurea

Lymphoid blast crises respond best to standard ALL therapy - prednisolone or vincristine. A second chronic phase may be reached which is managed with ALL maintenance therapy including CNS prophylaxis.

Myeloid blast crises are managed with AML therapy. Remission is less common.


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