Biological therapy for chronic myelogenous leukemia
Biological therapy is sometimes used to treat chronic myelogenous leukemia (CML). Biological therapy uses natural or artificial substances that change the way cells behave. Different types of biological therapies work in different ways. Some types kill, control or change how cancer cells behave. Other types strengthen the body’s immune system, control symptoms or lesson side effects of treatment. Biological therapy is also called biotherapy or biological response modifiers (BRMs).
In most cases, targeted therapies are now the main treatment for CML. Biological therapy is given if you cannot cope with the side effects of, or the CML is resistant to, imatinib (Gleevec) or other targeted therapies.
Biological therapy is used:
- to return blood cell counts to normal when CML is in the chronic or accelerated phase
- if CML relapses after a stem cell transplant
Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of biological therapy. You may also receive other treatments.
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Interferon alfa (Intron A, Wellferon) is the biological therapy occasionally used to treat CML. It can be given alone or in combination with the chemotherapy drug cytarabine (Cytosar, Ara-C).
This drug is usually injected into tissue just under the skin and sometimes into the muscle. It is given as long as the blood cell counts remain normal.
Interferon alfa can sometimes cause severe side effects, so it may not be offered to some people.
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Side effects can happen with any type of treatment for CML, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
Side effects can develop any time during, immediately after or a few days or weeks after biological therapy. Sometimes late side effects develop months or years after biological therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of biological therapy will depend mainly on the type of drug, the dose and your overall health. Interferon alpha may cause these side effects:
- flu-like symptoms, such as fever and chills
- skin problems, including redness, itching and dryness
- loss of appetite
- nausea and vomiting
- sore mouth
- hair loss
- yellowing skin (jaundice)
- allergic reaction
Tell your healthcare team if you have these side effects or others you think might be from biological therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
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American Cancer Society. Leukemia - Chronic Myeloid (Myelogenous). Atlanta, GA: 2013: http://www.cancer.org/acs/groups/cid/documents/webcontent/003112-pdf.pdf.
Cancer Care Ontario. Drug Formulary. Toronto, ON: Cancer Care Ontario;
O'Brien SG, Goldman JM . Diagnosis and treatment of chronic myeloid leukemia. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 5: pp. 45-62.