period (months to one or two years). It has been shown to produce an improved survival in patients who respond.
The only possible chance for a prolonged survival or possible cure is the use of an allogeneic bone marrow transplant while the disease is in the chronic phase. With such a transplant soon after diagnosis, there will perhaps be a 25 to 40 percent chance for a longer survival. Once the disease is in the blastic phase, even with intensive treatment similar to the treatment for acute leukemia there is only about a 20 percent response rate at best, with the duration of the response generally less than a year.
Since no standard treatment offers a cure, prevents the blastic phase from occurring or prolongs the average survival, all newly diagnosed patients should be considered for an allogeneic marrow transplant and for clinical trials of new therapeutic approaches.
Standard Treatment Most CML patients have unusually high white blood cell counts, so the initial standard therapy tries to lower the counts toward more normal levels. There are two ways of doing this:
• Chemotherapy is the most common method, with either hydroxyurea or busulfan taken as an oral medication.
Both are effective and offer excellent control over a prolonged period. Busulfan is longer acting and has the
potential of overdosage unless the blood counts are followed closely. It also has the potential long-term side
effect of causing lung complications. Hydroxyurea also has to be monitored closely by the physician. It is a
