Chronic myeloid leukemia (CML) is a type of cancer that affects your blood and bone marrow. It can also be called chronic myelogenous leukemia, chronic granulocytic leukemia, or chronic myelocytic leukemia.

Most cases of CML are treated with tyrosine kinase inhibitor (TKI) therapy. TKIs are a class of medications that target certain types of cancer cells.

In some cases, your doctor might advise you to switch from one type of TKI to another. They might also recommend other treatments in addition to or instead of TKIs, such as chemotherapy and stem cell transplant.

Here are some things to consider before you switch treatments.

The treatment plan your doctor recommends will depend on several factors, including:

  • The phase of the cancer. CML has three phases — chronic phase, accelerated phase, and blast crisis phase. Different treatments are used to treat different phases.
  • Your history of treatment. If you’ve received past treatments for CML, your doctor will take into account how you responded to those treatments.
  • Your age, general health, and medical history. If you’re pregnant, older, or have a history of certain medical conditions, you may be at a higher risk of side effects from certain treatments.
  • Your personal needs, limits, and preferences. Talk with your doctor about any personal, social, or economic limitations that might affect your ability to follow certain treatment plans.

If your treatment plan isn't working, is difficult to follow, or is causing serious side effects, your doctor might recommend changes. If you’re pregnant or want to become pregnant, that can also affect your treatment options.

If your current treatment plan isn't working, your doctor might ask how closely you’ve been following it.

It’s important to follow your treatment plan just as your doctor prescribed. Skipping or missing doses of medication reduces its effectiveness.

Before your doctor makes changes, they might encourage you to follow your current plan more closely. If you’re finding it difficult to stay on track, let your doctor know. They might adjust your treatment or offer tips to help you manage.

Treatments for CML can cause side effects like fatigue, nausea, vomiting, and diarrhea. Some types of treatment can cause more serious side effects, although this is rare.

Before you try a new treatment, ask your doctor about the risk of side effects. If you change from one treatment to another, you might experience more, fewer, or different side effects. Your doctor can talk to you about the benefits and risks of switching treatment.

If you think you might be experiencing side effects from treatment, let your doctor know. They might adjust your treatment plan or recommend other strategies to help prevent or relieve your side effects.

Types of medications, supplements, and foods can interact with certain treatments. In some cases, those interactions can make treatment less effective or increase the risk of side effects.

Before you begin a new treatment, ask your doctor and pharmacist if there are any medications, supplements, or foods that you should avoid during treatment. Let them know about any medications and supplements that you currently take.

If you’ve been taking TKIs and you stop using them, you might develop withdrawal symptoms, such as rash or musculoskeletal pain.

Before you stop using any medications, ask your doctor and pharmacist about the risk of withdrawal. They can help you recognize and manage potential withdrawal symptoms.

The cost of treatment can vary widely, depending on:

  • the specific medications you receive
  • your health insurance coverage
  • your eligibility for financial support programs

Changing from one treatment to another might raise or lower your cost of care.

If you have health insurance, consider contacting your insurance provider to learn which treatments are covered. Ask them how your out-of-pocket costs might change if you switch medications.

If you’re concerned about your ability to pay for treatment, let your doctor know. In some cases, they might adjust your treatment plan. Your doctor or pharmacist might also know about manufacturer-sponsored discounts or other financial support programs for which you might be eligible.

If your current CML treatment isn't working, your doctor will likely advise you to switch medications. Before you try a new treatment, talk to your doctor about the risk of side effects, interactions, and the cost of care.

If you have questions or concerns about your recommended treatment plan, let your doctor know. They can help you understand and weigh your treatment options.