Supportive Therapy for the Patient With Chronic Myelomonocytic Leukemia

Chronic myelomonocytic leukemia (CMML) can be hard to treat. For many people with CMML, the main goal is to prevent the problems caused by low blood cell counts. For instance, low red blood cell counts (anemia) can cause severe fatigue. Treating the anemia with blood transfusions and/or erythropoietin can help patients feel better and allow them to be more active.

Some people are concerned about a slight risk of infection (hepatitis or HIV) spread by blood transfusion. This possibility is very unlikely, and the benefits of the transfused cells greatly outweigh this risk.

People with CMML often need a lot of blood transfusions. This can cause excess iron to build up in the body. This extra iron can deposit in the liver and heart, affecting how well the organs work. This iron build up is usually seen only in people who receive many transfusions over a period of years. Drugs called chelating agents can be used to treat and prevent iron overload from transfusions. Chelating agents are substances that bind with iron so that the body can get rid of it. They can be given intravenously (IV) or as an injection (shot) under the skin.

CMML patients with bleeding problems caused by a shortage of platelets may benefit from platelet transfusions.

People with CMML tend to get infections very easily. They should be especially careful to avoid cuts and scrapes and care for any injury right away. They should tell their doctors about any fever, signs of pneumonia (cough, shortness of breath), urinary infection (burning when urinating), or other signs of infection right away. Doctors will treat any known or suspected infections with antibiotics. See Infections in People with Cancer for more details.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Nazha A, Prebet T, Gore S, Zeidan AM. Chronic myelomoncytic leukemia: Are we finally solving the identity crisis? Blood Rev. 2016;30(5):381-388.

Patnaik MM, Tefferi A. Chronic myelomonocytic leukemia: 2016 update on diagnosis, risk stratification, and management. Am J Hematol. 2016;91(6):631-642. 

Last Medical Review: October 1, 2017 Last Revised: October 24, 2017

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