Supportive Therapy for the Patient With Chronic Myelomonocytic Leukemia

For many patients with chronic myelomonocytic leukemia (CMML), the main goal of treatment is to prevent the problems caused by low blood cell counts. For example, low red blood cell counts (anemia) can cause severe fatigue. Treating the anemia with red blood cell transfusions and/or erythropoietin can help patients feel better and allow them to be more active. More information about erythropoietin can be found in Growth Factors for the Treatment of Chronic Myelomonocytic Leukemia. To learn more about transfusions, see Blood Transfusion and Donation

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.

Blood transfusions can cause excess iron to build up in the body. This extra iron can deposit in the liver and heart, causing the organs to function poorly. This iron build up is usually seen only in people who receive many transfusions over a period of years. Drugs called chelating agents (substances that bind with iron so that the body can get rid of it) can be used to treat and prevent iron overload from transfusions. The most commonly used drug is desferoxamine. This drug can be given intravenously or as an injection under the skin. It is inconvenient because the injection must be given slowly (over several hours) 5 to 7 times per week. In some patients, treatment continues for years. Deferasirox (Exjade®) is a newer drug that is taken by mouth once a day to treat iron overload. It has been used more for patients with certain congenital anemias (like thalassemia), but it can also be used to treat iron overload in patients with CMML.

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

Patients with CMML are susceptible to infections. They should be especially careful to avoid cuts and scrapes and to care for any that occur right away. They should tell their doctors immediately about any fever, signs of pneumonia (cough, shortness of breath), urinary infection (burning when urinating), or other symptoms of an infection. Doctors will treat any known or suspected infections with antibiotics. See Infections in People with Cancer for more detailed information.

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.

Last Medical Review: January 19, 2014 Last Revised: February 17, 2016

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