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Treating Chronic Myelomonocytic Leukemia (CMML)

If you’ve been diagnosed with chronic myelomonocytic leukemia (CMML), your treatment team will discuss your options with you. It’s important to weigh the benefits of each treatment option against the possible risks and side effects.

How is CMML treated?

Treatment for CMML may include:

Common treatment approaches

Treatment of CMML is based on how severe the disease is, as well as your age and overall health. For many people with CMML, supportive therapy to prevent or treat problems caused by low blood cell counts is an important part of treatment.

Who treats CMML?

Based on your treatment options, you might have different types of doctors on your treatment team. These doctors could include:

  • A hematologist: a doctor who treats blood disorders
  • A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy (Many doctors who treat leukemias are trained in both hematology and oncology.)
  • A radiation oncologist: a doctor who treats cancer with radiation therapy
  • A surgical oncologist (oncologic surgeon): a doctor who uses surgery to treat cancer

You might have many other specialists on your treatment team as well, including other doctors, physician assistants (PAs), nurse practitioners (NPs), nurses, nutrition specialists, social workers, and other health professionals. 

Making treatment decisions

It’s important to discuss all your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. Ask questions if something is not clear. You may feel that you need to make a decision quickly, but it’s important to give yourself time to absorb the information you have learned.

Talk with your doctor about the goals of each treatment and what you can expect while getting treatment. The goals of your care will drive your doctor’s recommendations. These types of talks are called “shared decision making.” Shared decision making is when you and your doctors work together to choose treatments that fit the goals of your care.

If time allows, it's often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

Thinking about taking part in a clinical trial

Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. 

If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials. 

Considering complementary, integrative, and alternative methods

You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors haven’t mentioned. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods are treatments that are used along with your regular medical care. Alternative treatments are used instead of standard medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful. For example, some supplements might interfere with chemotherapy.

Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. 

Help getting through cancer treatment

People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life. 

Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.

The American Cancer Society also has programs and services - including rides to treatment,  lodging, and more - to help you get through treatment. Call our Cancer Knowledge Hub at 1-800-227-2345 and speak with one of our caring, trained cancer helpline specialists. Or, if you prefer, you can use our chat feature on cancer.org to connect with one of our specialists.

Choosing to stop treatment or choosing no treatment at all

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but it’s important to talk to your doctors as you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with your doctor or a member of your supportive care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families.

The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask your cancer care team any questions you may have about your treatment options.

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