When you are first diagnosed with CML, most of the medical attention will be directed at lowering the elevated blood cell counts and controlling the leukemic disease process.
These treatment goals are critical, of course, because CML is life-threatening without immediate, effective therapy. But it’s also important not to neglect other medical conditions – a common situation for many people with CML. A recent analysis of two large databases in the U.S. found that about 41% of people with CML had another medical condition (Jabbour and colleagues. Clin Lymphoma Myeloma Leuk 2015;15:797-802). The most common medical conditions seen in people living with CML were heart disease, diabetes and lung disease.
This frequent occurrence of other medical conditions is largely due a person’s age. CML more commonly affects people later in life, and in the U.S. study, the median age at diagnosis was 56 years. Being diagnosed with one condition, such as CML, doesn’t offer any protection against the development of other medical conditions.
This U.S. survey is important for two reasons. If you have a medical condition, it may influence which CML medication your doctor will prescribe. For example, Sprycel can cause fluid accumulation around the lungs, so it may not be the best choice for people with cardiopulmonary disease. Tasigna is not recommended for people with certain types of heart rhythm abnormalities. Iclusig, which is used for people resistant to other TKIs because of a mutation, must be used only with caution in people with vascular disease (e.g. claudication), liver disease or heart failure.The study results also underscore that CML and its treatments should be viewed from the perspective of your overall health. In addition to your regular appointments with your CML team (the hematologist and nurse), you need to continue seeing your family physician for your regular health check-ups. These visits will ensure that you are regularly being monitored for heart disease risk factors (blood pressure, blood sugar, obesity, cholesterol). And while taking your TKI to treat your CML, you’ll still need to stick with your New Year’s resolutions – watching your weight and getting regular exercise – to maintain your overall health and fitness.