'Bright' Outlook, but Lifetime Treatment Needed for CML
By Daniel J. DeNoon
WebMD Health News
Reviewed By Louise Chang, MD
Nov. 10, 2009 -- Basketball legend Kareem Abdul-Jabbar today announced that he has suffered from leukemia for nearly a year.
Abdul-Jabbar, 62, has chronic myelogenous leukemia or CML. Once a fatal disease, oral medications now keep CML under control for 80% to 90% of patients, says leukemia expert Michael Deininger, MD, PhD, of Oregon Health & Science University in Portland.
"For the vast majority of patients diagnosed in the chronic phase of the disease, the outlook is very good," Deininger tells WebMD. "The outlook for CML patients in 2009 is bright."
Making the leukemia diagnosis particularly frightening was that Abdul-Jabbar in 2006 lost a close friend to leukemia: actor Bruno Kirby, then age 57. Abdul-Jabbar has a different form of leukemia than Kirby did.
CML usually results from genetic damage to cells in the bone marrow. These damaged or mutant cells acquire an abnormal chromosome, called the Philadelphia chromosome. The mutation causes an accumulation of an enzyme that triggers uncontrolled production of leukemia cells.
At first, the leukemia cells don't cause much of a problem except an enlarged spleen. This is the chronic phase of the illness.
"But if you don't treat the disease, it inexorably progresses toward an acute leukemia, and over time the cells acquire even worse mutations and their behavior starts to change," Deininger says. "If you don't treat at all, the overall survival is probably in the range of two to two-and-a-half years."
Fortunately, a drug called Gleevec blocks the abnormal enzyme. If Gleevec stops working -- over time, many patients' leukemia becomes resistant to the drug -- patients can switch to Sprycel or Tasigna, two drugs with similar action.
The drugs keep people alive, but they're expensive: Costs range from $20,000 to $30,000 a year, Deininger says.
"Until the arrival of Gleevec, allogenic bone-marrow transplant was the only treatment modality offering long-term survival -- if not cure -- to a large proportion of patients," he says. "The problems are that not everybody is eligible due to other pre-existing medical conditions, or to donor availability, or to age."
Abdul-Jabbar now serves as a spokesman for Novartis, the company that makes Gleevec and Tasigna. But given the chance to name the drugs in an ESPN interview, Abdul-Jabbar declined.
He noted that not all people with leukemia can benefit from the drugs, and said that he's serving as a spokesman to raise awareness of all forms of leukemia.
Deininger serves as a consultant for Novartis as well as for Bristol-Myers Squibb, the maker of Sprycel.
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WebMD Medical Reference from Healthwise: "Chronic Myelogenous Leukemia."
National Cancer Institute: "Chronic Myelogenous Leukemia Treatment."
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