Chronic Myeloid Leukemia: Therapy

General measures

• Nicotine restriction (abstaining from tobacco use)Note: Smoking doubles the mortality risk (risk of death) of patients with chronic myeloid leukemia (CML)
• Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
• Normal weight to strive for or maintain!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
  • BMI ≥ 25 → participation in a medically supervised weight loss program.
  • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
• Avoidance of environmental stress:
  • Ionizing rays
  • Benzene

Conventional non-surgical therapy methods

Stem cell transplantation (more precisely, hematopoietic stem cell transplantation; HSCT; here as allogeneic hematopoietic stem cell transplantation) is the only form of therapy that leads to the cure of chronic myeloid leukemia.The indication should be evaluated early in the course of the disease.The following groups of patients are eligible:

• Affected < 55 years
• Compatible donor

Vaccinations

The following vaccinations are advised before starting therapy:

• Influenza vaccination (seasonal quadrivalent inactivated vaccine).
• Pneumococcal vaccination: immunocompromised individuals should be vaccinated sequentially with the 13-valent conjugate vaccine PCV13 and six to 12 months later with the 23-valent polysaccharide vaccine PPSV23 against pneumococcus.
• Meningococcal vaccination (ACWY and B).
• Herpes zoster vaccination (only with inactivated vaccine.
• If necessary, booster vaccination against diphtheria, Haemophilus influenzae capsule type b (Hib), pertussis and tetanus.

Regular checkups

• Regular follow-up examinations for early detection of recurrence (recurrence of the disease).

Nutritional medicine

• Nutritional counseling based on nutritional analysis
• Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
  • Consume only limited energy-rich foods.
  • Moderate total fat intake
  • Little red meat (pork, beef, lamb, veal) and sausages.
  • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
  • High-fiber diet (whole grains, vegetables).
  • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
  • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
  • Refrain from polluted foods such as offal and wild mushrooms.
  • Do not eat moldy food
• Observe the following special dietary recommendations:
  • Diet rich in:
    • Vitamins (A, C, D, E, folic acid).
    • Minerals
    • Trace elements (selenium, zinc)
    • Omega-3 fatty acids
    • Secondary plant compounds (e.g. carotenoids, polyphenols).
• Selection of appropriate food based on the nutritional analysis
• See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
• Detailed information on nutritional medicine you will receive from us.

Sports Medicine

• Endurance training (cardio training) and strength training (muscle training).
  • In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases lasting 1 to 3 minutes alternate with rest phases also lasting 1 to 3 minutes. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
• Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
• For detailed information on sports medicine, please contact us.

Psychotherapy

• Psychosocial care
• Detailed information on psychosomatic care (including stress management) is available from us.