In 2026, the mother of four was diagnosed with chronic myeloid leukemia (CML), a blood cancer that affects how the bone marrow produces granulocytes, a type of white blood cell.

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She described the shock of receiving the diagnosis after two bone marrow biopsies — the first unsuccessful — and the relief of learning it wasn’t blast‑phase disease, which would have required chemotherapy.

“Also learning CML isn’t hereditary nor something ‘I did’ to cause it was a relief, yet still a bit puzzling… Life for me has changed in various ways, but treatment thus far is working,” she said, according to People.

Experts say that while CML treatments have dramatically improved outcomes, tolerability remains a major concern.

“Daily side effects and long‑term issues, such as arterial occlusive events, are major issues for patients. More patients want to achieve treatment‑free remission,” explains Dr. Andreas Hochhaus, Director of the Comprehensive Cancer Center in Germany.

Hamilton echoed that reality, sharing that despite the drug’s strong success rate, adjusting to treatment hasn’t been easy.

“The symptoms, bleeding… but I’m still on the better side than most, so I’m not complaining at all,” she told Hall. Hearing she was in remission left her stunned: “When the doctor said, ‘You’re going into remission,’ I just couldn’t believe it.”

WATCH: Tyrosine Kinase Inhibitor Therapy for Chronic Myeloid Leukemia

While Hamilton didn’t specify her treatment, SurvivorNet experts note that tyrosine kinase inhibitors (TKIs) are the standard targeted therapy for CML. These oral medications work by blocking cancer‑driving proteins and helping the body control abnormal cell growth.

CML Treatments With Minimal Side Effects

The development of new medications that minimize side effects while maintaining effectiveness is key to improving patient quality of life. A standout cancer drug example Dr. Hochhaus praises is asciminib (brand name: Scemblix), which targets BCR-ABL1, a gene characteristic of chronic myeloid leukemia. This BCR-ABL1-specific drug exclusively targets the BCR-ABL1 tyrosine kinase—an enzyme that contributes to cell growth, making it less likely to cause side effects compared to other tyrosine kinase inhibitors.

“Asciminib is better tolerated because it does not inhibit other kinases apart from BCR-ABL1,” Dr. Hochhaus notes. “Most side effects are produced by inhibition of non-targeted kinases, and this drug avoids that issue.”

Common side effects of existing tyrosine kinase inhibitors include:

• Fatigue (feeling and being sick/Tiredness)
• Headaches
• Abdominal (tummy) pain
• Swelling in the face and lower legs
• Muscle cramps/pain
• Rash
• Diarrhea

Dr. Hochhaus says long-term concerns include pleural effusions (fluid accumulation in the lungs) and arterial occlusive events (artery blockages that reduce blood flow). Finding a drug that bypasses these risks is a major step forward.

ASC4START Study: Comparing CML Treatments Asciminib to Nilotinib

Researchers launched the ASC4START study to assess asciminib’s effectiveness and tolerability further and compared it to nilotinib, a widely used CML treatment. The interim analysis revealed promising results.

“After nine months of treatment, 16 patients had to discontinue Asciminib, compared to 34 patients taking Nilotinib,” says Dr. Hochhaus. “This shows a very clear advantage for Asciminib, which is the major endpoint for this study.”

While asciminib is FDA-approved for first-line (initial treatment) and all-line use in the United States, access remains limited in many other countries. Researchers aim to expand approval worldwide, ensuring more patients can benefit from the drug’s tolerability and potential for treatment-free remission.

“Patients in the U.S. can be very happy to have Asciminib available,” Dr. Hochhaus says. “But that’s not the case in all countries. We need to demonstrate that Asciminib is well tolerated everywhere, and that’s what we’re doing with the ASC4START study.”

With continued research and advocacy, asciminib may soon become a standard treatment option globally, offering CML patients a better-tolerated, effective, and potentially life-changing alternative.

Understanding Leukemia and Its Various Types

Leukemia is a type of blood cancer that originates in the bone marrow and leads to the overproduction of abnormal white blood cells. These cells can crowd out healthy ones and interfere with the body’s ability to fight infection, carry oxygen, and prevent bleeding.

Leukemia is categorized based on:

• Progression speed:
  • Acute leukemia involves immature cells and progresses rapidly.
  • Chronic leukemia affects mature cells and develops more slowly.
• Cell origin:
  • Myeloid leukemia arises from cells that form red blood cells, platelets, and certain white blood cells.
  • Lymphocytic leukemia affects cells that become lymphocytes, a type of immune cell.
• Main Subtypes of Leukemia: Here are four key forms:
  • Acute Myeloid Leukemia (AML) – Fast-growing; starts in immature myeloid cells; aggressive and serious
  • Chronic Myeloid Leukemia (CML) – Slow-growing; affects mature myeloid cells; less aggressive than AML
  • Acute Lymphocytic Leukemia (ALL) – Rapid progression; begins in immature lymphocytes; common in children
  • Chronic Lymphocytic Leukemia (CLL) – Slow progression; develops from mature lymphocytes; more common in older adults

It’s important to note that chronic forms of leukemia tend to be less aggressive but may require longer treatment periods compared to acute types.

Symptoms & Diagnosis

Signs vary by leukemia type and can depend on the patient’s age, medical history, and disease stage. Common symptoms may include:

• Fatigue and weakness
• Frequent infections
• Easy bruising or bleeding
• Swollen lymph nodes
• Bone pain
• Unexplained weight loss

How CAR T-cell Therapy Offers Hope for Some Blood Cancer Patients

CAR T-cell therapy transforms a patient’s own immune cells into powerful cancer fighters. The journey begins with T-cells—white blood cells that help the immune system detect and destroy threats like viruses and cancer. Once collected from the patient’s blood, these cells are sent to a lab, where scientists use an inactivated virus to insert new genetic instructions.

These new genes teach the T-cells to produce special surface proteins known as receptors, allowing them to better recognize cancer cells. The modified cells are then multiplied in large numbers and infused back into the patient.

WATCH: The Value of CAR T-Cell Therapy for Patients.

Once inside the body, these re-engineered T-cells go to work, locking onto matching proteins—called antigens—on cancer cells and attacking them directly.

Dr. Siddhartha Ganguly, Carol Cockrell Curran Distinguished Centennial Chief in Hematologic Oncology at Houston Methodist Hospital and Neal Cancer Center, compares this cutting-edge therapy to a classic video game.

“CAR-T therapy aims to give ‘eyes’ to the T-cells. We remove the T-cells from the body by a blood draw, send them to the lab, and insert an anti-cancer gene before infusing them back into the patient. This gene allows the T-cell to ‘see’ the cancer cells… They will seek out the cancer and kill it, much like the video game Pacman,” Dr. Ganguly told SurvivorNet.

He notes that while CAR T-cell therapy, like many treatments, comes with possible side effects, it offers substantial hope for patients facing hard-to-treat blood cancers like advanced lymphoma and multiple myeloma.

A Deeper Look Into the Reengineering Process

Doctors reengineer a patient’s immune system with CAR T-cell therapy by first drawing blood and separating out the T-cells.

Then, using a harmless virus, the T-cells are genetically engineered to produce proteins called chimeric antigen receptors (CARs) on their surface. These receptors enable the cells to recognize and attach to a matching protein, called an antigen, on the tumor cell, just as a key fits into a lock. The process primes the T-cell to recognize the cancer and to fight it.

Next, the modified cells are multiplied into the millions in a laboratory.

The CAR T-cells are specific to your cancer. For example, some types of lymphoma cells have the antigen CD19 on their surface. CAR T-cell therapies for those cancer types only target the CD19 antigen.

A few days before the infusion, you’ll get chemotherapy to clear out some of your immune cells and prime your body to receive the CAR T-cells. This will help the CAR T-cells work better.

Finally, the modified T-cells will be infused back into your body to hunt down the cancer.

Several FDA-approved CAR T-cell therapies are currently in use, including:

• Abecma (idecabtagene vicleucel)
• Breyanzi (lisocabtagene maraleucel)
• Carvykti (ciltacabtagene autoleucel)
• Kymriah (tisagenlecleucel)
• Tecartus (brexucabtagene autoleucel)
• Yescarta (axicabtagene ciloleucel)

These therapies are used to treat various blood cancers, such as certain leukemias, lymphomas, and, more recently, multiple myeloma.

What’s the Effectiveness of CAR T-cell Therapy?

CAR T-cell therapy has delivered promising outcomes for patients with certain blood cancers, showing response rates as high as 80% in cases where other treatments have failed. For individuals with lymphoma, more than 54% of those treated with the FDA-approved therapy axicabtagene ciloleucel (Yescarta) and 40% of those who received tisagenlecleucel (Kymriah) achieved a complete response, meaning no detectable cancer remained.

Remarkably, among those treated with Yescarta, 40% remained in remission an average of 15 months following their infusion.

Typically, patients who receive CAR T-cell therapy have already had at least two previous treatments, often including rituximab (Rituxan) with chemotherapy and high-dose chemotherapy.

“Some of these patients had three, four, or five prior lines of therapy, and we were able to save their lives,” said Dr. Stephen Schuster, director of the Abramson Cancer Center’s lymphoma program, in an interview with SurvivorNet.

Medical research has shown response rates of between 80 and 100 percent. “It’s really unprecedented. This is something we had never seen before for patients who have had six or seven prior lines of therapy,” says Dr. Nina Shah, a hematologist with the University of California, San Francisco Medical Center.

CAR T-Cell Therapy Side Effects

CAR T-cell therapy is a form of cancer treatment that differs from traditional chemotherapy in a significant way: it generally doesn’t cause hair loss or nausea. But like any powerful treatment, it comes with its own set of side effects.

As CAR T-cells multiply in the body, they release inflammatory proteins called cytokines. This can trigger a condition known as cytokine release syndrome (CRS), which may cause symptoms like high fever, weakness, chills, and low blood pressure. Another potential side effect involves neurological changes, which can lead to confusion or a decreased sense of awareness.

WATCH: CAR T-Cell Therapy Side Effects

When side effects do appear, the most common and least severe is fatigue.
“That’s very normal, and it usually resolves in the first month,” says Dr. Shah.

However, CRS can sometimes be more serious. It occurs when the therapy causes a surge of cytokines—tiny immune-signaling proteins—to flood the bloodstream. This response can bring on a range of symptoms, from mild flu-like effects to more severe reactions.

Typical CRS symptoms include headache, fever, chills, scratchy throat, nausea, vomiting, diarrhea, joint or muscle pain, and extreme fatigue. In more serious cases, it can cause shortness of breath, low blood pressure, or a rapid heart rate. While most patients experience only mild to moderate reactions, it’s important to note that CRS can, in rare instances, become life-threatening.

Currently, scientists aren’t sure whether the side effects correlate with how well the treatment is working, so it’s difficult to tell patients whether their side effects or lack of them are a good or bad thing. “All I can say is that every patient is different, and every patient has a different course,” says Dr. Shah.

Data show that the quality of life for people who have undergone CAR T-cell therapy “actually improves when we talk about pain, fatigue, and emotional and social functioning. And so, whether or not you experience side effects, we hope that this therapy will improve your quality of life,” says Dr. Shah.

If you’re considering CAR T-cell therapy, talk with your doctor about all potential side effects—the mild, the serious, and everything in between.

Treatment doesn’t end once you’ve received the CAR T-cell infusion. “They typically have to be monitored very carefully after that for a number of weeks or even months, due to some of the potential side effects,” Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center, tells SurvivorNet.

Questions to Ask Your Doctor

If you’re living with leukemia, you may be talking with your care team about what your ongoing treatment could look like. After hearing about CAR‑T therapy, it’s natural to wonder whether it might be right for you—or whether another standard treatment better fits your specific type of leukemia. This list of questions can help guide your conversation with your doctor.

• What treatment plan do you recommend for my specific type of ALL, and why?
• What are the goals of each treatment phase (induction, consolidation, maintenance), and how long will they last?
• What side effects should I expect from chemotherapy, targeted therapy, or other treatments, and how can we manage them?
• Would a stem cell transplant or CAR‑T cell therapy be appropriate for my case, and what are the risks and benefits?
• How will treatment affect my daily life, including work, family responsibilities, and long‑term health?

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