University Hospitals Doctor Explains Myeloid Leukemia, Outlook for Carrasco

The Cleveland Indians have won six straight and are a season-high 12 games over .500 at the All-Star break as the baseball universe has arrived for the Midsummer Classic right here in Cleveland. But one person is missing from the excitement.

Cleveland Indians starting pitcher Carlos Carrasco revealed just before All-Star Week kicked off that he has been battling chronic myeloid leukemia (CML) in his month away from the team.

Dr. Benjamin Tomlinson, an assistant professor of medicine at University Hospital's Seidman Cancer Center explained the different types of leukemia and said a major breakthrough in treatment led to improved outlooks for CML patients.

“Chronic myeloid leukemia is actually a very unique form of leukemia,” he said. Before the early 2000s, it was associated with a five- to eight-year prognosis and patients almost always needed a bone marrow transplant to survive.

“It’s one of these cancers that has been revolutionized by the changes and advances in medicine,” Tomlinson said. “Most chronic myeloid leukemia is actually treated with targeted therapy, which is oral medications that target the very thing that create the cancer and makes the cancer, drive it, make it grow, make it proliferate. For the majority of patients, those pills work well enough that we hope that they’re going to have a normal life expectancy. It’s almost like a functional cure for them, although many of them have to be on those medications for their entire lives.”

Doctors work through a number of drug regimen options with patients to keep side effects to a minimum or even non-existent.

For a professional athlete, like Carrasco, who is in overall excellent physical condition and relatively young at 32, Tomlinson, who is not Carrasco’s doctor, said the expectation is to be able to return to normal physical activity relatively quickly once a course of treatment has been settled on.

“While all patients with CML present differently, a lot of them are going to present with enlarged spleens, and professional athletes are people that are at risk of trauma or increased physical activity. You have to be very cautious with that spleen to make sure that it doesn’t rupture,” he said.

With the season only half over, Carrasco and the team's talk of the righty getting back on the mound this year is not unreasonable, according to Tomlinson.

The spleen usually goes back to normal pretty quickly with proper therapy, Tomlinson said, and patients feel "back to normal" in a matter of weeks to months.