Leukemia

Treatments

Leukemia treatment is complex. It varies with the type of leukemia and is not the same for all patients. The doctor creates a leukemia treatment plan to fit each patient’s needs. The leukemia treatment depends not only on the type of disease, but also on certain features of the leukemia cells, the extent of the disease, and whether the leukemia has been treated before. It also depends on the patient’s age, symptoms, and general health.

Whenever possible, patients should be treated at a medical center that has doctors who have experience in leukemia treatment. If this is not possible, the patient’s doctor should discuss the leukemia treatment plan with a specialist at such a center.

Acute leukemia needs to be treated right away. The goal of acute leukemia treatment is to bring about a remission. Then, when there is no evidence of the disease, more therapy may be given to prevent a relapse. Many people with acute leukemia can be cured.

Chronic leukemia patients who do not have symptoms may not require immediate treatment. However, they should have frequent checkups so the doctor can see whether the leukemia is progressing. When treatment is needed, it can often control the disease and its symptoms. However, chronic leukemia can seldom be cured.

Most patients with leukemia are treated with chemotherapy. Some also may have radiation therapy and/or bone marrow transplantation (BMT) or biological therapy. In some cases, surgery to remove the spleen (an operation called a splenectomy) may be part of the treatment plan. Chemotherapy is the use of drugs to kill cancer cells. Depending on the type of leukemia, patients may receive a single drug or a combination of two or more drugs.

Leukemia Chemotherapy

Some anticancer drugs can be taken by mouth. Most are given by IV injection (injected into a vein). Often, patients who need to have many IV treatments receive the drugs through a catheter. One end of this thin, flexible tube is placed in a large vein, often in the upper chest. Drugs are injected into the catheter, rather than directly into a vein, to avoid the discomfort of repeated injections and injury to the skin.

Anticancer drugs given by IV injection or taken by mouth enter the bloodstream and affect leukemia cells in most parts of the body. However, the drugs often do not reach cells in the central nervous system because they are stopped by the blood-brain barrier. This protective barrier is formed by a network of blood vessels that filter blood going to the brain and spinal cord. To reach leukemia cells in the central nervous system, doctors use intrathecal chemotherapy. In this type of leukemia treatment, anticancer drugs are injected directly into the cerebrospinal fluid.

Intrathecal chemotherapy can be given in two ways. Some patients receive the drugs by injection into the lower part of the spinal column. Others, especially children, receive intrathecal chemotherapy through a special type of catheter called an Ommaya reservoir. This device is placed under the scalp, where it provides a pathway to the cerebrospinal fluid. Injecting anticancer drugs into the reservoir instead of into the spinal column can make intrathecal chemotherapy easier and more comfortable for the patient.

Chemotherapy is given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. In some cases, the patient has chemotherapy as an outpatient at the hospital, at the doctor’s office, or at home. However, depending on which drugs are given and the patient’s general health, a hospital stay may be necessary. Radiation therapy is used along with chemotherapy for some kinds of leukemia. Radiation therapy (also called Radiotherapy) uses high-energy rays to damage cancer cells and stop them from growing. The radiation comes from a large machine.

Leukemia Radiation Therapy

Radiation therapy for leukemia may be given in two ways. For some patients, the doctor may direct the radiation to one specific area of the body where there is a collection of leukemia cells, such as the spleen or testicles. Other leukemia patients may receive radiation that is directed to the whole body. This type of radiation therapy, called total-body irradiation, usually is given before a bone marrow transplant.

Leukemia Biological Therapy

Biological therapy is a form of leukemia treatment that involves treatment with substances that affect the immune system’s response to cancer. Interferon is a form of biological therapy that is used against some types of leukemia.

Leukemia Stem Cell Transplantation

Some patients with leukemia have stem cell transplantation. A stem cell transplant allows a leukemia patient to be treated with high doses of drugs, radiation, or both. The high doses destroy both leukemia cells and normal blood cells in the bone marrow. Later, the patient receives healthy stem cells through a flexible tube that is placed in a large vein in the neck or chest area. New blood cells develop from the transplanted stem cells.