Treatment for Acute and Chronic Leukemias
Treatment for leukemia depends on the type of leukemia a person has. It also depends on whether the patient has been treated for leukemia before. A doctor also considers the patient's age, symptoms, personal preferences, and general health when making recommendations for a treatment plan.
It is important that a person who is diagnosed with leukemia be treated at a center with doctors and nurses experienced in treating leukemia. If this is not possible, the patient's doctor should discuss the patient's treatment plan with a specialist.
Many patients want to learn all they can about their disease and their treatment choices so that they can take an active part in decisions about their care. They are likely to have many questions and concerns about their treatment options. Most patients want to know how they will function after treatment and whether they will have to change their normal activities. The doctor is the best person to answer a patient's questions, such as what treatment choices are, how successful it is expected to be and what the risks and side effects may be.
Types of Treatment
Acute leukemia should be treated immediately. The goal of treatment is to cause a remission in the cancer. When cancer is in remission, it appears as if the cancer is gone. Further treatment is given to prevent a return or relapse of the leukemia. Some people may be cured.
People with chronic leukemia do not always need treatment right away. Instead, they may have frequent checkups so the doctor can tell how the disease is growing. Treatment for chronic leukemia can often control the disease for a long time, but chronic leukemia is rarely cured.
There are different ways to treat leukemia. Treatment for leukemia is either systemic or local. Systemic treatments destroy or control leukemia cells throughout the entire body. Chemotherapy is a systemic treatment. A patient usually has a combination of different chemotherapy treatments. In some cases, radiation will also be used. Radiation is a local treatment used to destroy or control leukemia cells in a certain area. Treatments for leukemia include chemotherapy, radiation therapy, targeted therapy, biologic therapy, and bone marrow or stem cell transplant.
Goals of Treatment
Different types of treatments have different goals. Below is a list of treatments and their goals.
Chemotherapy. People with most types of leukemia are treated with chemotherapy. This treatment uses drugs to kill leukemia cells. Patients may take two or more drugs. Some cancer-killing drugs can be swallowed as a pill, but most are given intravenously. Acute leukemia patients usually are treated in a hospital.
Radiation therapy. The goal of radiation therapy is to kill leukemia cells using x-rays. This treatment is sometimes used along with chemotherapy or bone marrow transplantation to treat leukemia. Patients can receive radiation over the whole body (called total-body irradiation) or just to the part in which more leukemia cells have gathered. In adult patients with acute lymphoblastic leukemia (ALL), radiation of the brain is sometimes used to prevent the leukemia from spreading to the brain.
Bone marrow transplant. The goal of bone marrow transplants is to kill as many leukemia cells as possible by treating the body with very high doses of chemotherapy and radiation. Normally, the body cannot handle such high doses. Therefore, after a person is treated with these high doses, they need to be "rescued" with healthy, new bone marrow. The new bone marrow may come from a donor (called an allogeneic transplant) or from the person's own bone marrow (called an autologous transplant). In autologous transplants, the bone marrow is collected and preserved prior to the high-dose treatments.
Peripheral stem cell transplant. Peripheral stem cell transplant is based on the same idea as a bone marrow transplant, but it uses cells that are collected from the donor's or the patient's own blood rather than from bone marrow. The main difference is that stem cells are collected from the arm veins, not from the hip bones, as is usually the case in bone marrow. These transplants are given in centers that specialize in this form of treatment. They are now used more often than bone marrow transplants.
Other treatments that may be used for leukemia include:
Targeted therapy. These are newer drugs that target specific abnormal proteins in leukemia cells. They are usually very effective in the treatment of chronic myelogenous leukemia (CML), and they may be used for some other types of leukemia as well.
Biological therapy (sometimes called immunotherapy, biotherapy, or biological response modifier therapy). These relatively new cancer treatments use the body's immune system, either directly or indirectly, to fight cancer or to lessen the side effects that may be caused by some cancer treatments.
Blood transfusions. These are done to give red blood cells or platelets to replace those destroyed by the leukemia or the cancer treatment.
Other medicines may be given to prevent or treat damage to other systems of the body caused by leukemia treatment.
Doctors are improving treatments for leukemia and are finding new ways to treat it. These new methods are tested in clinical trials. Before beginning treatment, a person should ask his or her doctor if there are any clinical trials to consider.