Leukemia Treatment
Leukemia is a cancer that originates in the blood-forming tissues, primarily the bone marrow and lymphatic system. The cancer causes an overproduction of abnormal white blood cells, which can crowd out healthy blood cells and impair the body’s ability to fight off infection, carry oxygen to organs and tissues and control bleeding. Leukemia is relatively common, particularly among children and older adults.
There are several types of leukemia, which is broadly classified as acute or chronic and by the type of white blood cell affected (lymphocytic or myeloid). Acute lymphocytic leukemia (ALL) is the most common type in children, while acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) are more prevalent in adults.
Leukemia symptoms can include fatigue, bone and joint pain, frequent infections and easy bruising and bleeding. Treatment options, which can vary depending on the type and stage of the cancer, may include chemotherapy, radiation therapy, immunotherapy and bone marrow transplantation. Early diagnosis and treatment are essential to achieve the best possible outcome and quality of life.
Surgery for leukemia
Leukemia is not generally treated with surgery because, unlike many other types of cancer, it does not form solid tumors that can be surgically removed. However, a few surgical procedures may be part of an overall treatment plan for leukemia, including:
- Bone marrow biopsy – As part of the diagnostic process, a bone marrow sample may be extracted during a minor surgical procedure for microscopic analysis by a pathologist, who can identify cancerous cells.
- Central venous catheter (CVC) placement – A long-term intravenous (IV) line, such as a port or Hickman catheter, may be surgically placed to facilitate the administration of blood transfusions, chemotherapy and other medications.
- Splenectomy – If the spleen is significantly enlarged due to leukemia, its removal may be considered to alleviate symptoms and improve blood cell counts.
Chemotherapy for leukemia
A primary treatment for leukemia, chemotherapy involves the use of powerful drugs to target and destroy rapidly dividing cells, including cancer cells. Depending on the type and stage of the leukemia, the chemo medications may be administered orally, intravenously or directly into the cerebrospinal fluid. Chemotherapy for leukemia is typically given in cycles, with periods of treatment followed by periods of rest to allow the body time to recover.
Chemotherapy for leukemia can be used as:
- Induction therapy – To achieve remission by destroying as many leukemia cells as possible
- Consolidation or intensification therapy – To eliminate any remaining microscopic leukemia cells and help prevent relapse
- Maintenance therapy – To maintain remission and prevent recurrence over a longer period
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Schedule an AppointmentRadiation therapy for leukemia
Radiation therapy involves the use of high-energy rays or particles, which are precisely aimed at specific areas of the body to destroy cancer cells or inhibit their growth. While less frequently used than chemotherapy for leukemia, radiation therapy can be effective for specific purposes, such as:
- Total body irradiation (TBI) – Often used as part of the conditioning regimen before bone marrow transplantation, TBI can help eliminate leukemia cells throughout the body and suppress the immune system to help prevent transplant rejection.
- Targeted radiation – To reduce leukemia symptoms or prevent cancer spread, high-energy beams can be directed at specific areas of the body where leukemia cells have accumulated, such as the spleen, brain or spinal cord.
- Supportive care – Radiation therapy can be used to alleviate symptoms caused by enlarged organs or masses of leukemia cells.
Immunotherapy for leukemia
A promising and rapidly advancing area of cancer treatment, immunotherapy works by boosting the power of the body’s own immune system, helping it to recognize and attack cancer cells. Several approaches can be used for leukemia treatment, including:
- Monoclonal antibodies – Laboratory-made molecules can bind to specific proteins found on the surface of leukemia cells, marking the cells for destruction by the immune system.
- CAR T-cell therapy – This innovative treatment involves extracting and modifying a patient’s own T-cells to express chimeric antigen receptors (CARs) that specifically target and destroy leukemia cells. The modified T-cells are then infused into the patient’s bloodstream.
- Immune checkpoint inhibitors – Drugs such as pembrolizumab (Keytruda) and nivolumab (Opdivo) can help the immune system recognize and attack leukemia cells by blocking proteins that inhibit the body’s immune response.
- Cytokines – Substances such as interleukins and interferons can boost the immune system’s activity against leukemia cells.
Bone marrow transplantation for leukemia
Bone marrow transplantation involves replacing diseased bone marrow with healthy stem cells. This procedure may be considered for a patient who has not responded to other leukemia treatments or has relapsed. The process involves several steps:
- Conditioning therapy – High-dose chemotherapy and sometimes radiation therapy are used to destroy the diseased bone marrow and leukemia cells.
- Stem cell infusion – Healthy stem cells obtained from a donor (allogeneic transplant) or the patient’s own previously collected cells (autologous transplant) are infused into the patient’s bloodstream.
- Engraftment – The transplanted stem cells circulate in the bloodstream and travel throughout the body to reach the bone marrow, where they will begin to produce healthy new blood cells.
What are the most likely side effects of leukemia treatment?
Leukemia treatment can potentially produce side effects. The most common include mouth ulcers, nausea, vomiting, diarrhea, constipation, skin rashes, loss of appetite and fatigue.
Other possible side effects of leukemia treatment include:
- Low blood cell counts – Leukemia treatment is designed to target abnormal blood cells, but it can sometimes affect healthy blood cells as well, resulting in an overall decline in blood cell production.
- Infections – Because white blood cells help the body’s immune system fight off germs and other invaders, a reduced white blood cell count can increase susceptibility to infections.
- Graft versus host disease (GVHD) – After undergoing an allogeneic stem cell transplantation, the patient may develop GVHD, which occurs when donor immune cells mistakenly target healthy cells.
- Tumor lysis syndrome (TLS) – Sometimes induced by chemotherapy, TLS is a metabolic abnormality that results from a sudden release of dying cancer cells into the bloodstream. Left untreated, TLS can lead to serious medical complications, such as heart arrhythmias, seizures, loss of muscle control and kidney failure.
- Hyperglycemia and steroid-induced diabetes – Certain corticosteroids can produce high blood sugar levels, which can lead to the development of health complications in diabetic patients.
Frequently asked questions (FAQs) about leukemia treatment
The following FAQs-related articles provide additional information about leukemia treatment:
- Five things to know about leukemia treatment
- Five ways to prepare for leukemia treatment
- Are clinical trials right for me?
Benefit from world-class care at Moffitt Cancer Center
Moffitt is recognized as a Comprehensive Cancer Center by the National Cancer Institute, a designation that recognizes our commitment to continually advancing cancer care through groundbreaking research and clinical trials. At Moffitt, we understand that each patient and diagnosis is different, and the leukemia team in our Malignant Hematology Program works collaboratively with the team in our Bone and Marrow Transplant and Cellular Immunotherapy Program to determine the optimal treatment approach in every case.
If you would like to learn more about leukemia treatment, you can request an appointment with a specialist in Moffitt’s Malignant Hematology Program by calling 1-888-663-3488 or submitting a new patient registration form online.
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