Leukemia Treatment Options

Conditions & Diseases: Cancers

Treatment Options

The treatment approach differs from patient to patient, from one leukemia type to another, and from a leukemia stage or phase to another. There are a certain number of factors that influence the treatment approach:

- The leukemia type.
- The patient’s age and symptoms.
- Whether or not the leukemia cells are present into the cerebrospinal fluid.
- Leukemia cells' features.
- Whether or not the leukemia was treated before.

Leukemia treatment options include:

Chemotherapy: Most of the patients that suffer from leukemia receive chemotherapy. Chemotherapy is a systemic treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the leukemia cells, or to kills the leukemia cells. This type of treatment can be administrated only as a single drug or in combination with other drugs.

Chemotherapy can be administrated through several forms:

1) Oral administration as pills.

2) Intravenous
- as a injection into the vein or
- through a catheter (a thin, flexible tube) placed in the vein when the patient needs many IV treatments.

3) Injectable
- into the cerebrospinal fluid.
- into the spinal (the drugs are injected straight into the lower part of the spinal column).
- through a Ommaya reservoir (this is the name of a special catheter inserted beneath the scalp used to avoid the discomfort of the spinal injection).

The advantage of this last type of treatment approach is that the drugs travel on direct path from the brain and spinal cord to the leukemia cells.

Usually, chemotherapy is administrated in cycles where a treatment period is followed by a break period. The purpose of this treatment is to achieve a complete remission. The remission refers to the phase when leukemia sings and symptoms disappear, the leukemia cells are destroyed, and normal cells grow in the bone marrow. However, in the remission stage the cancer is not completely cured, but the leukemia cells do not show up in the blood and bone marrow.

Like every medicated treatment, chemotherapy can cause side effects. The complexity and extent of the side effects depend on the drug used and its dosage. The most common side effects include:

Frequent infection, easy bleeding and brushing, and tiredness and weakness (all caused by chemotherapy effects on the normal blood cells).
Temporary hair loss (chemotherapy also affect the hair cells causing the hair to fall out).
Mouth sore, lips sore, nausea, vomiting, diarrhea, and loss of appetite (chemotherapy affects the healthy cells from that line the digestive tract).
Fertility problems
- in women (irregular menstrual periods or the period may stop being followed by menopause symptoms like hot flashes and vaginal dryness)
- in men (the sperm production may stop)

Targeted Therapy: This treatment option is a new approach in the battle against leukemia. The advantage of this type of treatment is that it blocks the production of leukemia cells without killing healthy cells, like the chemotherapy approach does.

One type of targeted therapy is the Gleevec treatment. Clinical trials proved that Gleevec substantially reduced the number of leukemia cells in the patient's bone marrow and blood who suffered from chronic myeloid leukemia. The effectiveness of this treatment is explained by its effect. Like no other drug, Gleevec targets the abnormal enzyme (caused by the chromosomes mutation) that cause some of the blood and bone marrow cells to become cancerous and to multiply abnormally.

Another new drug used for patients with acute myeloid leukemia is Military (Gemtuzamab ozogamicin). This drug is a combination between an acute myeloid leukemia blast cell's antibody and a toxin, and works by killing the leukemia cells.

The side effects of targeted therapy are mild because this treatment only targets leukemia cells. However, the most common side effect is retaining water which causes the patient to bloat and swell.

Biological Therapy or Immunotherapy: This is another new type of leukemia treatment used to improve the body’s natural defenses. This treatment uses the body’s immune system either to fight against cancer, or to decrease the side effects caused by the cancer treatment.

Biological therapy is administrated as an injection into the vein. This treatment is used in patient with chronic lymphocytic leukemia and chronic myeloid leukemia. In the first case (chronic lymphocytic leukemia patients) the doctor administrates a monoclonal antibody that attaches to the leukemia cells in the blood and bone marrow, and allows the immune system to kill them. In the second case (chronic myeloid leukemia patients) the doctor administrates a natural substance called interferon which slows down the growth process of leukemia cells.

Biological therapy side effects vary from patient to patient depending on the substance used. The most common side effects include:

Rashes
Swelling, and
Flu-like symptoms

Radiation Therapy or Radiotherapy is a cancer treatment which uses high-energy rays or particles to destroy cancerous cells (leukemia cells). Leukemia patients can receive either an external radiation therapy where several organs like the spleen, brain, or other organs where leukemia cells have been collected in, are radiated, or total-body irradiation where the body is irradiative through a bone marrow transplant.

The radiation therapy side effects include:

Feeling tired as the treatment continues, and
Skin irritation (the skin becomes red, dry, or tender in the area where the body is irradiated)

Stem Cell Transplantation or Bone Marrow Transplant: This is a treatment option for some leukemia patients. During this procedure, the patient receives healthy bone marrow cells from a donor, either yourself as a donor or someone else. A bone marrow transplant involves two steps. First, the patient follows a treatment with radiation or chemotherapy which kills the abnormal bone marrow. Second, the patient will receive, through a procedure similar with a blood transfusion, healthy stem cells. The stem cells enter the body through a catheter inserted into a large vein from the neck or chest area. These healthy stem cells will allow healthy new blood cells to develop.

There are several types of stem cells transplantation classified according to two criteria:

A) The “organ donor” from where the stem cells are removed.

There are three types of transplants:

1) Bone marrow transplantation: This type of transplant uses stem cells from the bone marrow.
2) Peripheral stem cell transplantation: This type of transplant uses stem cells from the peripheral blood.
3) Umbilical cord blood transplantation: This type of transplant uses stem cells from the umbilical cord blood (collected from a newborn baby umbilical cord). Umbilical cord blood transplantation is used for patients with no donor.

B) The “human donor” who provides the stem cells.

According to this criteria, there are also three types of transplant:

1) Autologous stem cell transplantation: This type of transplant uses the patient’s own stem cells. In this case, the stem cells are removed from the patient blood or bone marrow, and treated in order to kill leukemia cells. Sometimes, these stem cells are frozen until they are used for a transplant.
2) Allogenetic stem cell transplantation: This type of transplant uses stem cells collected from a donor (usually a sibling or parent, and rarely from an unrelated donor).
3) Syngeneic stem cell transplantation: This type of transplant uses stem cells from the patient’s identical twin.

Like every treatment, stem cell transplantation has a certain number of side effects. These include:

An increased risk for infections.
An increased risk for bleeding.
Graft-versus-host disease. This side effect occurs when the stem cells come from a donor and the stem cells react against the patient’s tissue affecting its liver, skin, or digestive tract.

Surgery: The only type of surgery used as a treatment option for leukemia is splendectomy (the surgical removal or the spleen), alternative used when the spleen has colleted a high amount of leukemia cells, and its swelling causes an increased level of discomfort for the patient.

Article by Alina Morrow,
Medical Writer
OmniMedicalSearch.com

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