Treatments for Leukemia

How is chronic lymphocytic leukemia treated?

While there is still no cure for chronic lymphocytic leukemia (CLL), there are several types of treatment designed to bring this disease into remission, including chemotherapy, radiation therapy, biological therapy, bone marrow transplantation, and peripheral stem cell transplantation. Currently, bone marrow transplantation, peripheral stem cell transplantation, and biological therapy-which involves using the patient's own immune system to fight the disease-are being tested in clinical trials and have not been approved by the Food and Drug Administration (FDA).

Observation-Doctors sometimes observe the patient and patterns of cancer growth for up to or longer than a year before choosing a treatment option.

Chemotherapy-In chemotherapy, a specific combination of drugs is either injected into or swallowed by the patient to fight cancer cell growth. The dosage and type of drug(s) used vary from case to case and from stage to stage.

Radiation Therapy-High-level doses of radiation are used to shrink or eliminate cancerous cells and tumors.

Biological Therapy-This type of treatment is used to rejuvenate the immune system (so that it can again fight infection and disease) and to restore noncancerous cells destroyed by chemotherapy or radiation. It is sometimes called immunotherapy, biotherapy, or biological response modifier (BRM) therapy.

Bone Marrow Transplantation-This is a procedure in which the bone marrow of a leukemia patient is replaced with his own marrow (extracted before treatment) or the marrow of a donor.

Peripheral Stem Cell Transplantation-In stem cell transplantation, healthy stem cells are drawn from the patient's blood or marrow and frozen; after the patient completes chemotherapy, the healthy stem cells are injected back into his body.

Once a patient has been diagnosed with CLL, more extensive testing is performed to determine whether or not the cancer has spread through the body. The doctor then classifies the disease's progression as Stage 0, 1, 2, 3, 4, or Refractory. Treatment is tailored to each specific stage.

Stage 0: In Stage 0, there is an overabundance of white blood cells (lymphocytes) in the blood, but typically, there are no other symptoms of CLL-in other words, the lymph nodes, liver, and spleen are not enlarged, and there is a healthy, appropriate number of platelets and red blood cells in the blood.

To treat Stage 0 CLL, the doctor may recommend chemotherapy. In less urgent cases, the doctor might utilize the observation method.

Stage 1: In this stage, there is an overabundance of lymphocytes in the blood, and the lymph nodes are enlarged; however, the spleen and liver are of normal size, and there are an appropriate number of platelets and red blood cells in the blood.

Stage 1 CLL is treated with observation, chemotherapy, radiation therapy, or a combination of these methods. Occasionally, doctors rely on clinical trial treatments.

Stage 2: In Stage 2, the blood and lymph nodes are overloaded with lymphocytes, and the liver and spleen are swollen.

Stage 2 CLL is treated with observation, chemotherapy radiation therapy for the lymph nodes and/or spleen, a clinical trial treatment, or a combination of these methods.

Stage 3: Stage 3 CLL is marked by too many lymphocytes in the blood, too few red blood cells (a condition called anemia), and possible swelling of the spleen, liver, or lymph nodes.

Stage 3 CLL is treated with observation, chemotherapy, surgical removal of the spleen, radiation therapy for the spleen, clinical trial treatments, or a combination of these treatments.

Stage 4: Patients with Stage 4 CLL have too many lymphocytes and too few platelets in their blood (which inhibits clotting), anemia, and swelling in their liver, spleen, or lymph nodes.

Stage 4 CLL is treated with observation, chemotherapy drugs, surgical removal of the spleen, radiation therapy for the spleen, and/or clinical trial treatments.

Refractory: In the Refractory stage, CLL does not respond to any type of treatment. Often, doctors recommend the aforementioned clinical trial treatments.

How is acute myeloid leukemia treated?

Currently, there is no cure for acute myeloid leukemia (AML), but a variety of treatments are available to bring about remission, including chemotherapy (the most commonly used treatment), radiation therapy, and clinical trials, such as bone marrow transplantation and biological therapy.

Chemotherapy-In chemotherapy, a specific combination of drugs is either injected into or swallowed by the patient to fight cancer cell growth. The dosage and type of drug(s) used vary from case to case and from stage to stage.

Radiation Therapy-High-level doses of radiation are used to shrink or eliminate cancerous cells and tumors.

Biological Therapy-This type of treatment is used to rejuvenate the immune system (so that it can again fight infection and disease) and to restore non-cancerous cells destroyed by chemotherapy or radiation. It is sometimes called immunotherapy, biotherapy, or biological response modifier (BRM) therapy.

Bone Marrow Transplantation-This is a procedure in which the bone marrow of a leukemia patient is replaced with his own marrow (extracted before treatment), or the marrow of a donor.

Some patients receiving bone marrow from a donor experience an adverse reaction. This condition, Graft Versus Host Disease (GVHD), can often be prevented with the use of cyclosporine, an immunosuppressive drug. Also known by the brand names Neoral, Sandimmune, and SangCya, cyclosporine keeps the white blood cells (lymphocytes) of the transplanted bone marrow from rapidly multiplying and attacking the body. Cyclosporine is prescribed for daily use and is taken orally. Side effects of cyclosporine include increased growth of facial hair, nausea, raised blood pressure, and in some patients, kidney damage.

There is no staging for AML. The method of treatment used is dependent upon the patient's specific case and whether or not his AML has previously been treated.

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