Treatment Options

If you have been diagnosed with leukemia or another form of cancer of the immune or blood system you should seek immediate help from an oncology specialist, a hematologist, or a board certified hematology/oncology specialist. Oncology specialists focus on the study and treatment of cancer. Hematologists are specialists that study disorders of the blood. The best type of doctor to see is one who has board certification in both fields - a hematology oncologist. You can check to see what board certifications your doctor has at the American Board of Medical Specialties (ABMS).

There are various treatment options for people with cancer and leukemia:  chemotherapy, radiation therapy, bone marrow or stem cell transplants, monoclonal antibodies, as well as clinical trials.  These treatments are often used in combination.

When deciding on a treatment plan a number of factors will be taken into consideration such as: your age, overall health, the type of cancer, and the stage of the disease. A specialist will help you determine which treatments to pursue based on your needs and desires.

Chemotherapy
Chemotherapy is one of the most common treatments for patients diagnosed with leukemia or another form of cancer. Patients often start chemotherapy treatment very soon after being diagnosed. Chemotherapy uses strong drugs to kill rapidly growing cells, such as cancer cells. Unfortunately, other healthy cells (such as hair cells) that grow rapidly are also damaged by chemotherapy. Chemotherapy can cause a variety of side effects including a weakened immune system, increased bleeding, temporary hair loss, nausea, fatigue, vomiting, lack of appetite, etc.

In leukemia patients, chemotherapy is used to kill the leukemia cells and hopefully achieve remission. Remission is where the blood does not show signs of leukemia cells and normal blood production is restored. Once the disease is in remission, the patient should consider long-term treatment options such as further chemotherapy or a blood stem cell transplant.

Radiation Therapy
Radiation therapy is often used in along with chemotherapy.  During radiation therapy, beams of high-energy radiation are focused at the cancer cells to kill them.  To destroy a tumor, radiation is focused on the specific area(s) of the body that are infected.  Radiation therapy can also be used on the entire body before a stem cell or bone marrow transplant.  Some side effects of radiation therapy are fatigue, skin rashes, and dry, sensitive skin.

Stem Cell or Bone Marrow Transplant
Another option for leukemia patients is to have a stem cell or bone marrow transplant.  Stem cell and bone marrow transplants are often preceded by intensive chemotherapy and/or radiation therapy to prepare the body to receive the transplant. For a stem cell transplant, the next step is to introduce the stem cells into the patient.  This is primarily done through a vein in the neck or chest. These new stem cells then replicate and replace the cells that were destroyed during chemotherapy and/or radiation therapy.  There are currently three sources from which stem cells are being used for transplants:  bone marrow, circulating blood (or peripheral blood), and umbilical cord blood.

In a bone marrow transplant the stem cells may be provided by the patient (autologous transplant) or by a donor (allogeneic transplant).  In an autologous stem cell transplant, the patient's blood stem cells are collected and frozen, and then reintroduced into the patient after he/she has received intensive chemotherapy and/or radiation therapy.  In an allogeneic transplant, the stem cells are taken from a donor and infused into the patient within 24 hours. The donor may or may not be a relative of the patient.  Allogeneic transplants are more common than autologous transplants because there is a greater chance for patients to relapse if they have autologous transplants.  A relapse is when a patient contracts leukemia again after being in remission.

Monoclonal Antibodies
Monoclonal antibodies (MoABs) are used to assist the body's immune system in getting rid of the disease.  Once the monoclonal antibodies are put into the patient's body, they seek out and bind themselves to the leukemia cells.  Then the immune system responds by destroying the antibodies and the cancer cells simultaneously.  However, it is important to keep in mind that monoclonal antibodies are a recent development in leukemia treatment, thus the long-term effectiveness is still being investigated.