Your treatment may consist of more than one chemotherapy drug or biological therapy. The short-term goal is a complete remission, which means the bone marrow has less than 5% blasts, the absolute neutrophil count is more than 1,000 and the platelet count is more than 100,000. The long-term goal is for an extended disease-free state and cure.
A course or cycle is the period of time from the start of chemotherapy until the blood and bone marrow cell counts are back to normal or you are able to receive further treatment. In some cases, leukemia cells are destroyed only in the blood and not in the bone marrow during the first course of chemotherapy. In these cases, a second course may be needed. If the leukemia does not respond to one or two courses of treatment, or if a relapse occurs, a different drug program may be used to attempt to bring about a remission.
A specific treatment plan is called a protocol. Each protocol is usually named by letters with each letter standing for a particular drug. A protocol may be considered standard or experimental therapy. Your doctor will discuss with you the advantages and disadvantages of a particular type of therapy.
Radiation therapy is used with chemotherapy for some kinds of leukemia. Radiation therapy for leukemia patients may be directed to:
- A specific area of the body where there is a collection of leukemia cells, such as the spleen or testicles
- The entire body. This is called total-body irradiation and usually is given before a stem cell transplant
Biological therapies help the immune system fight cancer, infections and other diseases. They include growth factors, interleukins and monoclonal antibodies. Biological therapies may be given alone or with chemotherapy.
Banner MD Anderson is leading into the future of leukemia treatment by developing innovative targeted therapies. These agents are specially designed to treat each cancer's specific genetic/molecular profile to help your body fight the disease. Many of the doctors who treat leukemia at MD Anderson are dedicated researchers who have pioneered and actively lead national and international clinical trials with novel targeted agents.
Sometimes a splenectomy, or surgical removal of the spleen, is needed. The spleen is located on the left side of in the abdomen and acts as a filtration system for blood cells. In chronic leukemia, the spleen tends to collect leukemia cells, transfused platelets and red blood cells. Frequently, the spleen enlarges from storing these cells, making it difficult for chemotherapy to reduce diseased cells. If the spleen is not removed, it sometimes grows so large that it causes breathing difficulty and compresses other organs.
Stem cell transplantation (SCT), which used to be called bone marrow transplant, destroys leukemic bone marrow cells using high doses of chemotherapy and in some cases, radiation therapy. Because high-dose chemotherapy severely damages the bone marrow's ability to produce cells, healthy stem cells then are given intravenously to stimulate new bone marrow growth.
Like other leukemia treatments, SCT is highly individualized. Your care will be planned specifically for you, considering such factors as type of leukemia, past response to chemotherapy, availability of stem cells for replacement, your age and the status of the leukemia.
Learn more about Stem Cell Transplantation