Leukemia is a malignant blood disorder that develops in bone marrow, blood and other tissues.
The types of leukemia are named after the specific blood cell that becomes cancerous, such as the lymphocytic cells (white blood cells) or the myeloid cells (bone marrow cells).
There are four main types of leukemia in adults each with many subtypes:
Acute lymphocytic leukemia (ALL)
Chronic lymphocytic leukemia (CLL)
Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML)
A Marshfield Clinic Cancer Specialist will work with you to determine the best possible treatments based on your type of leukemia.
Chemotherapy drugs interfere with the growth of cancer cells, eventually causing the cells to die.
Most patients are treated with more than one drug at the same time.
Radiation therapy may be recommended for patients with ALL to prevent or treat Leukemia in the lining of the spinal cord and brain (central nervous system).
Radiation therapy uses high-energy X-rays to kill cancer cells.
In certain circumstances use of higher doses of chemotherapy or radiation therapy may be used to treat leukemia.
Because radiation therapy and chemotherapy destroy stem cells when they eradicate cancer cells, stem cell transplantation may be used to rebuild a patient's supply of those cells.
In stem cell transplantation, before a patient begins radiation or chemotherapy doctors give the patient a medication to increase the number of stem cells in the blood, and then collect stem cells, a process called apheresis.
After the stem cells are removed, the blood is returned to the body. There are two forms of transplantation:
Allogeneic stem cell transplants refer to stem cells that are taken from one person and given to another.
With these transplants, the donor's cells must match the recipient's. In many cases, the stem cell donor is related to the recipient, typically a brother or sister.
However, stem cells from unrelated donors can be used if the tissue types matches.
It may also be possible to use cells from banked cord blood.
Allogeneic stem cell transplantation is most commonly used for acute leukemia.
Autologous stem cell transplants are performed when high doses of chemotherapy are used to treat cancer.
The chemo drugs can destroy the patient's bone marrow, so some stem cells are taken from the blood stream (apheresis) prior to treatment when the patient is in remission.
The stem cells are frozen and the patient is given high-dose chemotherapy (with or without radiation) to treat the leukemia.
The stem cells are then thawed and given back through a catheter to replace what was destroyed.
Monoclonal antibodies (specifically for CLL):
Monoclonal antibodies are laboratory-made drugs that find and attach to specific places (proteins) on the surface of cancer cells.
When they attach, they stop the protein from doing its job, such as making cancer cells grow. Monoclonal antibodies can be used alone or in combination with other therapies.
Rituximab is an example of a monoclonal antibody commonly used to treat chronic lymphocytic leukemia (CLL).
Targeted therapies (specifically for CML):
This term describes drugs that target various proteins that contribute to the growth of cancer.
Unlike chemotherapy drugs that kill both healthy and cancer cells, targeted therapies selectively kill only cancer cells, which decrease side effects.
Imatinib (Gleevec) is an example of targeted therapy used to treat chronic myeloid leukemia (CML).