Leukemia Treatment: Chemotherapy to Bone Marrow Transplant

Any cancer diagnosis requires prompt medical attention from oncology specialists. Oncology is the branch of medicine that studies and treats cancer. Leukemia treatment may be guided by an oncologist, a hematologist
(a specialist in blood disorders), or by a specialist in radiation oncology. Pediatric oncology concentrates on treating children who have cancer.

A number of factors influence leukemia treatment, including age, the nature of the cancer and the progression of the disease. Acute forms, which are more common in children, are often treated successfully. The goal for such treatment is an eventual cure.

 

Chronic forms of the disease, on the other hand, are less likely to be cured. Instead, management of the disease and slowing the cancer's progression are the most common treatment options. Palliative care also helps to control symptoms.

The treatment of choice for most cases, acute or chronic, is chemotherapy. Chemotherapy drugs target rapidly growing cells and kill them. Chemotherapy is often used in combination with radiation therapy, or with a bone marrow transplant.

 

Because chemotherapy drugs affect the entire body, healthy cells with naturally high growth rates, such as hair follicles, are also damaged by the treatment. Side effects of this damage can include a lowered resistance to infection, increased bleeding, fatigue, temporary hair loss, nausea, vomiting and a lack of appetite, among others. Fertility may be affected by chemotherapy (although most children who undergo chemo grow into normally fertile adults).

Radiation therapy focuses beams of high-energy radiation at cancer cells, killing them. The beam is usually directed at specific body areas. However, a total body irradiation is often performed before stem cell or bone marrow transplants. Side effects from radiation therapy include fatigue, skin rashes, and dry, tender skin.

A stem cell or bone marrow transplant begins with intensive chemotherapy and/or radiation therapy. The therapy is given at levels that destroy not only abnormal cells, but also healthy blood cells in the bone marrow. Once this is done, stem cells are introduced into the body (usually through a vein in the neck or chest). The new stem cells then replicate and replace the destroyed cells.

 

A bone marrow transplant may use stem cells provided by a donor (allogeneic), or the patient may opt to freeze his or her own bone marrow stem cells for use (autologous). Donor cells may react negatively with the rest of the body. Other possible side effects include heightened risk of infection or bleeding difficulties until the new stem cells replace the old.

Monoclonal antibodies are a recent development in leukemia treatment, and are still undergoing investigation to determine their long-term effectiveness. The aim of monoclonal antibody therapy is to assist the body's own immune system in targeting and eradicating the disease.

 

Monoclonal antibodies are introduced into the patient's body, where the antibodies seek out leukemia cells and bind to them. The immune system then responds to the antibodies, destroying the cancer cells at the same time.

Palliative care provides symptom relief to patients in the last stages of leukemia. Although it is most often associated with symptom relief, palliative care also uses chemotherapy and other treatment options to slow the progression of the disease and extend life. People living with chronic forms of the cancer are more likely to require palliative care than people with acute leukemia.

 

CLL (chronic lymphocytic leukemia) progresses slowly, and tends to be a disease of the elderly. If diagnosed at an early stage, an oncologist may suggest watchful waiting. Essentially, this means symptoms are monitored, and treatment is only begun when symptoms begin to interfere with quality of life.