Leukemia is a relatively rare disease in the US. Because of that, it’s critical that you have treatment from a cancer center that cares for hundreds of people with leukemia each year, where doctors and other caregivers have special expertise in the disease.
At Columbia Cancer, we take a multidisciplinary team approach, providing the most innovative treatments and the highest level of patient care. Our internationally known hematologists (those who study blood diseases), oncologists, and stem cell transplant specialists work together to design a treatment program tailored to your needs and wishes.
If you have leukemia, your treatment will depend on what type of the disease you have.
Treatment for Acute Leukemias
Acute myeloid leukemia and acute lymphocytic leukemia are treated quickly after you’ve been diagnosed. Our goal is to rid your body of leukemia cells and restore production of normal blood cells. Once you’re in remission, you will likely need more treatment to keep leukemia from returning. In some cases, you will have a stem cell transplant.
Treatment for ALL
If you have ALL, your treatment depends on the subtype, the number of blasts in your blood, whether abnormal chromosomes such as the Philadelphia chromosome are present, whether you’ve been treated for ALL before and how, and your general health.
You might have chemotherapy, targeted therapy against the Philadelphia chromosome, antibody therapy, radiation, stem cell transplant, or investigational treatments and therapy combinations.
Treatment for AML
If you have AML, your treatment depends on whether you have abnormal chromosomes or gene mutations, whether you’ve been treated for AML before and how, and your age and general health.
You might have chemotherapy, targeted therapy, antibody therapy, stem cell transplant, or investigational treatments and therapy combinations.
Treatment for Chronic Leukemias
Chronic myeloid leukemia (CML) is usually treated with medications taken in pill form.
Chronic lymphocytic leukemia (CLL) grows slowly. You might not need treatment until you have symptoms or if it interferes with normal blood cell production.
Treatment for CML
You won’t start treatment for CML until you have significant symptoms or your blood counts drop. Your treatment will depend on the disease’s stage, if you have abnormal chromosomes or gene mutations, your age, and your overall health.
If you have intermediate- or high-risk CML, you might have supportive care including blood transfusions, chemotherapy, targeted therapy, antibody therapy, stem cell transplant, or investigational treatments and therapy combinations.
Treatment for CLL
If you have CLL, your treatment depends on the phase of your disease (chronic, accelerated, or blastic), if you have additional abnormal chromosomes, whether you’ve had treatment for CML before and how, and your overall health.
- Chronic phase CML is treated with drugs that block the BCR-ABL protein involved in this disease, called tyrosine kinases. Which tyrosine kinase inhibitor you take depends on several factors, including prior treatment and individual side effects of each drug. You might also have a stem cell transplant.
- Accelerated phase CML is treated with TKI drugs, stem cell transplants, chemotherapy, and investigational treatments and therapy. combinations.
- Blastic phase CML is treated with stem cell transplants, chemotherapy, and investigational treatments and therapy combinations.
You might have supportive care that helps address leukemia symptoms. They include:
- Transfusions if you develop low red blood cells or platelets
- Antibiotics to fight infections related to a drop in white cell counts
- Growth factor injections to help your bone marrow make more healthy white and red blood cells
There are several different types of medications that can be given to treat leukemia.
Chemotherapy uses medications to stop cancer growth and spread and to prevent cancer from recurring by causing rapidly dividing cancer cells to become damaged and die.
Chemotherapy is “systemic” medicine—it interferes with all fast-dividing cells in your body. This action is why chemotherapy causes side effects like hair loss. You’ll either get chemotherapy through an IV in our infusion center, through a pill, or through the fluid in your spinal cord or surrounding your brain (intrathecally).
Your doctor will do tests like tumor molecular profiling to determine which drugs or drug combinations will best fight your disease with the lowest possible toxicity and side effects.
For leukemia, your doctor may also use chemotherapy to prepare your body for a stem cell (bone marrow) transplant.
Chemotherapy drugs are generally given in cycles, with a period of treatment followed by a period of rest.
Antibody therapy is also called passive immunotherapy because it doesn’t directly cause your immune system to respond to a disease. Instead, it uses a lab-made protein called an antibody that attaches itself to the cancer cells’ surface.
This protein makes the cancer cell more visible to your immune system. It can also block growth signals sent to cancer cells.
If the protein is cloned from a single cell in the lab, it’s called a monoclonal antibody. There are two kinds of antibody treatments:
Naked antibodies identify specific cancer cells and start an immune response.
Conjugated antibodies deliver radioactive isotopes or drugs directly to the cancer cells.
Antibody therapy often has milder side effects than chemotherapy because it targets specific parts of a cancer cell and leaves normal cells unharmed. You’ll usually have antibody therapy in our Infusion Center over several weeks. You’ll also usually have drugs to reduce common side effects before each infusion.
Scientists have developed new drugs to target genes, proteins, and the tissue environment that encourages cancer cells to grow. These are called targeted therapies.
Unlike chemotherapy, targeted therapy does not harm all the cells in your body. That’s why they may have fewer side effects.
Targeted therapy is often combined with regular chemotherapy or other medications to increase the chance that the cancer will respond and decrease the risk of it coming back.
Stem Cell Transplant
Leukemia is caused by a malfunction in the cells produced by your bone marrow. If you have ALL or AML, you might have a stem cell (bone marrow) transplant. This procedure is done less often for CLL and CML.
Stem cells are part of your bone marrow. They can become any type of blood cell your body needs—red blood cells, white blood cells, or platelet. A stem cell transplant regenerates your bone marrow’s ability to create healthy cells.
Many factors go into your decision to have a stem cell transplant. Your experienced care team will walk you through the pros and cons of this decision based on your specific situation.
Before you have the transplant procedure, you will have high-dose chemotherapy called the “conditioning regimen.” After the conditioning regimen, which wipes out your bone marrow, your noncancerous stem cells will be given back to you by infusion.
Stem cell transplants can have serious side effects, including graft versus host disease. Your care team is highly experienced in treating this illness and others. We’re also at the forefront of science to develop new therapies for this illness.
You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship for patients. Columbia Cancer offers clinical trials for leukemia. You can talk to your care team about whether a clinical trial is an option for you.