How is leukemia treated?

Treatment varies with the type and stage of the disease. For acute leukemia, the immediate goal of treatment is remission, which means no more cancerous cells can be detected and the bone marrow appears normal. The patient undergoes aggressive chemotherapy (the use of drugs to kill cancer cells) in a hospital for about 4 weeks. Since acute leukemia patients have extremely low counts of healthy blood cells, they usually are given transfusions of red blood cells and platelets. They also receive drugs to fight infection, and to reduce nausea and vomiting that may occur as side effects of the chemotherapy.

  • Acute lymphocytic leukemia: People with ALL are likely to attain satisfactory remission after several weeks of aggressive chemotherapy. To keep the disease under control, they will continue receiving low-dose chemotherapy and possibly radiation therapy (use of radiation to kill cancer cells) for a month or more to eliminate remaining traces of cancer. At home, they will receive an on-and-off maintenance treatment for months or years.
  • Acute myelogenous leukemia: Several chemotherapy drugs are effectively used to treat AML. However, it has been found that the genetic makeup of the abnormal leukemia cells can vary. Treatment can be suited to a particular patient based on the analysis of genetic makeup. If the disease is resistant to treatment, the best chance of a lasting remission or cure depends on successful bone marrow transplantation.
  • Chronic lymphocytic leukemia: CLL generally affects older people and progresses slowly. Conventional treatment tends to be conservative. As long as symptoms are absent, the disease requires no treatment. If swelling appears in lymph nodes and other organs, CLL usually can be controlled for years with chemotherapy. Many people with CLL lead basically normal lives and die of unrelated causes.
  • Chronic myelogenous leukemia: Modern treatment has essentially cured CML although the medicine, in the form of pills, usually needs to be taken forever. Cure is possible even for those patients for whom the pills fail with bone marrow transplantation.

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