Treatment
How is leukemia treated?
Before leukemia can be treated, its type has to be identified. A simple full blood count reveals signs of cancer in the blood, and the diagnosis follows from the rise in the cancer cells known as blasts.
A biopsy taken from the bone marrow shows whether the marrow itself is involved. What matters for treatment is identifying the subtype of the leukemia, because the treatment method changes with it.
Chemotherapy is the first method that comes to mind in treating leukemia. Chemotherapy drugs are chemical medicines that destroy the cancer cells causing the disease. The type, dose and route of the drugs used all vary with the type of leukemia.
Radiotherapy (radiation treatment) uses high-energy beams to damage leukemia cells and stop them growing. Radiation can be applied to a single part of the body or to all of it, and it is also used in preparation for a stem cell transplant.
Biological agents and immunotherapy drugs are used in these patients to help the person's own immune system recognise cancer cells. Defence cells that detect malignant cells more readily thanks to these drugs then help clear the cancer cells away.
Bone marrow transplant
As is generally accepted, one of the most effective treatments for leukemia patients is bone marrow transplantation . In this method, also known as stem cell transplantation, the patient's own healthy marrow can be used, or a first transplant can be carried out from a tissue-matched sibling, close relative or donor.
The aim of a bone marrow transplant is to replace the person's diseased marrow with healthy marrow. Before the procedure the patient is given high-dose chemotherapy and radiotherapy so that the diseased marrow is removed completely. Blood-forming stem cells are then infused with the aim of rebuilding healthy marrow. A bone marrow transplant is considered one of the major medical procedures, and in a first-time recipient it can cause side effects such as a sudden drop in blood pressure, headache, nausea, vomiting, pain, shortness of breath, fever and chills. More serious side effects also exist; whether they appear depends on the person's age, general health, the condition being treated and the type of transplantation.
GVHD (graft-versus-host disease) describes an important condition in which the donor's blood cells attack the cells in the recipient's body. Beyond GVHD, transplant rejection, damage to internal organs and bleeding are among the serious side effects that can follow a transplant. Treatment planning for leukemia is carried out by haematology-oncology specialists. Choosing an oncology hospital and planning treatment can vary with both the type of leukemia and factors specific to the patient. Giving supportive treatment alongside the drugs during chemotherapy matters a great deal, especially in acute leukemia. Because chemotherapy also affects the patient's normal blood cells, it increases susceptibility to infections, bleeding and anaemia. For this reason antibiotics and, where needed, transfusions of blood and other blood products may be given alongside chemotherapy.
Alongside antibiotics, antifungal treatment and antiemetic drugs for nausea are among the medicines doctors may prescribe when required. In CML patients, tyrosine kinase inhibitors containing imatinib act against the mutated gene and its products, and have given rise to a revolutionary treatment plan. Another important feature of these drugs is that they cause fewer side effects than chemotherapy.
Do not ignore the symptoms: the role of early diagnosis
Acute and chronic leukemias cover many kinds of blood disease and involve complex stages of diagnosis and treatment. Because treatment is more effective the earlier the diagnosis is made, becoming informed about these conditions matters. Even though mortality has fallen and survival has risen over the years in the light of new methods, leukemia remains among the conditions that demand attention, because it is life-threatening.
In 1975 the five-year cancer survival rate for people with leukemia was around 30%; today it is above 60%. The single biggest reason is awareness and early diagnosis. So if you notice symptoms of leukemia in yourself or in the people around you, do not put off going to the nearest health facility and seeking help from a specialist.