Leukemia Treatment Options
While a leukemia diagnosis can certainly be scary, the good news is that there are many treatment options available— all of which are offered by the leukemia program at Rocky Mountain Cancer Centers (RMCC). You can be confident that our multidisciplinary team of leukemia experts— hematologists, medical oncologists, radiation oncologists, oncology nurses, and registered dietitians— will answer your questions and recommend treatment options based on your unique diagnosis and needs.
Before making a decision on treatment, your RMCC oncologist will take certain factors into consideration including:
- The type of leukemia (acute or chronic)
- Your age
- Whether leukemia cells were found in your cerebrospinal fluid
It also may depend on certain features of the leukemia cells. Your RMCC oncologist also considers your symptoms and general health.
Depending on what type of leukemia you have, you may or may not need treatment right away. Acute (fast-growing) leukemia needs to be treated right away, while treatment for chronic leukemia (slow-growing) can sometimes wait.
Your doctor can describe your treatment choices, the expected results, and the possible side effects. Together, you can work toward developing a treatment plan that meets your medical and personal needs.
People with chronic lymphocytic leukemia who do not have symptoms may be able to put off having cancer treatment. By delaying treatment, they can avoid the side effects of treatment until they have symptoms.
If you and your doctor agree that watchful waiting is a good idea, you’ll have regular checkups (such as every 3 months). You can start treatment if symptoms occur.
Although watchful waiting avoids or delays the side effects of cancer treatment, this choice has risks. It may reduce the chance to control leukemia before it gets worse.
You may decide against watchful waiting if you don’t want to live with untreated leukemia. Some people choose to treat the cancer right away.
If you choose watchful waiting but grow concerned later, you should discuss your feelings with your doctor. A different approach is nearly always available.
Many people with leukemia are treated with chemotherapy. Chemotherapy uses drugs to destroy leukemia cells.
Depending on the type of leukemia, you may receive a single drug or a combination of two or more drugs. You may receive chemotherapy in several different ways:
- By mouth: Some drugs are pills that you can swallow.
- Into a vein (IV): The drug is given through a needle or tube inserted into a vein.
- Through a catheter (a thin, flexible tube): The tube is placed in a large vein, often in the upper chest, which is useful for patients who need many IV treatments. The health care professional injects drugs into the catheter, rather than directly into a vein. This method avoids the need for many injections, which can cause discomfort and injure the veins and skin.
- Into the cerebrospinal fluid: If the pathologist finds leukemia cells in the fluid that fills the spaces in and around the brain and spinal cord, the doctor may order intrathecal chemotherapy. The doctor injects drugs directly into the cerebrospinal fluid in one of two ways:
- Into the spinal fluid: The doctor injects the drugs into the spinal fluid.
- Under the scalp: Children and some adult patients receive chemotherapy through a special catheter called an Ommaya reservoir. The doctor places the catheter under the scalp and then injects the drugs into the catheter. This method avoids the pain of injections into the spinal fluid.
Intrathecal chemotherapy is used because many drugs given by IV or taken by mouth can’t pass through the tightly packed blood vessel walls found in the brain and spinal cord. This network of blood vessels is known as the blood-brain barrier.
Usually, chemotherapy is given in cycles. Each cycle has a treatment period followed by a rest period.
When it comes to where you have your treatment, there are options. You may have your treatment in a clinic, at the doctor’s office, or at home. However, some people may need to stay in the hospital for treatment.
People with chronic myeloid leukemia and some with acute lymphoblastic leukemia may receive drugs called targeted therapy. Imatinib (Gleevec) tablets were the first targeted therapy approved for chronic myeloid leukemia, however, there are now other targeted therapy drugs that are also used.
Targeted therapies use drugs that block the growth of leukemia cells. For example, a targeted therapy drug may block the action of an abnormal protein that stimulates the growth of leukemia cells.
Some people with leukemia receive drugs called biological therapy or immunotherapy. Biological therapy for leukemia is a treatment that improves the body’s natural defenses against the disease.
One type of biological therapy is a substance called a monoclonal antibody, which is given by IV infusion. This substance binds to the leukemia cells, killing them or helping the immune system destroy them.
For some people with chronic myeloid leukemia, biological therapy is a drug called interferon, which is injected under the skin or into a muscle. It can slow the growth of leukemia cells.
Depending on your particular situation, you may have your treatment in a clinic, at the doctor’s office, or in the hospital. Your oncologist may also administer other drugs at the same time to prevent side effects.
Bone Marrow Transplants
Bone marrow transplants are most often used to help people with leukemia and lymphoma. In leukemia, the bone marrow transplant may work against the blood cancer directly. This happens because of an effect called graft-versus-tumor that can occur after allogeneic transplants.
Graft-versus-tumor occurs when white blood cells from your donor (the graft) attack any cancer cells that remain in your body (the tumor) after high-dose treatments. This effect improves the success of the treatments.
Leukemia Clinical Trials
At Rocky Mountain Cancer Centers, advancing cancer care through research and innovation is part of our commitment to our patients. As part of the national US Oncology network, we are able to provide access to the latest therapies available through clinical trials.
If taking part in a clinical trial is something that interests you, talk with your specialist to see if you fit the criteria. Search clinical trials for leukemia.