Howes x's List: Treatments

• • Biological therapy. Biological therapy works by helping  your immune system recognize and attack leukemia cells.  
  • Targeted therapy. Targeted therapy uses drugs that attack  specific vulnerabilities within your cancer cells. For example, the drug  imatinib (Gleevec) stops the action of a protein within the leukemia cells of  people with chronic myelogenous leukemia. This can help control the disease.  
  • Radiation therapy. Radiation therapy uses X-rays or other  high-energy beams to damage leukemia cells and stop their growth. During  radiation therapy, you lie on a table while a large machine moves around you,  directing the radiation to precise points on your body. You may receive  radiation in one specific area of your body where there is a collection of  leukemia cells, or you may receive radiation over your whole body.  
  • Stem cell transplant. A stem cell transplant is a procedure  to replace your diseased bone marrow with healthy bone marrow. Before a stem  cell transplant, you receive high doses of chemotherapy or radiation therapy to  destroy your diseased bone marrow. Then you receive an infusion of blood-forming  stem cells that help to rebuild your bone marrow. You may receive stem cells  from a donor, or in some cases you may be able to use your own stem cells. A  stem cell transplant is very similar to a bone marrow transplant.

• Chemotherapy is the standard treatment for many types of leukemia. Even when a cure is  not possible, chemotherapy may help you live longer and feel better.
• Chemotherapy for leukemia is usually a combination of drugs. This is because  different drugs attack leukemia cells in different ways. The combination also  helps keep the leukemia cells from becoming resistant to any one drug. Other  drugs used to treat leukemia help prevent infection and help your body grow new  blood cells.
• Nausea  and vomiting are the most common side effects of chemotherapy for leukemia, and  the most feared. But having chemotherapy does not mean that you have to suffer  with nausea and vomiting. Your doctor may prescribe medicines  to control nausea and vomiting. There are also things you can do at home.

• Acute leukemia

   

  Different types of leukemia are best treated with different kinds of  medicine.

   
   
  • Acute  lymphoblastic leukemia (ALL) drugs include prednisone,  vincristine, daunorubicin,  L-asparaginase  or pegaspargase,  methotrexate,  and cyclophosphamide.  Imatinib (Gleevec) and  nelarabine  (Arranon) are  sometimes used to treat ALL. Dasatinib  (Sprycel) is  a newer drug for treating some ALL that has not improved with other drugs.  
  • Acute  myelogenous leukemia (AML) drugs include daunorubicin, idarubicin, cytosine arabinoside,  and mitoxantrone.⁹  Gemtuzumab (Mylotarg) may  be given to people whose AML has relapsed. It helps your body destroy cancer  cells.  
  • Acute  promyelocytic leukemia (APL) drugs include all-trans-retinoic acid (ATRA)  and chemotherapy with arsenic  trioxide, idarubicin, or  daunorubicin. ATRA helps control the risk of life-threatening bleeding from disseminated  intravascular coagulation (DIC). Later treatment can include ATRA with or  without methotrexate  and 6-mercaptopurine.  Or if a first round of ATRA and chemotherapy does not work, arsenic trioxide may  be used.⁹  
  • To treat leukemia in the brain or prevent it from spreading to the brain and  central nervous system, methotrexate  and cytarabine/cytosine  arabinoside are injected into the spinal canal. This is called  intrathecal chemotherapy.
   

  Supportive treatments during cancer treatment include:

   
   
  • Antibiotics and immunoglobulins  help to prevent or fight infections. This is important when you do not have  enough normal white blood cells to fight infections on your own.  
  • Transfusions of red blood cells and platelets.  
  • Epoetin and hematopoietic  stimulants help your body make new blood cells.  
  • Allopurinol  to prevent kidney problems and gout.  
  • Saline or steroid eyedrops for relief during treatment with cytarabine/cytosine  arabinoside.

• Chronic leukemia

   

  Treatments for chronic  lymphocytic leukemia (CLL) are usually given intravenously for limited  periods of time. If there is relapse, medicines are given again. For chronic  myelogenous leukemia (CML), medicine is usually taken by mouth for the rest  of your life. Treatment choices may include:

   
   
  • Chemotherapy for chronic leukemia can involve a single drug or a combination  of drugs. For example, you may be given a combination of cyclophosphamide,  vincristine, and prednisone.  Other drug choices include fludarabine, chlorambucil, hydroxyurea  (hydroxycarbamide), cytarabine, busulfan, rituximab, and alemtuzumab.  
  • Allopurinol  may be given to prevent kidney problems and gout.  
  • Dasatinib (Sprycel) blocks the growth of cancer cells. It can be used for  CML that has not been helped by imatinib or  other drugs.  
  • Imatinib  (Gleevec) blocks the growth of cancer cells. It is often given to people who  have CML. Nilotinib  (Tasigna) may  be given to people who cannot take imatinib.  
  • Immune globulin (IG)  helps prevent infections. It is sometimes used for people with chronic  lymphocytic leukemia (CLL), because CLL weakens the immune system. Bendamustine  hydrochloride (Treanda) is  sometimes given to slow the progression of CLL.

3 more annotations...

• How is it treated?

   

  What type of treatment you need will depend on many things, including what  kind of leukemia you have, how far along it is, and your age and overall  health.

   
   
  • If you have acute leukemia, you will need quick treatment to stop the  rapid growth of leukemia cells. In many cases, treatment makes acute leukemia go  into remission. Some doctors prefer the term "remission" to "cure," because  there is a chance the cancer could come back.  
  • If you have chronic lymphocytic leukemia, you may not need to be treated  until you have symptoms. But chronic myelogenous leukemia will probably be  treated right away. Chronic leukemia can rarely be cured, but treatment  can help control the disease.
   

  Treatments for leukemia include:

   
   
  • Chemotherapy, which uses  powerful medicines to kill cancer cells. This is the main treatment for most  types of leukemia.  
  • Radiation treatments.  Radiation therapy uses high-dose X-rays to destroy cancer cells and shrink  swollen lymph nodes or an enlarged spleen. It may also be used before a stem  cell transplant.  
  • Stem cell  transplant. Donated stem cells can rebuild your supply of normal blood cells  and boost your immune system. Before the transplant, radiation or chemotherapy  is used to destroy cells in bone marrow and make room for donated cells.  
  • Biological therapy.  This is the use of special medicines that improve your body's natural defenses  against cancer.