Leukemia

Treatment

The treatment of leukemia depends on the stage and spread of cancer cells However, a patient may be treated through the following methods:

• Chemotherapy: Chemotherapy is a treatment technique that uses drugs to kill cancerous cells. The drugs may be delivered through the mouth or as an intravenous injection. The drugs reach the site of cancer through blood; thus, the therapy effectively treats cancer in different parts of the body. Previously, chemotherapy was the mainstay of treatment for leukemia. However, with the introduction of newer effective therapies, chemotherapy is generally used in specific situations, such as when patients fail to respond to newer therapies or during stem cell transplants. The drugs may be used alone or in combination, based on the types of leukemia.
• Radiation therapy: Radiation therapy involves using high-energy radiation to kill cancer cells or delay their growth. Radiation therapy is not usually in patients with leukemia. It is applied only during special circumstances, such as the swollen spleen (to shrink the size of the spleen when it starts interfering with other organs). It is also a part of the stem cell transplantation process and relieves bone pain in patients in which the bone gets damaged due to cancerous cells in the bone marrow.
• Targeted therapy: Certain proteins and enzymes in the cancer cells play a vital role in the growth, division, and spread of cancer cells. Preventing the action of these proteins results in reducing or stopping the growth and division of cancer cells. An abnormal gene, BCR-ABL, is present in chronic myeloid leukemia cells. This gene is not present in healthy cells. The protein, BCR-ABL, synthesized by this gene results in the growth and division of chronic myeloid leukemia cells. Tyrosine kinase inhibitors inhibit the expression of BCR-ABL, thereby preventing the progression of chronic myeloid leukemia.
• Immunotherapy: Immunotherapy drugs enhance the capacity of immune cells to kill cancer cells. These drugs interfere with the process that assists the cancer cells in evading the damaging effect on the immune system.
• Bone marrow transplant: Bone marrow transplant is the process of transplanting bone marrow after removing the original bone marrow. The patients may be advised to undergo bone marrow transplant if the advanced therapies cannot avoid or slow down cancer progression. It is also used when the cancer is in the blast or accelerated phase. Two types of stem cell transplant are available, i.e., autologous stem cell transplant and allogeneic stem cell transplant.
• T-cell therapy: T-cell therapy is a proven treatment for certain types of leukemia. During the chimeric antigen receptor (CAR)-T cell therapy, the T-cells of the immune system are obtained, genetically engineered to fight against cancer cells, and infused into the body.
• Surgery: Surgery is sometimes used in patients with leukemia. If the patients have swollen spleen and its increased size interferes with the functioning of nearby organs, they are recommended to undergo splenectomy. It is usually used when radiation therapy and chemotherapy cannot shrink the spleen's size. Removing the hyperactive spleen may also improve blood counts and lower the requirement for blood transfusions.