Leukemia

Treatment

Stem Cell Transplantation
It is the method of replacing immature blood-forming cells that were destroyed by cancer treatment. A stem cell transplant allows a patient to be treated with high doses of drugs, radiation, or both. The high doses destroy both leukemia cells and normal blood cells in the bone marrow. Later, the patient receives healthy stem cells through a flexible tube that is placed in a large vein in the neck or chest area. New blood cells develop from the transplanted stem cells.

Bone marrow transplantation, peripheral stem cell transplantation and umbilical cord blood transplantation are the three types of transplantation. Bone marrow transplantation is the procedure of replacing bone marrow and peripheral stem cell transplantation is the method of replacing blood-forming cells. In umbilical cord blood transplantation, umbilical cord blood from a newborn baby which contain high concentrations of stem cells needed to produce new blood cells, is injected to restore an individual's own blood production system suppressed by anticancer drugs, radiation therapy or both.

Transplantation may be autologous, allogeneic or syngeneic.

Autologous stem cell transplantation - Patients own stem cells are used in this transplantation. The stem cells are removed and treated outside the body to kill any leukemia cells. It is then frozen and stored. These stored cells are returned to the patient, after receiving high dose chemotherapy or radiotherapy.
Allogeneic stem cell transplantation - In this transplantation the healthy stem cells come from a donor. Blood test is done to make sure that the donor's cells match the patient's cells.
Syngeneic stem cell transplantation - This type of transplant uses stem cells from the patient's healthy identical twin.

Patients who have a stem cell transplant usually stay in the hospital for several weeks. Until the transplanted stem cells begins to produce enough white blood cells, patients have to be carefully protected from infection.

Side Effects : SPatients who have a stem cell transplantation face an increased risk of infection, bleeding, and other side effects of the large doses of chemotherapy and radiation they receive. In addition, graft- versus-host disease (GVHD) may occur in patients who receive bone marrow from a donor. In GVHD, the donated marrow reacts against the patient's tissues (most often the liver, the skin, and the digestive tract). GVHD can be mild or very severe. It can occur any time after the transplant (even years later). Drugs may be given to reduce the risk of GVHD and to treat the problem if it occurs.

Biological Therapy
Biological therapy involves treatment with substances that affect the immune system's response to cancer. This type of treatment improves the body's natural defenses against cancer. The therapy is given by injection into a vein.

Biological therapies like interferon and monoclonal antibody are used in chronic myeloid leukemia and chronic lymphocytic leukemia respectively. These naturally occurring compounds are directly inserted through a catheter to slow the growth of leukemia cells.

Side Effects : The side effects of biological therapy differ with the types of substances used and from patient to patient. Rashes or swelling where the biological therapy is injected are common. Flu-like symptoms also may occur.

The goal of treatment is to bring about a remission. Remission means a decrease in or disappearance of signs and symptoms of cancer. In partial remission, some signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer may still be in the body.

After Treatment
Leukemia and its treatment can lead to other health problems. Because leukemia patients develop infections very easily, they may receive antibiotics and other drugs to help protect them from infections. They are often advised to stay out of crowds and away from people with colds and other infectious diseases. If an infection develops, it can be serious and should be treated promptly. Dental care also is very important.

Regular follow-up exams are very important after treatment for leukemia. Patients should continue to have regular checkups and should also report health changes or problems to their physician. Checkups usually include careful physical exam, blood tests, x-rays, bone marrow aspiration, or spinal tap.

Avoiding risk factors such as smoking, exposure to toxic chemicals, and exposure to radiation may help prevent leukemia.

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