The treatment process which you may have to undergo will depend on a number of factors like your age, health, medical history , type of leukemia stage of leukemia etc.
Here is a list of some common methods of treatment used to treat leukemia .
Chemotherapy
The most commonly used method to treat leukemia is chemotherapy. The method requires the use of drugs to kill cancerous cells. You may receive a single drug or combination of drugs depending on the type of leukemia.
These drugs can be taken in the form of pills or can be directly injected in the veins. Since there are side-effects associated with these drugs, they are given in cycles with rest periods in between.
In some cases, the drugs are directly injected in the cerebrospinal fluid. This process is known as intrathecal chemotherapy. It is given to prevent cancer from spreading to the brain or spinal cord. It is also a recommended treatment when the cancer has already affected the brain and spinal cord.
To prevent injections into the cerebrospinal fluid, a special catheter known as Ommaya reservoir is placed under the scalp of the patient.
Chemotherapy is an effective and preferred form of treatment for various types of cancers, but it also has severe side effects. The common side effects include loss is hair, nausea, vomiting, mouth sores, loss of appetite, fatigue, easy bruising and bleeding, etc. Increased affinity to infections may also occur due to destruction of a large number of WBCs by the drugs.
In some cases, chemotherapy may cause damage to ovaries and testes of patients and cause infertility. Children undergoing treatment via chemotherapy may grow up to become infertile adults.
Biological therapy
Biological therapy includes treatment through substances which are naturally produced in the body of living organisms or their synthetic forms developed in labs. By using these substances, the immune system of your body can be enabled to identify and attack cancerous cells.
Substances used in biological therapy can include antibodies, tumour cells, cytokinesis (substances produced by your body to control the immune system). Monoclonal antibodies like alemtuzumab are antibodies which react against a specific target are used to cure various types of cancer including leukemia.
They react against the CD52 antigen, a protein found inside the B-cell chronic lymphocytic leukemia cells.
One advantage of using biological therapy over chemotherapy is that the side effects of the latter are less severe. The side effects may include rash or swelling at the site of injection for IV infusions of the therapeutic agents, headache, muscle aches, fever, or tiredness.
Targeted therapy
Targeted therapy is a method of treating cancer in which the drugs used do not kill cancerous cells but interfere with their functionalities. It results in lesser damage to normal cells than in the case of chemotherapy. For example, the drugs may block the cells ability to grow rather than killing them.
Drugs used in Targeted therapy are also known as molecularly targeted drugs and precision medicines.Treatment through Monoclonal antibodies (that we discussed earlier) is also considered as targeted therapy.
Imatinib and dasatinib are two substances that may be used to treat ALL and CML. these cells attack the cancer-promoting protein formed by the BCR-ABL gene translocation.
Like the previous two treatment methods, drugs are given either orally or injected. The side effects of this method include nausea, vomiting, diarrhoea, muscle cramps, or rash.
Radiation Therapy
Radiation therapy is delivered through passing high energy beams through affected parts of the body. This method is adopted during treatment of leukemia if cancer has spread to the brain, spleen, and other areas.
Just like other treatment methods, radiation therapy also has some side effects. If radiation therapy is given to your stomach, you may suffer from nausea, vomiting, and diarrhoea. Radiation therapy also makes the skin in the affected region red, dry and tender. Fatigue is a very common symptom of this method.
Stem Cell Transplant
In this treatment procedure, the patient’s white blood cells and bone marrow are destroyed by giving high doses of chemotherapy or radiation. Then a transplant of stem cells is done through intravenous infusion which travels to the bone marrow and starts producing normal blood cells. The transplanted stem cells come from a donor.
Autologous stem cell transplant is a process in which a patient’s stem cells are removed and treated to eliminate leukemia cells. The healthy stem cells are then returned back to the bone marrow.
Allogeneic stem cell transplant is a process in which healthy stem cells are transplanted from a donor’s body.
Syngeneic stem cell transplant is a process in which the stem cells are transplanted from a healthy identical twin of the patient.
Stem cells may be removed it harvested in different ways. The cells can be taken out from the blood or harvested from the bone marrow or blood in the umbilical cord.
Stem cell transplant is a risky process, therefore the person undergoing treatment is required to stay in the hospital for several days for better monitoring. After the procedure, infection and bleeding may occur due to a shortage of necessary blood cells. The recipient may suffer from a disease called graft-versus-host disease or GVHD. In this disease, the donor’s white blood cells attack the patient’s normal cells. GVHD generally affects the liver, skin and digestive tract. It can occur at any time after the transplant, even several years after the process. Steroids and medications which suppress the immune system are used to give relief to the patient suffering from GVHD.
Chimeric Antigen Receptor (CAR) T-cell treatment
Chimeric antigen receptor (CAR) T-cell treatment is an innovative treatment for leukemia. It received approval from the U.S. FDA in 2018. It is used for treating patients up to the age of 25 years who suffer from B-cell lymphomas that have either relapsed or are refractory to treatment. It is also used in certain other types of leukemia.
It is also available in various clinical trials. This treatment has a potentially serious side effects. The side effects may include mild flu, fast heart rate, low blood pressure, nerve damage, suppressed immune system and a condition known as tumour lysis syndrome which is a result of rapid destruction of cancer cells.
Since this process is very new, the patients who have undergone treatment have not been followed over a long time.
Supportive Treatments
Treatment procedures have some harmful side effects. Many side effects result from the depletion of normal blood cells. So to minimise the unpleasant experiences, doctors also provide supportive treatment to patients.
There are a number of supportive and preventive treatments which may be provided to you if you are undergoing treatment for leukemia.
- Vaccines against flu or pneumonia
- Blood or platelet transfusions
- Anti-nausea medications
- Antibiotics or antiviral medications to treat or prevent infections
- White blood cells growth factors to promote the growth of white blood cells.
- Red blood cells growth factors
- Intravenous injections of immunoglobulins to help fight infections
Now imagine how costly it can get if you need to undergo the imaging tests + biopsy + surgery + chemo therapy or radiation therapy for 6 months.
Cost of Treatment of Leukemia
Cost of treatment of leukemia can be very high. Chemotherapy, radiation therapy, or any other form of therapy can last for several years. Treatment procedures also involve treating various symptoms of leukemia. Hence, the cost rapidly escalates.
With the help of our treatment cost calculator, you can find out the approximate cost of your cancer treatment.
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Complications of Leukemia
Most of the complications related to leukemia arise due to depletion of normal blood cells like GVHD, bleeding, frequent infections, weight loss, and anaemia, etc. Complications also include relapse or a progression of the disease after its remission through treatment.
There are some complications which are related to specific types of leukemia. In a few cases of CLL, the cells transform into aggressive lymphoma through a process known as Richter transformation. People who have suffered from CLL the past are at a much higher risk to develop cancer again or other types of blood-related disorders and blood cancers.
Another complication known as tumour lysis syndrome occurs in patients undergoing acute treatment. The quick destruction of a large number of leukemia cells results in a large amount of phosphate accumulation in the body which causes problems in metabolism and even kidney failure.
Children undergoing treatment for leukemia may suffer from suffering effects like impairment of central nervous system, stunted growth, infertility, cataracts, increased risk of cancers, etc.
What is the Prognosis of Leukemia?
The prognosis of leukemia depends on various factors like age, health, and type of leukemia the patient is suffering from. It has been observed that the mortality rate is higher in elderlies when compared to adults and children. The five-year survival rate is highest among children. A study on five-year survival rates for different kinds of leukemia for a period from 2007-2013 gave the following result:
CML – 68%
CLL – 86%
AML – 27% overall while it was 66% for children and teens younger than 15
ALL – 71% overall while it was 90% for children
How Often Does Leukemia Recur?
In chronic forms of leukemia like CML, recurrence is common. The likelihood of any type of leukemia depends upon the type including specific molecular attributes of cancerous cells and the patient’s response to the initial treatment.