While standard protocols have been established for the treatment of virtually all cancers, physicians will often modify them for their individual patients. These modifications are based on many factors including the patient’s age, general health, desired results, and the specific characteristics of his or her cancer. Since the treatments described in this report represent the standard therapeutic approaches, your physician may not strictly adhere to them.
Treatment will depend on the type of leukemia you have, the cells’ characteristics, the extent of disease, past treatments, your symptoms, and your overall health. Several therapies may be used in combination.
The goal of treatment for acute leukemia is to destroy all evidence of the disease, with blood and bone marrow returning to normal. The main method of treatment is chemotherapy.
Acute leukemia requires immediate medical care. The traditional stages of treatment for acute leukemia are:
Induction – the goal being complete remission
Consolidative treatment, including possible bone marrow transplantation
One complication associated with ALL treatment is the development of new cancers later in the life (as opposed to a recurrence of the original ALL). In a recent study, researchers followed 2,169 children and adolescents who had achieved complete remission after treatment for ALL. They found that almost 11% of these patients developed secondary cancers of various types over a period of 30 years. This is substantially higher the rate of similar cancers in the general population. It is critical, therefore, that young patients successfully treated for ALL are closely monitored throughout their adult lives for an increased risk of cancer.
Chronic leukemia is rarely curable; chronic leukemias can be treated and even enter remission, but a long-term cure is rare. Drug and biologic therapy may be very effective in controlling the disease for periods of time; however, therapy aims to control symptoms and slow progression of the disease.
Your doctor may suggest holding off the start of treatment and watching for changes; this is called watchful waiting. Watchful waiting does not appear to increase the mortality rate in people who have been diagnosed with a chronic form of leukemia, although there is evidence that bone marrow transplantation for chronic myelogenous leukemia (CML) is more effective when done within the first year after diagnosis. Thus, careful decisions regarding the best long-term plan for treatment of CML in particular should be made early on, even if observation is ultimately the first choice.
When therapy is done, it usually involves chemotherapy, targeted drug therapy (Gleevec), and biologic therapy.
Existing treatment protocols have been established and continue to be modified through clinical trials. These research studies are essential for determining whether or not new treatments are both safe and effective. Since highly effective treatments for many cancers remain unknown, numerous clinical trials are always underway around the world. You may wish to ask your doctor if you should consider participating in a clinical trial. You can find out about clinical trials at the government website
Cecil Textbook of Medicine
. 21st ed. St. Louis, MO: W.B. Saunders Company; 2000: 944-958.
Conn's Current Therapy
. 54th ed. St. Louis, MO: W.B. Saunders Company; 2002: 413-434.
Bast R, Gansler TS, Holland JF, Frei E.
Cancer Medicine e. 5
. Hamilton, Ontario: B.C. Decker Inc.; 2000
Updated Acute Leukemia section on 3/29/2007 according to the following study, as cited by
DynaMed's Systematic Literature Surveillance
: Hijiya N, Hudsdon MM, Lensing S, et al. Cumulative incidence of secondary neoplasms as a first event after childhood acute lymphoblastic leukemia. JAMA. 2007 Mar 21;297(11):1207-1215.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a