Treatment for Leukemia
Leukemia is not a single disease. Instead, the term leukemia refers to a number of related cancers that start in the blood-forming cells of the bone marrow. There are both acute and chronic forms of leukemia, each with many subtypes that vary in their response to treatment. In addition, children with leukemia have special needs that are best met by care in pediatric cancer centers. Such centers have trained medical professionals whose sole purpose is to address the unique concerns of children.
Leukemia treatment plans often are personalized and geared toward each individual patient. In general, there are five major approaches to the treatment of leukemia:
- chemotherapy to kill leukemia cells using strong anti-cancer drugs;
- interferon therapy to slow the reproduction of leukemia cells and promote the immune system's anti-leukemia activity;
- radiation therapy to kill cancer cells by exposure to high-energy radiation;
- stem cell transplantation (SCT) to enable treatment with high doses of chemotherapy and radiation therapy; and
- surgery to remove an enlarged spleen or to install a venous access device (large plastic tube) to give medications and withdraw blood samples.
Oncologists administer these treatments in a variety of combinations. Each method has its advantages and drawbacks. It usually is worthwhile to get a second opinion about treatment before entering into a specific program; in some instances, a second opinion may be required by the patient's insurance company. For example, stem cell transplantation (SCT) is very costly and entails a long stay in the hospital. Some insurance companies still consider this to be an "experimental" procedure and will not pay for SCT-related expenses.
The treatment of leukemia depends on a number of factors. The most important of these are the histopathologic (diseased tissue) type of leukemia, its stage, and certain prognostic features, such as the patient's age and overall health.
Interferons are a class of proteins that are released by virus-infected cells. They help normal cells to make antiviral proteins. Interferons also help the body to reduce leukemia cell proliferation (growth and reproduction), while strengthening the body's immune response.
Interferon-alpha (INFa) is a type of interferon that frequently is used to treat leukemia. In addition, based on an patient's response to INFa, a physician can better predict the anticipated length of survival.
Interferon-alpha can be given by a number of method—that is, by injection into a vein, into a muscle, or under the skin—although subcutaneous (under the skin) injection is the customary route. INF-a usually is offered to all newly diagnosed patients who are not candidates for stem cell transplantation. Often IFN-a is started at a low dose (e.g., 3 MIU daily), with gradual increases over time. Unfortunately, though, this drug is not without side effects. Possible IFN-related complaints include fevers, chills, muscle aches, bone pain, headaches, concentration difficulties, fatigue, nausea, vomiting, and general flu-like symptoms when starting the drug. Such symptoms usually last for 1 to 2 weeks, but may be lessened by drugs such as acetaminophen. Side effects recur if the INF-a dosage is increased, but they are temporary and usually improve after INF-a therapy is completed.