Knowing the different types of leukemia treatment

Leukemia is a cancer of the blood cells and bone marrow, but most often a cancer of the white blood cells. 

There are about 400,000 people currently living with or in remission from leukemia in the United States, and in 2023 there will be around 60,000 new cases.

Leukemia’s classification depends on how fast and in which cell type it grows. There are four main types of leukemia, and treatment will vary according to diagnosis:

• acute myeloid leukemia (AML)
• chronic myeloid leukemia (CML)
• acute lymphocytic leukemia (ALL)
• chronic lymphocytic leukemia (CLL)

Treatment options include drugs, therapies, and surgeries.

Types of leukemia treatment

Your treatment for leukemia depends on several factors, such as your type of leukemia, age, and genetics. 

The main treatment for leukemia is chemotherapy, which can be combined with other types of therapies and procedures, including:

• chemotherapy
• bone marrow transplant
• immunotherapy
• radiation therapy 
• splenectomy or removal of the spleen

Chemotherapy for leukemia

Doctors may recommend chemotherapy drugs as they can treat all four major types of leukemia.

Chemotherapy works by killing cancerous cells and can come as pills, capsules, or liquid, including:

• vincristine or liposomal vincristine (Marqibo)
• daunorubicin or daunomycin (Cerubidin)
• doxorubicin (Doxil)
• cytarabine (Ara-C)
• asparaginase or l-asparaginase (Elspar)
• mercaptopurine (Purinethol or Purixan)
• methotrexate (Trexall)
• cyclophosphamide (Cytoxan)
• nelarabine (Arranon)

Due to the strength of these medication types, they can also damage healthy cells and cause side effects, such as hair loss, lack of appetite, fatigue, and diarrhea.  

Dexamethasone

Dexamethasone is a steroid commonly given with chemotherapy to reduce possible allergic reactions to chemotherapy drugs. 

Doctors can give dexamethasone sodium phosphate by injection into your veins or muscle, and it is common in palliative care. Some of the brand names include:

• Mas Care-Pak 
• Readysharp dexamethasone
• Dexonto 0.4%

Your doctor may also prescribe dexamethasone tablets, with varying doses depending on your specific treatment plan. These may include:

• a 10-day dose of dexamethasone 1.5 milligrams (mg)
• a 6-day dose of dexamethasone 1.5 mg (Dexpak)

Prednisolone

Prednisolone is another steroid given in conjunction with chemotherapy drugs to help limit possible allergic reactions. Some of the brand names for prednisolone oral tablets include:

• Millipred
• Orapred Odt
• Pediapred
• prednisolone anhydrous

Methylprednisolone 

Methylprednisolone belongs to a class of drugs known as glucocorticoids. Methylprednisolone (Depo-medrol) helps reduce inflammation and commonly treats and manages leukemia. 

This medication is available in the form of a tablet or an injection.

Hydrocortisone

Hydrocortisone (Cortef) is an injectable corticosteroid that reduces inflammation and possible allergic reactions. 

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Bone marrow transplant

The bone marrow produces red blood cells, white blood cells, and platelets. As leukemia can affect how the bone marrow produces blood cells, a bone marrow transplant may help in the treatment of leukemia.

After a bone marrow transplant, you will get healthy stem cells from a donor. This procedure replaces unhealthy stem cells with healthy ones and can help eliminate leukemia cells.  

Immunotherapy

Immunotherapy works by using medicines to help your body’s own immune system recognize and destroy cancerous cells.

Some immunotherapies used to treat leukemia include:

• monoclonal antibodies
• CAR T-cell therapy
• interferon therapy

Radiation therapy

Radiation therapy uses high energy radiation to target and eliminate cancerous cells’ DNA. This stops leukemia cells from growing.

Your doctor will consider several factors before recommending radiation therapy to treat leukemia, including overall health and age.

Splenectomy 

Some people with CLL have leukemia cells gathering in their spleen. This can cause the spleen to enlarge, which can then lower your blood cell count.

In some cases, doctors may consider a splenectomy or removal of the spleen. 

Diagnosis 

An accurate diagnosis is key to finding the right treatment option. To diagnose leukemia, your doctor may usually:

• perform a physical exam 
• look into your medical history
• order blood tests, such as a complete blood count (CBC) and a peripheral blood smear
• arrange for a bone marrow biopsy
• order genetic and imaging tests
• arrange for a lymph node biopsy

Looking after your mental health

Receiving a leukemia diagnosis can be difficult for you and your loved ones, so allowing some space to think is important.

While your doctor and healthcare team can help you find and follow the best treatment plan, they should also provide information to help you come to terms with the diagnosis.

Remember that you’re not alone — your loved ones, healthcare team, and different resources are there to help you, and you can find information, resources, and support through the following organizations:

• Lymphoma and Leukemia Society (LLS)
• American Cancer Society (ACS)
• CancerCare

Summary

Leukemia is a cancer that mostly affects white blood cells. There are four main types of leukemia — each differs depending on how fast the cancerous cells grow and which type of cells grow.

Doctors may prescribe several treatment options depending on the leukemia type. These treatment options include chemotherapy, radiation therapy, and immunotherapy.

If you are diagnosed with leukemia, know that you’re not alone. Many helpful resources are available online and through your doctor and healthcare team for you and your loved ones.

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