How is leukemia Treated?

Treatment usually begins by addressing the signs and symptoms your child has such as anemia, bleeding and/or infection. In addition, treatment for leukemia may include some or all of the following:

• Chemotherapy
• Intrathecal medications/chemotherapy
• Blood and marrow transplantation
• Biological therapy medications
• Blood transfusions
• Antibiotics

Chemotherapy refers to medicines that help fight cancer. They are given by mouth, in the vein, in the muscle or under the skin. Intrathecal chemotherapy is chemotherapy that is injected into the spinal fluid to prevent or treat leukemia in the brain and spinal cord.

Intrathecal medications/chemotherapy involves inserting medications through a needle into the fluid-filled space surrounding the spinal cord.

Radiation therapy uses high-energy waves such as x-rays to kill or shrink cancer cells. It is sometimes used to treat leukemia in the central nervous system or other places such as the eye or the testes.

Blood and marrow transplantation consists of three steps: 1) collection of healthy stem cells from a donor without cancer or from the patient himself or herself; 2) administration of high doses of chemotherapy and possibly radiation therapy to kill any remaining leukemia cells; and 3) infusion of the healthy stem cells through an intravenous line to produce normal blood-forming cells. Bone marrow or stem cell transplantation is commonly used to treat  Acute Lymphocytic Leukemia (ALL) that has not responded to chemotherapy.

Biological therapy consists of high doses of hormones or other proteins that are normally made by the human body; pharmaceutical companies make these substances. They are used to prevent or treat damage to other systems of the body caused by leukemia treatment.

Blood transfusions are sometimes used for patients who have anemia who cannot make their own red blood cells. Platelets are commonly transfused when platelet counts are low. White blood cells are occasionally transfused to treat severe infections that do not respond to antibiotics. Plasma, the fluid part of blood in which the blood cells are suspended, is transfused in patients who are not able to make the proteins that clot the blood.

Antibiotics. Antibiotics are used to prevent or treat infections.

Treatment stages:

Treatment of leukemia takes months or years and takes place in three or more stages, as described below.

Induction. Induction refers to the first month or so of treatment in which a combination of chemotherapeutic drugs is given to reduce the numbers of leukemia cells from billions to millions. The goal in this stage of treatment is to reduce the number of leukemia cells in the marrow to less than 1 in 20 (5%) and to make room for the return of the normal red blood cells, white blood cells and platelets. When this happens, the leukemia is said to be in "remission." This phase may last approximately one month and can be repeated if the goal is not achieved.

Consolidation. In ALL, consolidation involves one or two months of drug treatment. During this phase, leukemia cells are still present in the body although they may not be detectable in a blood test or bone marrow examination.

Intensification. In ALL, intensification involves repeating chemotherapy combinations similar to those used in induction and consolidation several months later. It may involve bone marrow or stem cell transplantation or higher-dose chemotherapy. Acute Myelocytic Leukemia (AML) treatment often stops at this point.

Maintenance. This treatment stage further reduces the number of leukemia cells through the use of repeated courses of less intense chemotherapy every 28 days for an additional 18 months in girls and 30 months in boys. Regular outpatient visits are required to determine response to treatment, detect any recurrent disease and manage any side effects of the treatment.