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Using Chemo to Treat Leukemia
Leukemia is a form of cancer that starts in blood-forming tissue, namely bone marrow, and effects the bloodstream. It can spread beyond the bone marrow and blood. This can result in the growth of a tumor in the brain, heart, or other areas of the body. Chemotherapy, which involves the use of anticancer drugs to destroy cancer cells, is often used to treat this type of cancer. Treatments using different chemotherapy for leukemia address the different types of this disease.
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Acute Myeloid and Lymphocytic Leukemia
Acute myeloid leukemia (AML) is one of the most common forms of this disease with 11,500 new cases expected each year in America alone. It is a fast growing version of leukemia in which abnormal cells are formed in bone marrow instead of infection-fighting white blood cells, overtaking healthy white blood cells, red blood cells and platelets. The abnormal cells, known as blast cells, develop very quickly, allowing the cancer to progress very quickly.
The most common type of leukemia in children, acute lymphocytic leukemia (ALL) is similar to AML in that it develops rapidly and treatment involves two intense chemotherapy phases, administered as soon as possible.
Chemotherapy for AML and ALL usually starts with what is called induction chemotherapy. Treatment is intense for about one week and then two or three weeks are allowed for recovery. Chemotherapy induction is repeated if remission does not occur. The goal is to destroy almost all of the cancer cells. Cytarabine and an anthracycline such as daunorubicin or idarubicin, are generally used together during this phase.
If the cancer goes into remission, meaning only a small amount of abnormal cells still exist, then consolidation chemotherapy is used to attempt to destroy any remaining cancer cells. Cytarabine is often used in high doses for three or more cycles, although doctors may use other types of chemo drugs. This process can last for two to three years. To deal with the side effects of chemotherapy patients can talk to their doctors about complementary therapies.
As it is common for cancer cells to reach the spinal cord with ALL, sometimes a different method is used in addition to induction chemotherapy. To prevent or treat leukemia that has affected the spinal cord and brain an injection is put into the spinal fluid.
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Treating Chronic Leukemia
With chronic myleoid leukemia (CML) and chronic lymphocytic leukemia (CLL) the cancer starts in the bone marrow but it develops over a period of months to years rather then days to weeks. Most people who have CML have a gene mutation, known as the Philadelphia chromosome. Ten to fifteen percent of all leukemia cases are CML, which rarely affects children. CLL is also mostly a disease of the over 60 age group. It is a more common type of leukemia.
The disease progresses very slowly with both chronic forms, unlike the acute forms of leukemia. Because of this chemotherapy treatment is much less intense. It generally involves the oral administration of anticancer drugs. Imatinib, dasatinib, and nilotinib are often used to treat patients with CML. Fludarabine, cyclophosphaminde, rituximab, and bendamustine are all given to CLL patients.
While there are different chemotherapy treatments for leukemia as there are different manifestations of the disease the basic premise is the same — chemo drugs are introduced into the body to try and destroy all abnormal cells. If the cancer is acute then a more intense therapy is required. With slower developing cancer cases less intense therapy is needed. While there are side effects of taking chemo medications and anticancer drugs are not always successful, there are many people living today because of chemotherapy treatments for leukeumia.
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Cancer Treatment Centers of America <http://www.cancercenter.com/leukemia/chemotherapy.cfm>
The Leukemia and Lymphoma Society <http://www.leukemia-lymphoma.org/all_page?item_id=7059>
Children's Hospital of Wisconsin <http://www.chw.org/display/PPF/DocID/21996/router.asp>
National Cancer Institute <http://www.cancer.gov/cancertopics/pdq/treatment/adultALL/Patient/page4>