Treatment depends on the type of leukemia, the stage of the cancer when you were first diagnosed, your age and overall health and your symptoms. The goal of treatment is to get your blood counts back to normal. If this occurs and the bone marrow looks healthy under the microscope, the cancer is said to be in remission.
Chemotherapy is used to treat acute lymphocytic leukemia (ALL) and acute myeloid leukemia and may be recommended for early stage chronic lymphocytic leukemia (CLL).
Patients typically receive their first course of chemotherapy in the hospital over a period of several weeks. Later, you may receive chemotherapy as an outpatient. If ALL spreads to the brain and spinal cord, you may receive chemotherapy directly into the space around your brain or in the spinal column, or radiation therapy to the brain. If your leukemia returns or does not respond to other treatments, a bone marrow or stem cells transplant is usually recommended.
Usually, no treatment is prescribed for early stage chronic lymphocytic leukemia (CLL), but physicians closely monitor their patients. If chromosome testing suggests that you have a high-risk type of CLL, treatment may be started earlier.
Treatment may also be started if infections keep returning, leukemia is growing rapidly, you have low blood count (anemia and thrombocytopenia) or are suffering fatigue, loss of appetite, weight loss or night sweats.
Several chemotherapy drugs are commonly used to treat CLL. Rarely, radiation may be used for painfully enlarged lymph nodes. Blood transfusions or platelet transfusions may be required if blood counts are low. Bone marrow or stem cell transplantation may be used in younger patients with advanced or high-risk CLL. A transplant is the only therapy that offers a potential cure for CLL.
Medications are available for treatment of some types of leukemia.
A medication called Gleevec is the first line of treatment for chronic myelogenous leukemia (CML). The medication is a pill, taken by mouth, and is associated with very high rates of remission and survival.
In some cases, a chemotherapy medicine called hydroxyurea (Hydrea) is used temporarily to reduce the white blood cell count if it is very high at diagnosis. Characterized by a very high count of leukemia cells, the blast crisis phase is very difficult to treat. Treatment is similar to AML or ALL. The only known cure for CML is a bone marrow transplant or stem cell transplant.
Treatment may not be necessary in the early stages of hairy cell leukemia. Some patients may need an occasional blood transfusion.
If treatment is needed because of very low blood counts, a variety of chemotherapy drugs can be used. Chemotherapy usually relieves symptoms for many years.
Removal of the spleen may improve blood counts, but is unlikely to cure the disease. Antibiotics can be used to treat infections. People with low blood counts may receive growth factors and, possibly, transfusions.