• Chemotherapy for Leukemia

    Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body in order to kill cancer cells. Chemotherapy may be given either alone or along with radiation therapy. When given alone, it is given in a higher dose designed to kill off cancer cells. When given along with radiation therapy, it is delivered at a lower dose and is designed to make the cancer more sensitive to the radiation.
    The type and combinations of drugs that are used to treat leukemia will vary depending on the type of leukemia, as well as the age and condition of the patient. In general, there are several equally effective combinations available for each of the major types of leukemia, giving physicians the ability to tailor treatment to patient needs and tolerance.
    Chemotherapy is usually given by vein, but some forms can be given by mouth. Your medical oncologist will tell you how many cycles or courses of chemotherapy are best for you.
    Two phases of chemotherapy are used to treat acute leukemia:
    • Induction—to bring about a remission
    • Consolidation—to kill any leukemia cells still in the body and reduce the chances of the cancer coming back
    Chemotherapy may not be given for chronic leukemias until the patient begins to develop rapidly increasing cell counts, more immature cells in the blood, or significant symptoms from the leukemia.

    Side Effects and Management

    Side effects depend on the type of chemotherapy you receive, as well as how many cycles you receive and how often. The most common chemotherapy-associated side effects are:
    • Nausea and vomiting
    • Fatigue or tiredness
    • Hair loss
    • Irritation to the tube that connects the mouth to the stomach—esophagitis
    • Infertility and/or premature menopause—if fertility is a concern, talk to your doctor about storing sperm or eggs before starting therapy
    A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.
    Long term side effects can include damage to the heart and peripheral nerves, some cognitive dysfunction, and, very rarely, development of other cancers, including other leukemias.

    References

    Acute leukemia overview. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/acute-leukemia-overview. Updated October 2014. Accessed December 7, 2015.

    Leukemia. American Cancer Society website. Available at: http://www.cancer.org/cancer/leukemia/index. Accessed December 7, 2015.

    Leukemia—for patients. National Cancer Institute website. Available at: http://www.cancer.gov/types/leukemia. Accessed December 7, 2015.

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