Thanks to many successful clinical research trials over the past decade, and a better understanding of how our genetics affect cancer treatment, we have many leukemia treatment options available today. The hematologic oncologists at Rocky Mountain Cancer Centers (RMCC) will evaluate all of the options for your specific type of leukemia and stage.
A personalized treatment plan is created and discussed with you. We are here to answer your questions and discuss possible side effects so you're aware of what may come once treatments begin.
Some of the factors considered when choosing the right plan for a patient include:
- The type of leukemia
- How quickly the cancer cells are growing (acute vs chronic)
- Your age
- Whether leukemia cells were found in your cerebrospinal fluid
- Your general health condition
How Soon Does Leukemia Treatment Begin After Diagnosis?
Depending on what type of leukemia you have, you may or may not need treatment right away. Acute (fast-growing) leukemia needs to be treated quickly because the cancer cells are showing signs of rapid growth.
Treatment for chronic leukemia (slow-growing) can sometimes wait until it's progressed a bit further. However, chronic leukemias may require treatments periodically over the course of many years.
Your hematologic oncologist can describe your treatment choices, the expected results, timing, and the possible side effects.
Find a Leukemia Specialist Near You
What is Watchful Waiting?
People with chronic lymphocytic leukemia who do not have symptoms may be able to delay starting cancer treatment. By waiting, they can avoid the side effects of treatment until they have symptoms. If you and your oncologist agree that watchful waiting is a good idea, you’ll have regular checkups (such as every 3 months). You'll need to tell the doctors right away, however, if symptoms begin to appear.
Although watchful waiting avoids or delays the side effects of cancer treatment, this choice can be stressful for some people. Talk to your doctor if you feel the leaving the leukemia untreated at first causes you anxiety.
If you choose watchful waiting but grow concerned later, you should discuss your feelings with your doctor. A different approach is nearly always available.
Leukemia Treatment Close to Home
Chemotherapy for Leukemia
Many people with leukemia are treated with chemotherapy drugs to destroy leukemia cells.
Depending on the type of leukemia, you may receive a single drug or a combination of two or more drugs. You may receive chemotherapy in several different ways:
- By mouth: Some chemo drugs for leukemia are pills that you can swallow.
- Into a vein (IV): The drug is given through a needle or tube inserted into a vein.
- Through a port: A small "port" can be surgically inserted under the skin, usually in the upper chest area so that needle sticks into the veins are reduced. The infusion nurse sends the drugs into the body through this entry point. The port can be removed after chemotherapy treatment cycles are complete.
- Into the cerebrospinal fluid: If the pathologist finds leukemia cells in the fluid that fills the spaces in and around the brain and spinal cord, the doctor may order intrathecal chemotherapy. The doctor injects drugs directly into the cerebrospinal fluid in one of two ways:
- Into the spinal fluid: The doctor injects the drugs into the spinal fluid.
- Under the scalp: This method avoids the pain of injections into the spinal fluid.
Intrathecal chemotherapy is used because many drugs given by IV or taken by mouth can’t pass through the tightly packed blood vessel walls found in the brain and spinal cord. This network of blood vessels is known as the blood-brain barrier.
Usually, chemotherapy is given in cycles. Each cycle has a treatment period followed by a rest period.
At RMCC we are able to give patients chemotherapy at our locations throughout Colorado including Denver, Colorado Springs, Boulder and throughout the Front Range.
Targeted Therapy for Leukemia
People with chronic myeloid leukemia (CML) and some with acute lymphoblastic leukemia (ALL) may receive drugs called targeted therapy. Imatinib (Gleevec) tablets were the first targeted therapy approved for chronic myeloid leukemia, however, there are now other targeted therapy drugs that are also used.
Targeted therapies use drugs that block the growth of leukemia cells. For example, a targeted therapy drug may block the action of an abnormal protein that stimulates the growth of leukemia cells.
Types of targeted therapy drugs for leukemia include:
- Tyrosine kinase inhibitors (TKIs)
- Monoclonal antibodies
Tyrosine kinase inhibitors (TKIs)
TKIs are the preferred first treatment for CLL and CML, as well as some cases of ALL. These oral drugs block kinases, the proteins inside cancer cells that tell them to grow and reproduce. Some proteins allow cancerous cells to survive longer than they should. TKIs interfere with cell communication. They stop leukemia cells from multiplying and cause the cells to die.
Monoclonal antibodies
Monoclonal antibodies are lab-made proteins that attach to a targeted substance outside or inside leukemia cells. You receive this treatment through an IV. Depending on the drug, monoclonal antibodies treat leukemia by:
- Killing cancer cells directly
- Guiding the delivery of chemotherapy drugs to cancer cells, making chemo more effective
- Delivering a radioactive substance called an isotope directly into cancer cells
- Activating checkpoint proteins in cancer cells to help the immune system find and destroy the diseased cells
Immunotherapy for Leukemia
Some people with leukemia receive drugs called biological therapy or immunotherapy. Biological therapy for leukemia is a treatment that improves the body’s natural defenses against the disease.
There are several types of immunotherapy that can be used for leukemia treatment. These include:
- Allogeneic bone marrow transplant
- Therapeutic cancer vaccines
- CAR T cell therapies
- Monoclonal antibody therapies
- Donor lymphocyte infusions
One type of biological therapy is a substance called a monoclonal antibody, which is given by IV infusion. This substance binds to the leukemia cells, killing them or helping the immune system destroy them.
For some people with chronic myeloid leukemia (CML), biological therapy is a drug called interferon, which is injected under the skin or into a muscle. It can slow the growth of leukemia cells.
Depending on your particular situation, you may have your treatment in a clinic, at the doctor’s office, or in the hospital. Your oncologist may also administer other drugs at the same time to prevent side effects.
Bone Marrow Transplants for Leukemia
Bone marrow transplants are not used for most patients. However for those who have leukemia affecting the bone marrow this can ben effective option. The process involves using high doses of chemotherapy to kill as many cancer cells in the bone marrow as possible. This is followed by a transplant of bone marrow to reestablish healthy stem cells.
Clinical Trials for Leukemia
At Rocky Mountain Cancer Centers, advancing cancer care through research and innovation is part of our commitment to our patients. We participate in clinical trials through Sarah Cannon Research Institute (SCRI), a joint venture with US Oncology Research and one of the world’s leading oncology research organizations conducting community-based clinical trials.
Clinical trials bring the latest and most advanced treatment options to patients before they're available to all patients and could be a good option if your oncologist feels you qualify. If taking part in a clinical trial is something that interests you, talk with your specialist to see if you fit the criteria.
