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Treatments and drugs
By Mayo Clinic staffUnlike other types of cancer, leukemia isn't a solid tumor that your doctor can surgically remove. Leukemia treatment is complex. It depends on many factors, including your age and overall health, the type of leukemia you have and whether it has spread to other parts of your body.
Therapies used to fight leukemia include:
- Chemotherapy. Chemotherapy is the major form of treatment for leukemia. This treatment uses chemical agents to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of one or more drugs. These drugs may come in a pill form, or they may be injected directly into a vein.
- Biological therapy. Also known as immunotherapy, biological therapy uses substances that bolster your immune system's response to cancer.
- Kinase inhibitors. For most people with CML, the drug imatinib mesylate (Gleevec) is the first line of therapy. Imatinib mesylate is a type of cancer drug called a kinase inhibitor. It was specifically developed to inhibit the BCR-ABL protein, and it has proved effective in treating the early stages of chronic myelogenous leukemia. The Food and Drug Administration has approved two other kinase inhibitors, dasatinib (Sprycel) and nilotinib (Tasigna), which may help people who can't take or who've become resistant to imatinib.
- Other drug therapy. Arsenic trioxide and all-trans retinoic acid (ATRA) are anti-cancer drugs that doctors can use alone — or in combination with chemotherapy — to treat a certain subtype of AML called promyelocytic leukemia. These drugs cause leukemia cells with a specific gene mutation to mature and die.
- Radiation therapy. Radiation therapy uses X-rays or other high-energy rays to damage leukemia cells and stop their growth. You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation directed at your whole body.
- Bone marrow transplant. This process replaces your leukemic bone marrow with leukemia-free marrow. In this treatment, you receive high doses of chemotherapy or radiation therapy, which destroys your leukemia-producing bone marrow. This marrow is then replaced by bone marrow from a compatible donor. In some cases, you may also be able to use your own bone marrow for transplant (autologous transplant). This is possible if you go into remission and then save healthy bone marrow for a future transplant, in case the leukemia returns.
- Stem cell transplant. Stem cell transplant is similar to bone marrow transplant except the cells are collected from stem cells that circulate in the bloodstream (peripheral blood). The cells used for transplant can be your own healthy cells (autologous transplant), or they can be collected from a compatible donor (allogeneic transplant). Doctors use this procedure more frequently than bone marrow transplant because of shortened recovery times and possible decreased risk of infection.
- Clinical trials. Some people with leukemia choose to enroll in clinical trials to try out experimental treatments or new combinations of known therapies.
- Supportive care. No matter what kind of cancer therapy you choose, you'll likely need medications to control pain and side effects.
