Treatment and Prevention
CLL can result in an elevated white blood cell count that can remain stable for years and not require treatment. Often though, mild treatments are required to keep the total count within a manageable range. Rarely, more aggressive treatments are needed for changes in the white blood cell count or to treat complications such as anemia.
Doctors commonly treat CML with a class of medication called tyrosine kinase inhibitors. This class is also called targeted molecular therapies and works by interfering with the abnormal cells' ability to overstimulate production of various types of blood cells. After the treatment, many people with leukemia have no signs of leukemia (also called remission) for short periods of time, and some go into long-term remissions in which abnormal cells are no longer found in their blood.
White blood counts and overall health must be monitored, but sufferers can usually continue with normal activities during the therapy.
More aggressive treatments are used to try to get acute leukemias into remission - the stage where normal levels of blood cells are restored. A combination of different chemotherapy medications are used for this.
During the course of therapy, however, levels of some blood components may fall, causing anemia (a lack of red blood cells) or an increased risk of infections. If the number of red blood cells or platelets get too low, a blood transfusion might be necessary. People with acute leukemias may need to take antibiotics to fight infections. Side effects of chemotherapy include nausea, vomiting, and hair loss.
Bone marrow transplant is the only cure for CML, but it is rarely used today because of success with the ability of tyrosine kinase inhibitors to act on the Philadelphia chromosome to induce a remission. Bone marrow transplant is more commonly used for
AML and ALL when chemotherapy alone has a low chance of resulting in a cure. This treatment depends on an exact match between the donor's bone marrow and the bone marrow of the person receiving it. Otherwise, the body will recognize the transplanted cells
as "foreign" and reject them.
Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network.