The treatment of leukemia depends on the type and level of the disease and is adapted to each patient. In general, chemotherapy, the use of drugs that destroy rapidly dividing cells, is the main treatment for acute or chronic leukemia. In acute leukemia, intensive chemotherapy and the use of some drugs, either simultaneously or sequentially, to kill as many leukemia cells as possible. Antibiotics and red blood cell and platelet transfusions help keep blood in a low number of patients who are dangerous because they received intensive chemotherapy.
Radiation is sometimes used to shrink the collection of leukemia cells that accumulate in various parts of the body, such as the lining of the brain and spinal cord in acute lymphocytic leukemia, or in the lymph nodes in lymphocytic leukemia. chronicle. If left untreated, a buildup of cells in the lining of the brain and spinal cord can cause headaches, blurred vision, and confusion, and in other parts of the body it can cause swelling and pain in the affected area.
Especially in younger patients, if doctors determine that chemotherapy alone is not likely to be successful or if patients have relapsed after chemotherapy, allogeneic (genetically different) stem cell transplants may be done. In this procedure, either very intense total body irradiation or high-dose chemotherapy or both were used. Chemotherapy and radiation are designed to destroy all the leukemia cells in the patient’s body, but this treatment also destroys the blood-forming system in the patients’ bone marrow. For this reason, healthy stem cells, bone marrow cells that enable long-term blood formation, are then inserted into patients to replace the blood-forming system. Stem cells must come from an immunologically suitable donor, usually siblings, but if their match is not available, an unrelated donor can sometimes be sought. The latter can be identified in the voluntary donor database. This database can be searched for people with matching tissue types that are identical or very similar. Previously, stem cells could only be transplanted from a donor’s bone marrow. This procedure is known as a bone marrow transplant. Recent advances now make it possible to recover stem cells from the blood, or from the placenta and umbilical cord blood (“cord blood”) after the birth of newborns, making the transplant procedure much easier. simple and less risky for the donor. Stem cells from the umbilical cord blood are frozen, banked, and can be used later for patients who need them. The amount of stem cells in this sample may not be enough for older adults and is more commonly used for children or younger adults who need transplants and need donor, unrelated match.
The unexpected effect of allogeneic stem cell transplantation is what is known as the graft-versus-leukemia effect. Immune cells recognize small tissue types of donor antigen (antibody-producing proteins) that are incompatible with the recipient. Immune cells from this donor attack the recipient’s network, including leukemia cells and normal tissue. The attack on normal tissue receptors as a disease called graft versus host. This attack can be acute or chronic, and very mild or very severe. This is a serious and undesirable complication of allogeneic stem cell transplantation. Graft versus leukemia cells, on the other hand, is the desired effect and is partly responsible for some of the benefits of transplantation, especially in patients who received transplants for treatment of acute or chronic myelocytic leukemia.
Transplantation is the most effective in children and young adults; in older adults they are usually too dangerous a procedure to apply. A transplant approach called non-myeloablative stem cells is being tested in older patients. Here very mild pretreatment with chemotherapy or radiation is used, while anti-immune therapy relies on the immune system to prevent the recipients from rejecting the donor stem cells. Leukemia graft stock that was attached as a surrogate for intensive care administered prior to transplantation for leukemia standards.
Immunotherapy is a promising new approach for the treatment of leukemia. With this technique, highly specific molecules known as monoclonal antibodies are made in the laboratory for the target molecule on the surface of leukemia cells. The antibody itself can kill leukemia cells, or radioactive substances or toxic cells attached to the antibody can kill leukemia cells when injected intravenously into the patient. This method provides an easy way to immediately deliver radioactive or toxic substances to leukemia cells, which can kill the cells with minimal effect on healthy cells.
The goal in treating acute leukemia is to kill the leukemia cells enough to cause remission, which means that red blood cell production is no longer suppressed, blood cell counts return to normal, and the patient’s symptoms return to normal. decrease. At that stage, further therapy is used to try to extend the scope of remission or cure. About 80 percent of children with acute lymphocytic leukemia can be cured. The cure rate for acute myelocytic leukemia is estimated to be about 40 percent in children, but is much lower in adults, depending on age. Because most patients are over 65 when they develop the disease, treatment is rare.
In chronic leukemia, a cure is rare, but current chemotherapy regimens have improved survival in patients from an average of about three years to more than six years. Chronic lymphocytic leukemia in its laziest form may not require treatment and may not progress or have serious health consequences for patients. In patients with active or progressive disease, new drugs and types of monoclonal antibodies are available to treat the disease. In chronic myelocytic leukemia, dramatic advances in therapy involve the introduction of drugs that specifically target the leukemia causing changes in the cells of the bone marrow. The introduction of this treatment has been projected to increase survival by more than a decade on average. Young patients with diseases who have a suitable stem cell donor can be cured by stem cell transplantation.