Leukemia - Treatment

Treatment of leukemia takes place in two steps. The goal of the first step is to bring the disease into remission. Remission means two things. First, no symptoms of the disease remain. Second, no abnormal white blood cells can be found in bone marrow. Two forms of treatment are used in this first step: chemotherapy and radiation.

Chemotherapy involves the use of certain chemicals that can kill cancer cells. These chemicals may be given orally (by mouth) or intravenously (through a vein in the arm).

Bone marrow transplantation (BMT) works only under very special circumstances. Specifically, bone marrow from a donor and a patient must match very closely. Usually this means the donor must be related to the patient, but not always. Sometimes non-relatives will also have very close matches. The question is how to find those non-relatives.

The task is not as easy as making a public announcement on the radio or television or in the newspaper. Experts estimate that the chance of the bone marrow of two unrelated people matching is somewhere between 1 in 10,000 to 1 in 20,000. How can doctors find that very rare person who can donate bone marrow to a patient?

Until the 1980s, there was no good answer to that question. Then, bone marrow transplant registries started springing up around the world. A bone marrow transplant registry is an office that keeps records of people's bone marrow types. In the United States, the National Bone Marrow Donor Registry (NBMDR) was created in 1986. People who wish to be considered as bone marrow donors must have a blood test. The results of that test are recorded at the NBMDR. When a leukemia patient needs a BMT, records are searched at the NBMDR. With luck, a good match is found and a bone marrow transplant can be conducted.

Radiation involves the use of high-energy rays, such as X rays, to kill cancer cells. A common source of radiation used to treat leukemia is the radioactive element cobalt 60. A radioactive element is an element that gives off high-energy radiation. A patient is placed on a table beneath a small piece of cobalt 60 contained in a large machine. The energy given off by the cobalt 60 is aimed at the patient's body. It kills cancer cells and may lead to remission.

Once remission has been achieved, treatment moves to the second step. The goal of this step is to treat the patient's bone marrow. Unless the bone marrow is changed, it will continue to produce abnormal white blood cells and the leukemia will eventually return.

The usual method for treating bone marrow is with a bone marrow transplantation. In a bone marrow transplantation, healthy bone marrow is injected into the patient's bones. If the transplantation is successful, the new bone marrow will start producing normal blood cells and the basic cause of leukemia will have been corrected.

Bone marrow transplantation is a difficult procedure. The bone marrow injected into a patient must be very similar to his or her own bone marrow. For this reason, close relatives may be the only people who can donate bone marrow for the procedure.

If foreign bone marrow is used for transplantation, the patient's immune system will attack it as if the transplanted bone marrow is a bacterium, virus, or some other disease-causing organism. In the process, the patient's immune system may start to kill off the cells in his or her body. There are drugs that can prevent this type of immune system reaction, but the drugs are quite dangerous and have serious side effects.

Alternative Treatment

Many alternative treatments are available that may prove helpful in combating the side effects of traditional cancer therapies. These alternatives, however, should not replace prescribed cancer treatments; rather, they are suggested to work in conjunction with conventional treatment.

Body work therapy such as acupuncture (Chinese therapy involving the use of fine needles), acupressure (Chinese therapy that involves applying pressure to certain points in the body), reflexology, and massage may help calm the patient and reduce stress. Relaxation techniques such as yoga and meditation may relieve nausea and discomfort. An exercise program, designed in consultation with a physician, may help promote physical and mental strength. A well-balanced diet high in fresh fruits and vegetables and whole grains and low in fats, sugar, and alcohol is suggested for overall well-being.

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