Medications
Cancer-fighting chemotherapy drugs are the mainstay treatment for all forms of leukaemia. They are used for both acute leukaemia and the acute phases of chronic leukaemia. Most are given by injection, though some are available as pills. You may receive treatment during doctor visits or at hospital. Many types of chemotherapy drugs may be used, including hydroxyurea (Hydrea), bustulfan (Myleran), chloramabucil (Leukeran), cyclophosphamide (Cycloblastin) and fludarabine (Fludara). Your drug or drug combination will depend on your type of leukaemia. The aim of chemotherapy is to destroy prolferating leukaemia cells so healthy cells will grow and perform their normal functions.
>I've been told that I have multiple myeloma. What is it? How is it treated?
Multiple myeloma is a leukaemia that affects types of cells in the bone marrow called plasma cells. They are a class of lymphocytes that produce antibodies to protect you against infection. When mutiple myeloma occurs, the plasma cells start to reproduce a single type of antibody (called immunoglobulin) and are not able to produce others. The result is that you have an increased susceptibility to infection. Symptoms include fatigue, weakness and bone pain (due to bone damage). The good news is that promising research is under way to improve survival rates following traditional treatment regimens such as high-dose chemotherapy and bone marrow transplantation.
If you have acute leukaemia, chemotherapy is given it phases. The first aims to quickly destroy cancer cells to bring a remission. Later treatements stabilise your condition and destroy hidden pockets of cancer, or 'sancturary sites', in the brain, teses or other areas.
If you have chronic leukaemia that is progressing, it's usually treated with monthly chemotherapy sessions, followed by a recovery period, then another treatment period, and so on.
At the same time chemotherapy drugs attack cancer cells, they can also damage normal cells, usually those with a fast growth rate, such as hair follicles or those in the intensive and the mouth. Chemo side effects often reflect damage to these systems and commonly include hair losss, nausea and vomiting, mouth sores, fatigue and infections. To counteract this, your doctor may prescribe medications called anti-emetic drugs to stop nausea and vomiting and improve your appetite, and sometimes antibiotics to prevent infections.
OUTLOOK FOR MAJOR TYPES OF LEUKAEMIA
TYPE OF LUEKAEMIA REMISSION SUCCESS LONG-TERM OUTLOOK
----------------------------------------------------------------------------------------------------------------------------------------
Acute lymphoblastic leukaemia The first round of chemotherapy Children tend to do better than
(ALL), the most common form of brings about remission in more adults. Half of children are free of
leukaemia in children. 90% of patients. diesease five years after
treatment.
Acute myeloid leukaemia (AML), Chemotherapy brings about a With drug treatment, up to 25% of
the most common adult form of remission in up to 80% of people. people are free of the disease
leukaemia. peak incidence in sixth after 10 years. Bone arrow
decade. Also called acute nonlymph- transplants can improve with. The overall cure rate is between
40% and 50%
Chronic lymphocytic leukaemia Most cases requires no specific Many people live 10 to 20 years
(CLL.), the second most common therapy unless disease progresses after diagnosis, although those
type in adults, mainly over age 60. and symptoms develop. with very advanced disease may
ocytic leukaemia (ANLL). live two years or less.
Chronic myecloid leukaemia (CML) Interferon often induces remission Five-year survival is about 40%.
affects mostly adults and is rare in for more than two years. Early bone If disease worsens ('blast crisis')
children. marrow transplant may offer cure , chemotherapy may extend sur-
in more than 50% of patients. vival 8 to 12 months. Drug
Gilvec shows promise, inducing
remissions in 90%.
Your doctor may also recommend an orla corticosteroid, usually prednisone, prior or in addition to chemotherapy. Leukaemia can cause your body to attack healthy cells and these drugs suppress this reaction. Another drug that may be helpful is interferon, an immune booster that has been very successful in treating hairy cell leukaemia and prolonging the period before leukaemia worsens in CMI. Interferon therapy can be very taxing, however, because it must be injected daily and those on it often feel as if they have a bad flu.
Gilvec is a promising new alternative. Available as a capsule, and taken once a day, this new kind of cancer drug disables a defective enzyme in the cancer cell and destroys it. Because it has little effect on healthy cells, Gilvec has few of the nasty side effects of chemotherapy drugs or interferon. In a study of 532 people with CML, all had tried interferon but, after six months, their leukaemia ahd worsened. The patients switched to Gilvec, and after 18 months, doctors could find no evidence of disease in 41 percent of the patients. Doctors still don't know if the drug offers a reprieve or a complete cure, although results so far have been very promising. The downside is that it can cause side effects, including muscle aches, nausea and a rash, and patients may have to take it for the rest of their lives.
PROMISING DEVELOPMENTS
The best chance for a possible cure for many people with leukaemaia is bone marrow transplant, sometimes called stem cell transplatation. In the procedure, you receive primitive blood cells called stem cells, which are found in the bone marrow and grow into healthy blood cells. If you have enough healthy stem cells, they may be collected from your own body, cleasned of leukaemia cells, then returned to you, a procedure called autolgous transplantation. More often, cells come from a donor who is genetically compatible (allo-geneic transplantation),often a sibiling or donor located through a national registry. Before the transplant you'll receive very high doses of chemotherapy and possibly total body radiation to kill leukaemia cells in your bone marow and suppress your immune response so that you don't reject the transplanted cells. Then, about 500 ml of the cells harvested from the donor's hip are infused into one of your veins. The new, healthy cells take up residence in your newly sanitised bone marrow, where they carry out of normal immune functions.
Other procedures may also be needed. If you are anaemic and fatigued, blood transfusions will make you feel much better. Radiation may be tried for CLL if there is enlargement of the spleen or lymph nodes. Sometimes for CLL and hairy cell leukaemia, surgery may also be necessary to remove a swollen spleen that's causing pain or other symptoms. If lots of leukaemia cells are circulating in your blood, your doctor may recommend a procedure called leukapheresis before chemotherapy. Here blood is taken from one arm, passed through a filtering machine that removes white blood cells and then returned to your body through the other arm. The technique will make you feel better and give your body a jump start to meet the effects of chemotherapy, which generally take effect several days later.
Cancer-fighting chemotherapy drugs are the mainstay treatment for all forms of leukaemia. They are used for both acute leukaemia and the acute phases of chronic leukaemia. Most are given by injection, though some are available as pills. You may receive treatment during doctor visits or at hospital. Many types of chemotherapy drugs may be used, including hydroxyurea (Hydrea), bustulfan (Myleran), chloramabucil (Leukeran), cyclophosphamide (Cycloblastin) and fludarabine (Fludara). Your drug or drug combination will depend on your type of leukaemia. The aim of chemotherapy is to destroy prolferating leukaemia cells so healthy cells will grow and perform their normal functions.
>I've been told that I have multiple myeloma. What is it? How is it treated?
Multiple myeloma is a leukaemia that affects types of cells in the bone marrow called plasma cells. They are a class of lymphocytes that produce antibodies to protect you against infection. When mutiple myeloma occurs, the plasma cells start to reproduce a single type of antibody (called immunoglobulin) and are not able to produce others. The result is that you have an increased susceptibility to infection. Symptoms include fatigue, weakness and bone pain (due to bone damage). The good news is that promising research is under way to improve survival rates following traditional treatment regimens such as high-dose chemotherapy and bone marrow transplantation.
If you have acute leukaemia, chemotherapy is given it phases. The first aims to quickly destroy cancer cells to bring a remission. Later treatements stabilise your condition and destroy hidden pockets of cancer, or 'sancturary sites', in the brain, teses or other areas.
If you have chronic leukaemia that is progressing, it's usually treated with monthly chemotherapy sessions, followed by a recovery period, then another treatment period, and so on.
At the same time chemotherapy drugs attack cancer cells, they can also damage normal cells, usually those with a fast growth rate, such as hair follicles or those in the intensive and the mouth. Chemo side effects often reflect damage to these systems and commonly include hair losss, nausea and vomiting, mouth sores, fatigue and infections. To counteract this, your doctor may prescribe medications called anti-emetic drugs to stop nausea and vomiting and improve your appetite, and sometimes antibiotics to prevent infections.
OUTLOOK FOR MAJOR TYPES OF LEUKAEMIA
TYPE OF LUEKAEMIA REMISSION SUCCESS LONG-TERM OUTLOOK
----------------------------------------------------------------------------------------------------------------------------------------
Acute lymphoblastic leukaemia The first round of chemotherapy Children tend to do better than
(ALL), the most common form of brings about remission in more adults. Half of children are free of
leukaemia in children. 90% of patients. diesease five years after
treatment.
Acute myeloid leukaemia (AML), Chemotherapy brings about a With drug treatment, up to 25% of
the most common adult form of remission in up to 80% of people. people are free of the disease
leukaemia. peak incidence in sixth after 10 years. Bone arrow
decade. Also called acute nonlymph- transplants can improve with. The overall cure rate is between
40% and 50%
Chronic lymphocytic leukaemia Most cases requires no specific Many people live 10 to 20 years
(CLL.), the second most common therapy unless disease progresses after diagnosis, although those
type in adults, mainly over age 60. and symptoms develop. with very advanced disease may
ocytic leukaemia (ANLL). live two years or less.
Chronic myecloid leukaemia (CML) Interferon often induces remission Five-year survival is about 40%.
affects mostly adults and is rare in for more than two years. Early bone If disease worsens ('blast crisis')
children. marrow transplant may offer cure , chemotherapy may extend sur-
in more than 50% of patients. vival 8 to 12 months. Drug
Gilvec shows promise, inducing
remissions in 90%.
Your doctor may also recommend an orla corticosteroid, usually prednisone, prior or in addition to chemotherapy. Leukaemia can cause your body to attack healthy cells and these drugs suppress this reaction. Another drug that may be helpful is interferon, an immune booster that has been very successful in treating hairy cell leukaemia and prolonging the period before leukaemia worsens in CMI. Interferon therapy can be very taxing, however, because it must be injected daily and those on it often feel as if they have a bad flu.
Gilvec is a promising new alternative. Available as a capsule, and taken once a day, this new kind of cancer drug disables a defective enzyme in the cancer cell and destroys it. Because it has little effect on healthy cells, Gilvec has few of the nasty side effects of chemotherapy drugs or interferon. In a study of 532 people with CML, all had tried interferon but, after six months, their leukaemia ahd worsened. The patients switched to Gilvec, and after 18 months, doctors could find no evidence of disease in 41 percent of the patients. Doctors still don't know if the drug offers a reprieve or a complete cure, although results so far have been very promising. The downside is that it can cause side effects, including muscle aches, nausea and a rash, and patients may have to take it for the rest of their lives.
PROMISING DEVELOPMENTS
- Advances in biotechnology are opening up potential new leukaemia treatments. A promising but still experience drug called Genasense made by Gentza in New Jersey disables a protein that helps tumour cells thrive. Early studies show the drug causes cancer cells already weakened by chemotherapy drugs to essentially commit suicide, a type of natural cell death that researchers call apoptosis. The drug is being tested against chronic lymphocytic leukaemia (CLL), melanoma and many other cancers.
Procedures
The best chance for a possible cure for many people with leukaemaia is bone marrow transplant, sometimes called stem cell transplatation. In the procedure, you receive primitive blood cells called stem cells, which are found in the bone marrow and grow into healthy blood cells. If you have enough healthy stem cells, they may be collected from your own body, cleasned of leukaemia cells, then returned to you, a procedure called autolgous transplantation. More often, cells come from a donor who is genetically compatible (allo-geneic transplantation),often a sibiling or donor located through a national registry. Before the transplant you'll receive very high doses of chemotherapy and possibly total body radiation to kill leukaemia cells in your bone marow and suppress your immune response so that you don't reject the transplanted cells. Then, about 500 ml of the cells harvested from the donor's hip are infused into one of your veins. The new, healthy cells take up residence in your newly sanitised bone marrow, where they carry out of normal immune functions.
Other procedures may also be needed. If you are anaemic and fatigued, blood transfusions will make you feel much better. Radiation may be tried for CLL if there is enlargement of the spleen or lymph nodes. Sometimes for CLL and hairy cell leukaemia, surgery may also be necessary to remove a swollen spleen that's causing pain or other symptoms. If lots of leukaemia cells are circulating in your blood, your doctor may recommend a procedure called leukapheresis before chemotherapy. Here blood is taken from one arm, passed through a filtering machine that removes white blood cells and then returned to your body through the other arm. The technique will make you feel better and give your body a jump start to meet the effects of chemotherapy, which generally take effect several days later.
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