Re-induction chemotherapy. This stage is used to treat ALL if it has come back after treatment. It is also used if a person still has signs of ALL after remission induction therapy. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells. Recent studies show that not all cancers have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors involved in your leukemia.
This helps doctors better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.
Such drugs include:. Talk with your doctor about possible side effects for a specific medication and how they can be managed.
Induction therapy usually begins in the hospital. Patients will often need to stay in the hospital for 3 to 4 weeks during treatment. However, depending on the situation, many patients can leave the hospital. Those who do, usually need to visit the doctor regularly during treatment. Some patients will need to stay in the hospital for consolidation therapy but most are able to go home.
Many patients with ALL can return to school or work while receiving maintenance therapy. Chemotherapy attacks rapidly dividing cells, including those in healthy tissue such as the hair, lining of the mouth, intestines, and bone marrow. This means that patients receiving chemotherapy may lose their hair, develop mouth sores, or have nausea and vomiting.
Because of changes in the blood counts, most patients will need transfusions of red blood cells and platelets at some point during their treatment. Treatment with antibiotics to prevent or treat infection is usually needed as well. It can also cause bruising and bleeding because of the decrease in the number of platelets and other problems with blood clotting.
Chemotherapy may cause fatigue by lowering the number of red blood cells. Chemotherapy may affect fertility , which is the ability to have a child in the future, and it increases the risk of developing a second cancer. Patients may want to talk with a fertility specialist before treatment begins, as there are options available to help preserve fertility. Learn more about the basics of chemotherapy and preparing for treatment. The side effects of targeted therapy include nausea, vomiting, diarrhea, edema or swelling in the legs or around the eyes, and, rarely, fluid in the lungs.
The side effects of targeted therapies for ALL are usually not severe and can be managed. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.
Radiation therapy is the use of high-energy x-rays to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.
For ALL, radiation therapy to the brain is sometimes used to destroy cancerous cells around the brain and spinal column.
Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements.
Most side effects go away soon after treatment is finished. Learn more about the basics of radiation therapy. A stem cell transplant is a medical procedure in which bone marrow that contains leukemia is destroyed and then replaced by highly specialized cells, called hematopoietic stem cells, that develop into healthy bone marrow.
Hematopoietic stem cells are blood-forming cells found both in the bloodstream and in the bone marrow. These stem cells make all of the healthy cells in the blood. Today, this procedure is more commonly called a stem cell transplant, rather than bone marrow transplant, because it is the stem cells in the blood that are typically being transplanted, not the actual bone marrow tissue. Side effects depend on the type of transplant, your general health, and other factors.
An ALLO stem cell transplant should also be considered. Palliative care will also be important to help relieve symptoms and side effects. For most patients, a diagnosis of refractory leukemia is very stressful and, at times, difficult to bear.
Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group. A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the disease does return.
Learn more about coping with the fear of recurrence. If the leukemia does return after the original treatment, it is called recurrent or relapsed leukemia. When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about your treatment options.
Often the treatment plan will include the treatments described above, such as chemotherapy, stem cell transplantation, targeted therapy, and radiation therapy, but they may be used in a different combination or given at a different pace.
Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent leukemia. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects. The treatment for recurrent AML often depends on the length of the initial remission.
If the AML comes back after a long remission, the original treatment may work again. If the remission was short, then other drugs are used, often through a clinical trial. An ALLO stem cell transplant may be the best option for patients whose leukemia has come back after initial treatment. However, many drugs and other approaches are being researched in clinical trials and these may provide other treatment options.
People with recurrent leukemia often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope.
Learn more about dealing with cancer recurrence. Recovery from leukemia is not always possible. If the leukemia cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced leukemia may be difficult to discuss because it is incurable. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns.
The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important. Patients with advanced leukemia who have no more effective treatment options available may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life.
You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning. After the death of a loved one, many people need support to help them cope with the loss.
Learn more about grief and loss. The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. You may use the menu to choose a different section to read in this guide. Common ways to give chemotherapy include: An intravenous IV tube placed into a vein using a needle.
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If this happens, or if you have signs or symptoms that suggest leukemia, you may undergo the following diagnostic exams:. Our caring team of Mayo Clinic experts can help you with your leukemia-related health concerns Start Here. Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system.
Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs.
These drugs may come in a pill form, or they may be injected directly into a vein. Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body.
You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a bone marrow transplant. Bone marrow transplant. A bone marrow transplant, also called a stem cell transplant, helps reestablish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will regenerate healthy bone marrow.
Prior to a bone marrow transplant, you receive very high doses of chemotherapy or radiation therapy to destroy your leukemia-producing bone marrow. Then you receive an infusion of blood-forming stem cells that help rebuild your bone marrow. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
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