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Chemotherapy for Leukemia

Chemotherapy (chemo) uses drugs to kill cancer cells. The drugs are passed through the blood and travel through the body. It may be used alone or with radiation therapy.

There are many kinds of drugs that can be used. The care team will help to find the best combination for each person. Chemo is most often given through an IV. Some leukemia has a high risk of spreading to the brain and spinal cord. In this case the chemo may be placed in the fluid around the brain and spine.

Chemo is given in cycles over a set time in 3 phases:

  • Induction —To remove all signs of leukemia.
  • Consolidation —To kill any leftover cells in the body after the first phase is done. It lowers the chances of cancer coming back.
  • Maintenance —To keep cancer from coming back once all signs of it are gone.

Chemo may not be given right away for chronic leukemias. Treatment may wait until blood cell counts change, or symptoms appear or worsen.

Side Effects and Management

Chemo is made to target cancer cells. However, it can also affect fast growing healthy cells. This can cause a range of health problems. The most common are:

  • Nausea and vomiting
  • Fatigue
  • Hair loss
  • Irritation to the tube that connects the mouth to the stomach—esophagitis
  • Infertility or premature menopause—If you plan on having children, talk to your doctor about preserving fertility before getting treated.

Most of these will fade once chemo has stopped. Other side effects may be long term. It can include damage to the heart and nerves, or some thinking and memory problems. Rarely, other cancers can form.

There are many ways to manage these problems. Medicines and lifestyle changes are the most common. In some cases, the cycles may be changed to lower the chances of serious problems. Talk to your care team as soon as these appear so they can be better controlled.

REFERENCES:

Initial management of acute myeloid leukemia (AML). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T906176/Initial-management-of-acute-myeloid-leukemia-AML. Updated February 22, 2019. Accessed March 13, 2019.

Initial management of chronic lymphocytic leukemia (CLL). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T907298/Initial-management-of-chronic-lymphocytic-leukemia-CLL. Updated January 16, 2019. Accessed March 13, 2019.

Management of acute lymphoblastic leukemia/lymphoma (ALL). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T906226/Management-of-acute-lymphoblastic-leukemia-lymphoma-ALL. Updated October 12, 2018. Accessed March 13, 2019.

Management of chronic myeloid leukemia in accelerated or blast phase. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T907373/Management-of-chronic-myeloid-leukemia-in-accelerated-or-blast-phase. Updated January 4, 2018. Accessed March 13, 2019.

Management of chronic myeloid leukemia in chronic phase. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T907372/Management-of-chronic-myeloid-leukemia-in-chronic-phase. Updated January 4, 2018. Accessed March 13, 2019.

Management of relapsed or refractory chronic lymphocytic leukemia (CLL). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T907299/Management-of-relapsed-or-refractory-chronic-lymphocytic-leukemia-CLL. Updated January 23, 2019. Accessed March 13, 2019.

Overview of leukemia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/overview-of-leukemia. Updated December 2018. Accessed March 13, 2019.

Last reviewed December 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP