Treatment of chronic lymphocytic leukemia depends on several factors that include overall health, age, and the area of the body affected the disease. Five of the most common types of treatments are as follows:
This type of treatment uses anti-cancerous drugs. The purpose of this method is to damage the cancerous cells and give minimum harm to healthy cells. Anti-cancer drugs prevent cancerous cells from reproduction and growth.
These drugs are normally administered through the vein that means they are injected intravenously. A catheter is usually used that lasts long to prevent frequent injections. It can also be given via a drip that is linked with a catheter. Some of the drugs are also given orally in tablet form or maybe given via intraperitoneal that means injecting under the skin. Usually, CLL is treated by this method.
For treating chronic lymphocytic leukemia by chemotherapy, some patients need to stay at the hospital for some weeks. Some patients are allowed to stay at home but called for regular check-ups and treatment.
To treat CLL, chemotherapy is done at three different stages that include induction therapy, maintenance therapy, and consolidation therapy.
This technique aims to kill cancerous cells or hinder their growth by using high energy rays. The part of the body with the accumulation of leukemia cells is exposed to the radiation. In the case of hematopoietic cell transplant, full-body can also be exposed to radiation.
In this treatment, the body’s immune system or the defense system to fight against cancer is boosted up by using some drugs. This is also known as biological therapy. CAR-T cell therapy, interleukins and interferon are included in the immunotherapy treatment.
In this treatment, drugs are used that focus only on the special functions of the cancerous cells. This treatment works in many ways, such as directly killing the leukemia cells, it may cut off the supply of blood to the leukemia cells that are crucial for their development, or these drugs hinder their capacity to reproduce or grow. There are many types of targeted therapies used; some of these are venetoclax, ibrutinib, ivisitinib, midostaurin, gilteritinib, fedratinib, ruxolitinib, ponatinib, nilotinib, dasatinib all of these work as tyrosine inhibitors. Some antibodies are also included, such as alemtuzumab, obinatuzumab, ofatumumab, rituximab, gemtuzumab, and inotuzumab.
Bone marrow or stem cell transplantation
In this method of treatment, higher than normal doses of chemotherapy are used. This enhances the likelihood of the cure of the disease. This method has substantial risks and can be very exhausting for the patient. In the recent techniques such as mini allografts, also called reduced intensity, allografts lower doses are used. Their goal is to boost thedefense system so that the body can fight against leukemia.
This treatment is very helpful for younger patients with CLL and can significantly enhance the chances of treatment success.
The soft tissue inside the bone is known as bone marrow and it is the site of stem cell production. The stem cells are the immature cells that grow into the body of new cells. High doses of chemotherapy damage stem cells. Doses depend on the severity of cancer and patients’ capacity to bear the high doses. After high dose therapy, damaged, stem cells are replaced by healthy cells in the body.
This treatment of stem cell transplantation can be further categorized based on the source of stem cells.
- Bone marrow transplantation: In this method, stem cells are taken directly from bone marrow.
- Peripheral stem cell transplantation: In this technique, stem cells are taken from blood.
Stem cells are usually taken from the patient before chemotherapy, which is known as an analogous donor, or they can also be taken from a person with closely match stem cells that are known as allogeneic donors.
Before the collection of stem cells, the donors are injected with growth factors that boost the production of stem cells in the bone marrow.
When the stem cells are taken from the blood, a syringe is used to draw blood from a vein, most commonly from the arm or the veins passing through the neck or chest. After the collection, the blood is placed in a centrifuge machine that rotates the blood at a very high speed to separate the stem cells. After the collection, the stem cells are packed in collection bags.
If the stem cells are taken from the patient’s blood itself, then after the collection of stem cells, the remaining blood is again infused into the body of the patient. To prevent the blood from clotting, anticoagulants are added in the blood when this blood is returned to the body; it may cause itching around the lips or fingers. The patient should immediately inform the nurse or doctor if he feels tingling so that it can be treated.
Stem cells can also be taken from the hip or breast bones under local anesthetic in operation theater. Just like the blood transfusion, stem cells are also transfused into the body of the patient after high dose chemotherapy.
When the stem cells are transfused into the blood, they will go into the bone marrow and as a result, the blood cell amount will become normal. This procedure is time-consuming, and the patient will go through several treatments at the hospital to speed up or facilitate the cure of the disease.
Patients can ask the doctor which treatment or transplant they are going to have. Each treatment is specifically planned for each patient. A complete treatment plan may include some of the methods which we have discussed above. A treatment plan depends on several factors that include the type of leukemia, overall health condition, age of the patient, and patients’ response to the first therapy, and some of the other factors are also included. Doctors will plan the treatment which will best suit the patient’s condition and that have higher chances of successful treatment.