Leukaemia

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Treatments

In general, cure and remission rates of leukaemia continue to improve for both children and adults.

Specific treatment depends on the type, severity, and symptoms. The goals of treatment are to address the cell shortages that are causing symptoms, push the leukaemia into remission, and, if possible, kill all of the abnormal white blood cells and therefore allow normal cells to reproduce and restore blood cell function.

Symptomatic treatment may include red blood cell and/or platelet transfusions and antibiotic therapy. If the spleen is too swollen, it may need to be surgically removed. Treatment of the leukaemia may include chemotherapy and steroidal drugs, antibody therapy and radiation. Both these treatments kill cells and relieve pain. In the case of CML, a specific non-chemotherapy class of drugs (tyrosine kinase inhibitors) has been designed to block the function of the abnormal protein produced by the bcr-abl mutation - which can control the disease for many years and perhaps indefinitely in some cases. The tablets are not apparently curative however.

If leukaemic cells have migrated into the cerebrospinal fluid, chemotherapy drugs that are injected directly into the spinal fluid may be required.

In some cases bone marrow or blood stem cell samples may be taken from the patient and frozen to be reintroduced into the same patient following treatment (autologous transplantation). Allogeneic bone marrow transplants (using a marrow sample from a compatible donor (usually a family member)) can be used to cure some cases of acute leukaemia. Bone marrow or peripheral blood stem cell transplants may be considered when other treatment regimens have failed to push the leukaemia into remission, or when the leukaemia has recurred.

Treatment and prognosis of chronic leukaemia depend upon which type a patient has: chronic lymphocytic leukaemia (CLL) or chronic myeloid leukaemia (CML). Researchers are continuing to investigate new therapies that may be useful in achieving remission and prolonging life. Patients with chronic lymphocytic leukaemia, however, may not need treatment for years if ever, e.g. not until the number of RBCs or platelets decreases. In addition, some therapies are associated with severe side effects that are worse than the patient's symptoms.

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