Various drugs and types of leukemia treatment

Leukemia is a type of blood cancer that starts in the bone marrow and then attacks the blood. If left untreated, the disease can spread to other parts of the body, such as the lymph nodes, liver, spleen, brain, spinal cord, or testes. So, how do you deal with and treat leukemia? What are the types of medication and drugs that doctors generally give to treat leukemia?

Various types of medication and drugs to treat leukemia

Leukemia cancer cells can develop very quickly and slowly. The type of leukemia that develops slowly, or is called chronic leukemia, treatment is generally not needed, especially if the patient does not have any symptoms of leukemia.

However, regular check-ups should still be done to review the progress of the disease. New treatment will be given when the disease has progressed and causes symptoms in the sufferer.

However, for patients with acute leukemia who develop rapidly and experience symptoms, medical treatment is needed. The type of treatment that will be given depends on the type of leukemia you have, the stage or spread of cancer cells, your age, your overall health condition, and the possible effects of treatment.

In general, there are five ways or types of treatment to treat leukemia, including various therapies to other forms of medical treatment. The following are the types of treatment:

1. Chemotherapy

Chemotherapy is the main way to treat and treat leukemia. This leukemia therapy uses drugs that are given in pill form, through an infusion into a vein or catheter, or an injection under the skin, to stop growth or kill cancer cells.

Chemotherapy drugs for leukemia are generally given in combination. The drug can be given in several cycles and can last for six months or more, depending on the variety of drugs and the recovery process from chemotherapy.

This treatment is generally given to patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). For patients with other types of leukemia, such as chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML), and hairy cell leukemia, chemotherapy can also be given, especially for those who are already developing or experiencing symptoms.

Reporting from the Leukemia & Lymphoma Society, chemotherapy for ALL and AML leukemia is carried out in two phases, namely induction and post-emission. Induction is the initial phase of a patient undergoing chemotherapy.

Therapy in this phase aims to kill as many cancer cells as possible to achieve remission, that is, when there are no cancer cells left in the blood and bone marrow and the patient feels better.

After achieving remission, patients with this type of leukemia still need to undergo chemotherapy to prevent the return of cancer cells. This phase is also known as post-emission. In the post-emission phase, apart from chemotherapy, the patient also sometimes performs a stem cell transplant stem cells.

2. Radiation therapy or radiotherapy

Radiotherapy or radiation therapy uses X-rays or high-energy rays to damage leukemia cells and stop their growth. This radiation therapy is usually done to prepare for a stem cell transplant or stem cells.

During the procedure, you are asked to lie on a table. Then, a machine moves around you, directing radiation to the point where the cancer cells are located or throughout your body.

Radiation therapy treatment is usually given for almost all types of leukemia. Here's the explanation:

• A type of ALL leukemia, radiotherapy can be given to prevent or treat the spread of cancer cells to the central nervous system, preparations for stem cell transplantation, and relieve pain due to the spread of leukemia cells to the bone, especially if chemotherapy has not helped.
• A type of AML leukemia, radiotherapy is usually given to prepare for a stem cell transplant and when the leukemia has spread beyond the bone marrow, including to the bones or the central nervous system.
• A type of CLL leukemia, radiotherapy is usually given when leukemia cells have developed in the bone marrow and are causing symptoms such as pain, shrinking an enlarged spleen if chemotherapy is unsuccessful, or shrinking enlarged lymph nodes in one area of ​​the body.
• A type of CML leukemia, radiotherapy is usually given when leukemia cells have developed in the bone marrow and causes symptoms such as pain, cancer cells have spread beyond the bone marrow, shrinks the enlarged spleen if chemotherapy is unsuccessful, and preparations before stem cell transplant

3. Immunotherapy

Immunotherapy or biological therapy is a type of treatment that uses drugs to boost the immune system to fight leukemia. Types of biological therapy commonly used for leukemia include interferon, interleukin, and CAR-T cell therapy.

Several types of leukemia that usually use this type of treatment, namely CML and hairy cell leukemia. In CML patients, biologic therapy with interferon alfa is generally given as first-line therapy, especially for patients who are unable to cope with the side effects of targeted therapy or who are resistant to targeted therapeutic drugs.

Interferons are also given to patients hairy cell leukemia, especially when you can't have chemotherapy or chemotherapy is no longer having an effect. Even pregnant women or those with very low levels of neutrophil blood cells are not recommended to undergo this biologic therapy.

Apart from these types of leukemia, ALL patients may also be able to get this type of treatment. Talk to your doctor about the type of medication and medication that is right for you.

4. Targeted therapy

Targeted therapy is a way to treat leukemia by using drugs that focus and specifically attack cancer cells. This targeted therapy works by blocking the ability of leukemia cells to multiply and divide, cutting off the blood supply that cancer cells need to live, or directly killing cancer cells.

Although it looks the same as chemotherapy, targeted therapy is less likely to affect and harm healthy cells. Some of the drugs commonly used in targeted therapy for leukemia include:

• Monoclonal antibodies, such as inotuzumab, gemtuzumab, rituximab, ofatumumab, obinatuzumab, or alemtuzumab.
• Tyrosine kinase inhibitors, such as imatinib, dasatinib, nilotinib, ponatinib, ruxolitinib, fedratinib, gilteritinib, midostaurin, ivositinib, ibrutinib, or venetoclax.

Targeted therapeutic treatment is generally given to patients with the types of leukemia ALL, CLL, CML, and hairy cell leukemia. In ALL patients, the targeted tyrosine kinase inhibitor therapy drug is usually given together with chemotherapy, whereas CML patients can be the first-line treatment.

Meanwhile, in CLL patients, targeted therapy is usually given to patients with developed leukemia and when the cancer cells come back (recurrences), and can be given at the same time as chemotherapy. However, this type of treatment can also be given when the patient is no longer responding to chemotherapy treatment.

As for the patient hairy cell leukemia, the most commonly prescribed target therapy drug, rituximab. This medicine can be given when chemotherapy cannot control the leukemia or the leukemia comes back again after chemotherapy is done.

5. Transplant stem cells or bone marrow

How to deal with and treat other leukemia, namely transplantation stem cells or stem cells or bone marrow. This type of treatment is generally carried out after chemotherapy or radiotherapy.

The transplant procedure is performed by replacing blood cancer-forming stem cells (which have been killed by chemotherapy / radiotherapy) with new, healthy cells. These healthy cells can be taken from your body before chemotherapy and radiation is done or from donor blood or bone marrow.

These healthy cells can then develop into bone marrow and new blood cells that the body needs.

Bone marrow stem cell transplantation is possible in patients with ALL and AML leukemia in the postemission phase. As for CML leukemia patients, this treatment is rarely given.

6. Other treatment

Apart from the common types of treatment above, other medical treatments are possible for leukemia patients. One of them is often done, namely surgery to remove the spleen.

This is generally done when the spleen is enlarged due to leukemia cancer cells and causes pain, and chemotherapy or radiotherapy cannot shrink it. However, not all patients will undergo this. Always consult your doctor for the type of treatment that is right for you.