Leukemia – Its Diagnosis and Cure

Is leukemia curable?
Certainly. Most leukemia are curable completely. Childhood acute lymphoblastic leukemia and some types of adult acute myeloid leukemia are curable to the extent of 75-80%.They are treated by a therapy called chemotherapy, which help in eradicating the bad cells from the bone marrow.

How is leukemia diagnosed?
The bad white cells are sometimes seen in the blood but at other times may be seen only in the bone marrow. Just like taking blood sample, bone marrow sample is taken by piercing a needle into the bones, usually in the pelvic bone.  Since the bone marrow is the birth place of all the blood cells, we can easily find out whether the blood cells are produced and maturing normally or not. If bad cells are seen, they can be stained to know the type of leukemia and processed further to see the chromosomal changes in them.

How is leukemia treated?
The initial therapy given as soon as the leukemia is diagnosed is called induction chemotherapy which is usually a combination of 2-5 drugs. They are either given continuously for 7-10 days or in a weekly basis, depending on the type of leukemia.

After the induction chemotherapy, the bad cells are killed and it takes around 3-5 weeks for the good cells to appear in the bone marrow. A bone marrow is repeated at this stage to see whether the bad cells are gone. If there are no bad cells, it is called remission. Remember ‘remission’ is not equivalent to cure. Even though the bone marrow shows no bad cells, there are still innumerable bad cells, present in the marrow but not visible to our eyes or even through the microscope. That is why treatment has to be continued for many more months.

The exact duration, number of cycles of chemotherapy has to be given etc. will depend on the type of leukemia and will be explained to you by your doctor. In general in acute myeloid leukemia, the chemotherapy cycles have to be given for 3-5 months. In acute lymphoblastic leukemia, repeated cycles are given for 4-6 months, after which the patient has to take tablets for 2 years.

What happens during chemotherapy?
The initial chemotherapy is called induction.Since the chemotherapy wipes off not only the bad cells but also the good ones, the patient will not have any good cells at all. This will be very severe during induction chemotherapy as even before starting therapy, the good cells are present only in a very small numbers. So till such time the good cells recover, the patient has high risk of infection (as there are no white cells) and also has high risk of bleeding (as there are very much reduced platelets).The red cells can be supplemented by transfusing blood.Platelets also can be transfused although they last in the body for few hours to few days only.White cells are difficult to transfuse routinely, but infections are treated with various antibiotics.

How do I know whether my leukemia has a high chance of cure or not?
This depends on various factors.As said earlier, the chromosomal damages in the white cells produce leukemia. Depending on the type of chromosomal damages, the leukemia are classified as good or bad types. Other leukemia is good or bad.In general good types have a high cure rate compared to the bad ones.

How do I know the progress of my disease?
The first stage is to find out the response to treatment. This can be done by assessing whether the “BAD LEUKEMIC CELLS” are cleared rapidly or not. This can be done by flow cytometric, cytogenetic or molecular assessment. Your doctor will explain in detail how it is being done.

What should the patient and the relatives have to do during treatment?

  • Follow all measures to prevent infections (as deliberated by your doctor)
  • Follow diet as advised
  • Remember “FEVER” occurring anytime during treatment is an emergency. Even if you are discharged, get advice from doctor regarding whom to contact and what to do if you get fever.
  • We advise most of the leukemic patients to resume normal work or studies after 5-6 months. If you have any MENTAL strains due to social stigmas or FINANCIAL strains, NEVER hesitate to discuss with your doctor as we have many “HELP” groups to tackle all your problems.

What will happen if I have a bad type?
It is important that your leukemia is recognized as good or bad within few weeks of diagnosis. Because, the bad types can still be cured, if very intensive chemotherapy is given. In some cases, bone marrow transplantation may be needed after the chemotherapy. Your doctor will tell you if you need one.

Department of Hemato oncology,
Coimbatore Kidney Centre

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