Leukemia is a cancer of the blood and bone marrow characterized by uncontrolled growth of abnormal white blood cells. Chemotherapy is the primary treatment for most types of leukemia and aims to destroy malignant cells, restore normal blood formation, and achieve long-term remission.
Types of Leukemia
- Acute Lymphoblastic Leukemia (ALL)
- Acute Myeloid Leukemia (AML)
- Chronic Lymphocytic Leukemia (CLL)
- Chronic Myeloid Leukemia (CML)
General Principles of Leukemia Chemotherapy
- Use of combination regimens improves cure rates
- Therapy is given in multiple phases over months to years
- Bone marrow function must be monitored constantly
- Supportive care is essential (antibiotics, transfusions, growth factors)
Chemotherapy of Acute Lymphoblastic Leukemia (ALL)
1. Induction Therapy (initial phase)
- Vincristine
- Prednisolone or Dexamethasone
- Daunorubicin
- L-Asparaginase
Goal: Achieve complete remission.
2. Consolidation Therapy
- Methotrexate
- Mercaptopurine (6-MP)
- Cytarabine
3. Maintenance Therapy
- Daily 6-MP
- Weekly Methotrexate
CNS Prophylaxis
- Intrathecal Methotrexate
Chemotherapy of Acute Myeloid Leukemia (AML)
1. Induction Therapy
- 7+3 regimen: Cytarabine (7 days) + Daunorubicin (3 days)
2. Consolidation
- High-dose Cytarabine
Treatment of Chronic Leukemias
Chronic Myeloid Leukemia (CML)
The mainstay treatment is targeted therapy:
- Imatinib (first line)
- Dasatinib
- Nilotinib
Chronic Lymphocytic Leukemia (CLL)
- Fludarabine
- Cyclophosphamide
- Rituximab (anti-CD20 antibody)
Targeted Therapy in Leukemia
- Tyrosine kinase inhibitors (TKIs) in CML
- Monoclonal antibodies in CLL and ALL
- FLT3 inhibitors in AML
Side Effects of Leukemia Chemotherapy
- Bone marrow suppression
- Severe infections
- Nausea and vomiting
- Hair loss
- Mouth ulcers
- Anemia and bleeding tendencies
- Organ-specific toxicity (heart, liver, kidneys)
Supportive Care
- Broad-spectrum antibiotics for infections
- Blood and platelet transfusions
- Growth factors (G-CSF)
- Anti-emetics
- Nutritional support
Patient Counseling
- Avoid exposure to infections during therapy
- Attend all chemotherapy sessions on time
- Report fever, bleeding, or breathlessness immediately
- Maintain a healthy diet and hydration
- Understand that treatment is long-term and requires patience
Detailed Notes:
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