Chemotherapy for leukemia is usually a combination of drugs. This is because different drugs attack leukemia cells in different ways. The combination also helps keep the leukemia cells from becoming resistant to any one drug.
Along with the chemotherapy drugs, other medicines may be given to help the chemotherapy drugs work better and prevent infection or bleeding. These drugs include epoetin and hematopoietic stimulants.
Some types of acute leukemia spread to the brain and spinal cord. Regular chemotherapy can't reach those areas, because your body puts up a special barrier to protect them. A different way of giving chemotherapy, called intrathecal chemotherapy, treats these areas by injecting the drugs directly into your spinal canal to attack any leukemia cells there.
For acute leukemia
Your treatment plan will include the kind of medicine that works best for the specific type or subtype of leukemia that you have.
- Acute lymphoblastic leukemia (ALL) may be treated with chemotherapy medicines (asparaginase, blinatumomab, clofarabine, daunorubicin, doxorubicin, methotrexate, nelarabine, or vincristine) and corticosteroids (dexamethasone or prednisone).
- Acute myelogenous leukemia (AML) may be treated with chemotherapy medicines (cytarabine, daunorubicin, idarubicin, or mitoxantrone).
- Acute promyelocytic leukemia (APL) may be treated with chemotherapy medicines (daunorubicin or idarubicin). Other medicines include arsenic trioxide and all-trans-retinoic acid (ATRA).
For chronic leukemia
- Chronic lymphocytic leukemia (CLL) may be treated with chemotherapy medicines (bendamustine, chlorambucil, cyclophosphamide, fludarabine, or vincristine), corticosteroids (such as prednisone), and monoclonal antibodies (such as alemtuzumab or rituximab).
- Chronic myelogenous leukemia (CML) may be treated with chemotherapy medicines (cyclophosphamide or cytarabine) and tyrosine kinase inhibitors (such as dasatinib, imatinib, or nilotinib).
For chronic myelogenous leukemia (CML), medicine is usually taken by mouth for as long as needed.