Leukemia

Most cases of leukemia occur in older adults, with more than half occurring after age 64. Leukemia is expected to strike more than nine times as many adults as children.

Even so, leukemia accounts for nearly a third of cancers in children between birth and age 14. The disease causes more deaths than any other cancer among children and young adults under the age of 20. Survival rates for children with leukemia have dramatically increased over the past 30 years.

An estimated 35,000 new cases of leukemia are diagnosed annually.

Under the leadership of Michael Lill, MD, Medical Director of the Blood and Marrow Transplant Program at Cedars-Sinai, a multidisciplinary team of experts provides advanced, comprehensive care to patients with leukemia.

Diagnosing Leukemia

Because leukemia causes an uncontrolled growth of blood cells that are not mature, the first step in diagnosing leukemia is a blood count.

Depending on the results of this test, the next step may be to do a bone marrow biopsy. In this test, the patient is under anesthesia while a large needle is inserted into the bone to remove a small sample of bone marrow. The sample is looked at under a microscope to see if abnormal cells are present. A biopsy also sometimes shows defects in genetic materials (chromosomes) that are linked to certain forms of leukemia.

The biopsy allows a doctor to determine what type of leukemia is present and design the most effective treatment.

Treating Leukemia

The goal of treatment is to bring about complete remission. This means that there is no evidence of the disease and the patient is able to return to good health with normal blood and marrow cells. If a person stays in remission for five years after treatment, he or she is considered cured.

The approach to treating leukemia is different for each major type of leukemia.

  • Chemotherapy. Certain drugs or combination may be given by mouth or injection to destroy cancer cells. The drugs travel through the bloodstream to the entire body. If cancer cells have spread to the brain, the drugs are injected into the fluid surrounding the brain through a needle inserted in the patient's back or in the brain (called intrathecal therapy).
  • Radiation therapy. High doses of X-rays kill cancer cells and cause tumors to shrink.
  • Blood and marrow transplantation (BMT). The doctor and the patient may decide to perform this procedure depending on cell abnormalities and the likelihood that the disease may come back after treatment. The patient's age and well being are key considerations. Bone marrow is collected and stored from the patient, a family member or other donor. High doses of chemotherapy drugs are given with or without radiation to destroy the cancerous cells, and then the collected bone marrow is re-injected to start production of healthy cells.
  • Blood stem cell transplantation. Instead of storing cells from the bone marrow, stem cells are collected from the patient's blood. The blood is passed through a machine that removes and collects the stem cells before returning the blood to the patient. The stem cells are then treated with drugs to kill any cancer cells and frozen until they are transplanted back to the patient.
  • Biologic therapy. Also called immunotherapy or biologic response modifier therapy, this procedure prompts the body to fight cancer by using substances made either by the patient's body or in a laboratory. The goal is to make the body's natural defenses against leukemia stronger and more active.