Leukemia treatment options

The leukemia specialists at OHSU Knight Cancer Institute are fellowship trained and have extensive knowledge about leukemia.

As the leader of our leukemia team, Dr. Brian Druker  provides expert treatment that is recognized around the world. He has access to the most advanced treatments and unique clinical trials, and unparalleled skill and experience in treating leukemia. Dr. Druker’s career includes developing the drug Gleevec®, a powerful weapon against chronic myeloid leukemia (CML) that changed the way CML is treated. Gleevec was designed to treat certain cancer-causing molecules, eliminating cancer cells while avoiding serious damage to healthy cells. Before Gleevec, only half of patients with CML survived their disease. In its first trials, Gleevec saved the lives of patients who tried it — patients who had exhausted other chances for a cure. Now, nearly 90 percent of people with CML survive.

We customize treatment plans for each leukemia patient and offer a variety of treatment options including chemotherapy, chemotherapy with bone marrow transplant, or monoclonal antibody therapy

Acute myeloid leukemia (AML)

If you have AML, your treatment will start with chemotherapy to put your leukemia into remission. This is designed to kill as many cancer cells as possible. After you are in remission, you will probably have more treatment in the hospital to kill off any remaining cancer cells. You may have chemotherapy with or without an allogeneic stem cell transplant, radiation therapy or, drugs that keep leukemia cells from dividing or help them turn into white blood cells. Medicines that help your own immune system fight leukemia cells are being tested in clinical trials.

Acute lymphoblastic leukemia (ALL)

If you have ALL, your treatment will start with chemotherapy to put the leukemia into remission. This chemotherapy is designed to kill as many cancer cells as possible. After you are in remission, you will probably have more treatment in the hospital to kill any remaining cancer cells. You will probably also have treatment for your central nervous system (brain and spinal cord), where ALL cells frequently “hide out” during the first phase of chemotherapy. This is because chemotherapy often cannot reach the brain and spinal cord. Other treatments include stem cell transplant, biologic therapy (boosting your own immune system), and anticancer drugs called tyrosine kinase inhibitors that treat some types of adult ALL. These drugs block the enzyme, tyrosine kinase, that causes stem cells to develop more white blood cells than your body needs. Two of these drugs are imatinib mesylate (Gleevec) and dasatinib (Sprycel).

Chronic myeloid leukemia (CML)

If you have CML, your treatment will start with imatinib mesylate (Gleevec) which blocks the abnormal protein that is causing your body to make more and more leukemia cells. Gleevec helps bring your levels of blood cells back to normal. Almost all people with CML get some benefit from Gleevec. This drug is a pill that is not the same as chemotherapy. It has little or no effect on healthy tissues, so the side effects are less severe than with chemotherapy, but you may still have some side effects. Your doctor can tell you how Gleevec might affect you. Gleevec does not cure CML, but it controls the disease for many patients as long as they are taking it. You might take another drug, such as dasatinib (Sprycel®), if your doctor thinks it will work better for you than Gleevec®.   

High-dose chemotherapy combined with a bone marrow transplant is the only treatment that can cure CML. This treatment works best for younger patients. If you are 60 years old or younger and have a bone marrow donor match, you may be a candidate for this treatment.

A bonemarrow transplant can be risky. Scientists are studying whether patients with CML do better in the long term with drugs such as Gleevec and Sprycel or with a transplant.

Chronic lymphocytic leukemia (CLL)

If you have CLL, you might not need treatment for a long time after diagnosis. When you do, you might have chemotherapy or monoclonal antibody therapy alone or in combination.  A stem cell transplant is also an option for some people with CLL.