Leukemia depletes the numbers of red blood cells, platelets, or other blood components. Blood transfusions are a way to replace cells and healthy blood cell counts. This helps with treating anemia symptoms, and improving infection control and blood clotting. Blood is given through an IV. The blood comes from a donor. Donated blood must match your blood type. Though donor and recipient blood is tested for type, you will be monitored for any signs of an adverse reaction during the transfusion.
Bone Marrow Transplant
Resistent, recurring, or advanced leukemia, and chemotherapy can significantly reduce the number of healthy blood cells in bone marrow. The loss of these cells will reduce the immune system's ability to fight infections or disease, which can lead to life-threatening infections. A bone marrow transplant (BMT) uses healthy stem cells (immature, unformed cells) from the bone marrow in your body or a donor to restore normal bone marrow function. The cells travel to bone marrow sites throughout the body and slowly repopulate numbers of red or white blood cells, or platelets. If the transplant is successful, the newly injected cells should be free of cancer and capable of producing healthy cells.
A BMT can be:
Healthy stem cells are harvested from your own body. They can be taken from the bone marrow or extracted from circulating blood. Circulating blood removed from the body is spun in a machine to separate the components in a process called apheresis. The blood is then circulated back into the body. The stem cells are frozen until all malignant leukemia cells are eliminated by chemotherapy (with or without radiation therapy). Lastly, the healthy stem cells are returned to the body to repopulate the blood cell count.
Allogeneic transplants involve a second person known as a donor. In order for bone marrow transplant to be successful, certain markers (called HLA types) on the donor's and recipient's blood cells and bone marrow cells must match. The recipient is given medications to suppress the immune system and prevent rejection of the donor's bone marrow. Prior to the bone marrow transplant, treatment to eliminate all malignant leukemia cells from the body may be done (conditioning).
The recepient's bone marrow is harvested with a needle, which removes bone marrow tissue. The donated marrow is filtered and given to the recipient through a vein in the chest. Once the procedure is done, the recipient is isolated to reduce the chance of infection while the healthy stem cells repopulate the blood cell count. It can take up to a month for bone marrow to be fully functional.
Biologic therapy (also called immunotherapy) helps the body fight cancer cells using natural processes. It may help stimulate the immune system to better attack cancer cells, control the growth of cancer, or change cancer behavior. This type of treatment also minimizes damage to healthy cells. This therapy is often used in combination with other leukemia treatments. At this time, biologic therapy may be used to treat leukemia in advanced stages under certain circumstances. Medications may include:
- Blinatumomab for acute lymphocytic leukemia (ALL) in adults
- Rituximab, obinutuzumab, ofatumumab, and alemtuzumab for chronic lymphocytic leukemia (CLL)
- Interferon for chronic myeloid leukemia (CML)
Biologic therapy is delivered through an IV, or injected under the skin or into the muscle, depending on the drug. The length of time it is given depends on type of leukemia that is being treated, the drug involved, and how well the treatment can be tolerated.
Discuss the benefits and risks of the various treatments with your doctor.
- Reviewer: Mohei Abouzied, MD
- Review Date: 12/2015 -
- Update Date: 02/09/2016 -