Chemotherapy, Targeted Therapy, Radiation, and More

Targeted Therapy for Leukemia

Unlike traditional chemotherapy, which generally does not discriminate between cancer cells and noncancer cells, targeted treatments home in on specific features of cancer cells that allow them to grow and multiply. They’re usually given in a pill form.

Some examples of targeted drugs are:

Certain targeted therapies are designed for specific types of leukemia. Your doctor can help you figure out if you’re a candidate for targeted treatment.

Side effects of these drugs are usually mild but may include:

• Diarrhea
• Nausea
• Fatigue
• Skin rashes
• Muscle pain (6)

Biological Therapy for Leukemia

Biological therapies are substances that work on the immune system, helping it fight cancer.

Some biological medicines used to treat leukemia are:

These drugs are often given along with chemotherapy or other treatments.

Side effects of biological therapy may include fever, chills, headache, nausea, and fatigue.

Researchers are also testing immunotherapy to treat certain forms of leukemia. (10)

CAR T-Cell Therapy for Leukemia

One newer type of immunotherapy, known as chimeric antigen receptor (CAR) T-cell therapy, involves removing specific immune cells from a person’s blood and altering them in the lab to improve their ability to find and fight cancer cells. The cells are then infused back into the patient, so they can seek out and kill leukemia cells. (1)

Studies of CAR T-cell therapy have shown potential in the treatment of chronic lymphocytic leukemia (CLL). But to date, CAR T-cell therapy has only received approval from the U.S. Food and Drug Administration (FDA) for treatment of B-cell acute lymphoblastic leukemia (B-ALL). These two drugs are approved for treating a subtype of B-ALL called B-cell precursor ALL:

• tisagenlecleucel (Kymriah) This drug is approved for patients ages 25 and under whose cancer is not responding to treatment or has come back after treatment two or more times.
• brexucabtagene autoleucel (Tecartus) This drug is approved for adults whose cancer is not responding to treatment or has come back after treatment.

CAR T-cell therapy can cause side effects ranging from very high fevers and low blood pressure to neurological toxicities such as confusion and delirium. Patients given CAR T-cell therapy will be monitored for a serious side effect called cytokine release syndrome, which is characterized by inflammation that presents as fever and affects multiple organs in the body. This complication can be severe and may need intensive care treatment to control. (12)

RELATED: CAR T-Cell Therapy Enhances the Human Immune Response to Cancer

Radiation for Leukemia 

Radiation therapy uses X-rays or other forms of energy to target leukemia cells. This treatment is sometimes used to prepare you for a stem cell transplant. (13)

Radiation is often combined with other therapies.

Possible side effects might include:

• Increased risk for infection
• Fatigue
• Nausea
• Diarrhea
• Skin irritation
• Loss of appetite (13)

Stem Cell Transplant for Leukemia

A stem cell transplant, which is also called a bone marrow transplant, is a medical procedure used to replace your bad bone marrow with healthy bone marrow. (14)

You’ll receive high doses of chemo or radiation, or a combination of both, to destroy your diseased bone marrow before having the transplant. Then, you’ll be given an infusion of blood-forming stem cells.

There are two types of stem cell transplants:

• Autologous With this type of transplant, you can use your own stem cells. The cells are removed from your blood, harvested, frozen, and then infused back into your body.
• Allogeneic Stem cells are taken from a matching donor, such as a close relative, and then injected into your body. Sometimes, donor sources might include umbilical cord blood or an unrelated donor. This is the main type of transplant used to treat acute leukemias. (1,15)

Allogeneic transplants are considered riskier than autologous transplants because they can cause a serious complication known as graft-versus-host disease. This occurs when the donor’s cells attack the patient’s healthy tissues and organs. (16) You will be given medicine to help prevent graft-versus-host disease.

Who Can Watch and Wait?

Some very slow growing leukemias, like CLL, may not require treatment right away. Your doctor may recommend a “watch and wait” approach. This means your healthcare provider will monitor your cancer without offering any treatment until it becomes necessary. Studies show there are no benefits to treating certain forms of slow-growing leukemia early on. (17)