UofL Health – Brown Cancer Center has a team of highly experienced physicians dedicated to the treatment of leukemia. Using a comprehensive team approach, we work together to give you customized care that includes the most advanced diagnostic methods and treatments.
As a regional leader in the treatment of leukemia, we offer access to numerous innovative new therapies and investigational agents that may help increase your chances of successful treatment. Many of these are not found in other centers. We have the full range of services needed to ensure comprehensive, yet specialized care.
Successful leukemia treatment begins with an accurate and precise diagnosis. We have the expertise and our specialized pathologists are highly experienced in diagnosing leukemia.
Our approach to leukemia is customized especially for you. We do not take a one-size-fits-all approach. Our first step is to carefully evaluate your risk factors to determine if treatment is necessary. If it is, we recommend the most advanced therapy with the least impact on your body.
Our Multidisciplinary Blood Cancers, Cellular Therapeutics and Transplant Program offers all the services needed to care for leukemia and its impact on your body, such as infections and bleeding issues. We strive to accomplish as much care as possible on an outpatient basis.
We are constantly striving to find new and better ways to fight leukemia and are able to offer a wide range of clinical trials for treatment. Many of the doctors who treat leukemia at Brown Cancer Center are also dedicated researchers.
If you are diagnosed with leukemia, your doctor will discuss the best options to treat it. This depends on several factors, including the type of leukemia, your age and your general health.
Facts
According to the American Cancer Society’s 2024 statistics, more than 50,000 people in the United States are diagnosed with leukemia each year. This includes about:
- 20,700 cases of chronic lymphocytic leukemia (CLL), most in older adults
- 20,800 cases of acute myeloid leukemia (AML), most in adults
- 6,550 cases of acute lymphocytic leukemia (ALL), about four in ten in adults
- 9,280 cases of chronic myeloid leukemia (CML), most in older adults
Leukemia is cancer of blood-forming tissue such as the bone marrow, the sponge-like material inside some bones. In healthy bone marrow, blood cells form and mature, then move into the bloodstream. Understanding what happens to your blood when you have leukemia, helps to know what makes up normal blood and bone marrow.
In leukemia, the normal production of blood cells changes. The bone marrow starts making too many abnormal, immature cells, called blasts or lymphoblasts, which crowd out other blood cells in the blood marrow, bloodstream and lymph system. They can travel to other places in the body, including lymph glands and the spleen.
Leukemia Types
Types of leukemia are grouped by the type of cell affected and by the rate of cell growth. Leukemia can be either acute or chronic.
Acute leukemia involves an overgrowth of very immature blood cells. This condition is life-threatening because there are not enough mature blood cells to prevent anemia, infection and bleeding. A diagnosis of acute leukemia is made when there are 20% or more blasts or immature cells in the bone marrow.
There are two main types of acute leukemia:
- Acute lymphocyte leukemia (ALL): Most prevalent during childhood and early adulthood, but it also is found in adults.
- Acute myeloid (or myelogenous) leukemia (AML): Occurs more often in adults.
Myelodysplastic Syndrome (MDS) is a condition in which the bone marrow does not produce enough normal blood cells. Some cases of MDS may, over time, progress to acute leukemia.
Myeloproliferative Disease (MPD), also known as myeloproliferative neoplasia (MPN), is a condition in which the bone marrow makes too many blood cells. Sometimes the disease progresses slowly and requires little treatment; other times it develops into acute myeloid leukemia (AML).
Chronic leukemia involves an overgrowth of mature blood cells. Usually, people with chronic leukemia have enough mature blood cells to prevent serious bleeding and infection. Chronic leukemia is found more often in people between ages 40 and 70. The main types of chronic leukemia are:
- Chronic lymphoblastic leukemia (CLL)
- Chronic myeloid (or myelogenous) leukemia (CML)
To look for specific types of leukemia, your doctor will examine features on the bone marrow cell surface and the appearance of the bone marrow cells under a microscope, as well as analyze chromosome number and appearance.
Symptoms
Many times, leukemia does not have symptoms in the early stages. When it does have signs, they vary from person to person and according to the type of leukemia. If you do have symptoms, they may include:
- Unexplained fever
- Persistent fatigue or feeling of weakness
- Unintentional weight loss, loss of appetite
- Easy bruising or bleeding, unexplained nose bleeds
- Shortness of breath
- Petechiae (tiny red spots under the skin caused by bleeding)
- Swollen lymph glands
- Anemia (low red blood cell counts)
- Night sweats
- Bone or joint pain
- Recurring infections
Symptoms of acute lymphoblastic leukemia may also include painless lumps under the skin in the groin, underarm or neck, and/or pain under the ribs.
These symptoms do not always mean you have leukemia. However, it is important to discuss any symptoms with your doctor since they may signal other health problems.
Diagnosis
Blood tests, imaging exams and even surgical procedures are used to check for cancer.
An accurate and precise diagnosis of leukemia is essential for effective treatment.
Diagnosis of leukemia is based on the results of blood and bone marrow tests, including bone marrow aspiration and bone marrow biopsy.
Treatment
Common cancer treatments include chemotherapy, radiation treatment and surgery. Doctors select a treatment plan based on your diagnosis and disease stage.
We bring together internationally renowned physicians with a specialized support team to customize your care. These highly experienced experts communicate and collaborate often, ensuring you receive comprehensive care.
If you are diagnosed with leukemia, your doctor will discuss the best options to treat it. This depends on several factors, including the type of leukemia, your age and your general health.
Your treatment for leukemia will be customized to your particular needs. One or more of the following therapies may be recommended to treat cancer or help relieve symptoms.
Chemotherapy
Your treatment may consist of more than one chemotherapy drug or biological therapy. The short-term goal is complete remission, which means the bone marrow has less than 5 percent blasts, the absolute neutrophil count is more than 1,000 and the platelet count is more than 100,000. The long-term goal is for an extended disease-free state and cure.
A course or cycle is the period of time from the start of chemotherapy until the blood and bone marrow cell counts are back to normal or you are able to receive further treatment. In some cases, leukemia cells are destroyed only in the blood and not in the bone marrow during the first course of chemotherapy. In these cases, a second course may be needed. If the leukemia does not respond to one or two courses of treatment, or if a relapse occurs, a different drug program may be used to attempt to bring about a remission.
A specific treatment plan is called a protocol. Each protocol is usually named by letters with each letter standing for a particular drug. A protocol may be considered standard or experimental therapy. Your doctor will discuss with you the advantages and disadvantages of a particular type of therapy.
Radiation Therapy
Radiation therapy is used with chemotherapy for some kinds of leukemia. Radiation therapy for leukemia patients may be directed to:
- A specific area of the body where there is a collection of leukemia cells, such as the spleen or testicles
- The entire body. This is called total-body irradiation and usually is given before a stem cell transplant
Biological Therapy
Biological therapies help the immune system fight cancer, infections and other diseases. They include growth factors, interleukins and monoclonal antibodies. Biological therapies may be given alone or with chemotherapy.
Targeted Therapies
We offer innovative targeted therapies. These agents are specially designed to treat each cancer's specific genetic/molecular profile to help your body fight the disease.
Surgery
Sometimes a splenectomy, or surgical removal of the spleen, is needed. The spleen is located on the left side of the abdomen and acts as a filtration system for blood cells. In chronic leukemia, the spleen tends to collect leukemia cells, transfused platelets and red blood cells. Frequently, the spleen enlarges from storing these cells, making it difficult for chemotherapy to reduce diseased cells. If the spleen is not removed, it sometimes grows so large that it causes breathing difficulty and compresses other organs.
Stem Cell Transplantation
Stem cell transplantation (SCT), which used to be called bone marrow transplant, destroys leukemic bone marrow cells using high doses of chemotherapy and in some cases, radiation therapy. Because high-dose chemotherapy severely damages the bone marrow's ability to produce cells, healthy stem cells then are given intravenously to stimulate new bone marrow growth.
Like other leukemia treatments, SCT is highly individualized. Your care will be planned specifically for you, considering such factors as the type of leukemia, past response to chemotherapy, availability of stem cells for replacement, your age and the status of the leukemia.