Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Leukemia treatment falls into two categories -- treatment to fight the cancer and treatment to relieve the symptoms of the disease and the side effects of the treatment (supportive care).
The most widely used antileukemic treatment is chemotherapy, that is, the use of powerful drugs to kill leukemia cells.
Treatment usually involves combinations of chemotherapy.
Depending on the medication, therapy may be administered by vein or by mouth.
In some cases, chemotherapy can be given at the doctor's office or some may be taken at home; in other cases, the patient may have to stay in a hospital. This depends on which agents the patient is receiving along with his or her overall condition (sometimes measured in terms of "performance status").
Many people with leukemia have a semi-permanent intravenous (IV) line placed in the upper chest, near the shoulder.
A thin, plastic tube called a catheter is passed through the skin of the chest and inserted into a large vein. It is held in place, usually for the planned duration or therapy, with a few stitches, which makes it possible to use the same vein on numerous occasions without worry about the intravenous line being pulled out. The line is often burrowed under the skin.
People who have leukemia in their cerebrospinal fluid, or who are at high risk of having leukemic cells migrate to the spinal fluid, receive chemotherapy directly into the cerebrospinal canal. This is known as intrathecal chemotherapy.
Intrathecal chemotherapy is necessary because drugs given via IV do not sufficiently penetrate into the cerebrospinal fluid or brain and, thus, cannot kill leukemia cells there. Insufficient penetration of drugs into the cerebrospinal fluid results in uncontrolled growth of leukemic cells in the cerebrospinal fluid. Sometimes the therapy is inserted into a sac placed in one of the larger fluid-filled areas of the brain, a ventricle. The sac is known as an Ommaya reservoir, so named after its developer.
The reservoir stays in place for the duration of the treatment.