Patients who come to the Siteman Cancer Center for treatment of leukemia are seen by a team of Washington University Physicians — medical oncologists, radiation oncologists and a health psychologist, as needed — often during the same visit. Experienced nurses then spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses offer patients printed materials on leukemia, chemotherapy, radiation therapy, bone marrow transplant and other related issues. As a unique feature of your care, we also offer the services of a palliative care specialist who can help you fit treatment into your own special circumstances, if needed.
Because leukemia is a blood disorder, radiation, chemotherapy and bone marrow transplant are the mainstays of therapy.
Siteman Cancer Center sees on average 265 new leukemia patients a year, many with AML. In their review of the program, the National Cancer Institute called it the pre-eminent leukemia program in the country. It is the only leukemia program with both a program project grant and a specialized program of research excellence grant from the NCI.
Radiation therapy may be utilized to kill cancer cells and shrink tumors. Chemotherapy uses drugs given by mouth or intravenously to kill cancer cells. Bone marrow transplants can restore the normal function of the bone marrow to produce red and white blood cells and platelets.
Siteman has the leading cancer genomics program in the country, and its clinicians are leaders in understanding the genes that cause leukemia and in the development of targeted therapies. Washington University Physicians at Siteman are actively involved in clinical trials that investigate new chemotherapy regimens and other approaches to cure. Much of the science for the trials was developed here and some trials are only offered at Siteman. Having your cancer treated at Siteman gives you access to new therapies that are as good as – or potentially better than – current standard therapies available elsewhere.
Types of Leukemia
- Acute lymphoblastic leukemia (ALL): This aggressive type of leukemia is characterized by having too many lymphoblasts (immature white blood cells) in the blood and bone marrow.
- Acute myeloblastic leukemia (AML): Also an aggressive, fast-growing disease, AML differs from ALL in that too many myeloblasts, as opposed to lymphoblasts, are found in the bone marrow and blood. The disease is also called acute myeloid leukemia, acute myelogenous leukemia and acute nonlymphocytic leukemia.
- Large granular lymphocytic leukemia (LGL): This disease exhibits an unexplained chronic elevation in large granular lymphocytes in the peripheral blood. It is sometimes known as T-cell large granular lymphocyte leukemia. This rare form of leukemia is chronic and slow-growing, manifesting itself with low blood counts, particularly neutrophils, increasing risk of infection.
- Chronic lymphocytic leukemia (CLL): CLL differs from the acute version in that the cancer is more slow-growing. In later stages of the disease, CLL can produce cancer cells in the lymph nodes, which is a secondary disease called small lymphocytic lymphoma.
- Chronic myelogenous leukemia (CML): Also called chronic myeloid leukemia (CML) or chronic granulocytic leukemia, this slowly progressing disease produces too many myelocytes in the bone marrow. Most people with CML have a gene mutation called the Philadelphia chromosome, a mutation not passed from parent to child.
- Hairy cell leukemia: This rare type of leukemia is characterized by abnormal B-lymphocyte white blood cells in the bone marrow, spleen and peripheral blood. When viewed under a microscope, these cells appear to be covered with tiny hair-like projections.
- Chronic myelomonocytic leukemia (CMML): CMML is a type of cancer that starts in blood-forming cells of the bone marrow and invades the blood. It affects mainly older adults. CMML patients have a high number of monocytes in their blood. Many patients have enlarged spleens and about 15 percent to 30 percent of CMML patients go on to develop acute myeloid leukemia (AML).