Leukemia has a wide range of treatments that can be used alone or in combination to give the best outcome for your specific cancer. That’s why careful diagnosis is so important.
As part of a research medical center, physicians at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis have access to a wide range of clinical trials to test new therapies as they emerge. Discuss with your physician how your cancer might benefit from clinical trials.
Because many of our patients come from over 100 miles away, you may be scheduled the same day for additional testing including bone marrow biopsies and imaging studies as well as scheduling with other cancer specialists, in addition to your primary hematologic oncologist.
Different types of leukemia respond to different treatments, so depending on your type, treatments will vary.
Acute lymphoblastic leukemia (ALL)
This aggressive type of leukemia has many different options for care, including different types of chemotherapy and oral targeted treatments, such as tyrosine kinase inhibitors. Total care may involve:
- Chemotherapy and targeted treatments followed by consolidation and maintenance chemotherapy.
- Stem cell transplant from matched unrelated donors, cord blood or mismatched related donors (both for initial treatment or relapse).
- Novel small-molecule inhibitors, cellular treatments, such as genetically modified T-cells, and novel protein treatment, such as monoclonal antibodies and bi-specific agents. These treatments can be both standard of care and part of clinical trials.
Acute myeloid leukemia (AML)
As an aggressive, fast-growing disease, AML has similar treatment options to ALL.
Novel approaches include:
- Incorporation of cancer genomics for predicting optimal drugs and therapy options.
- Use of small molecule inhibitors of tyrosine kinases.
- Outpatient chemotherapy with hypomethylating agents.
- Stem cell transplantation.
Chronic Lymphocytic Leukemia (CLL)
- Standard chemotherapy.
- Wide array of monoclonal antibodies.
- Antibody immunotoxin conjugates.
- Small molecule kinase inhibitors.
- Stem cell transplant.
Chronic myeloid leukemia
Although chemotherapy can be used, most patients are treated with small molecule tyrosine kinase inhibitors. Stem cell transplant is sometimes used for patients who fail oral tyrosine kinase inhibitors.
Hairy cell leukemia
This rare type of leukemia is usually managed by observation or a single-agent outpatient chemotherapy treatment for long-term management. Rarely, it may require investigational agents or small-molecule treatment.
Chronic myelomonocytic leukemia
This rare form of aggressive pre-leukemia or myelodysplastic syndrome is managed by observation, outpatient hypomethylating agent therapy, splenic radiation and stem cell transplant for patients who progress or fail to respond to treatment. It is incurable without stem cell transplant.