Leukemia Treatment Options

Adult Acute Lymphoblastic Leukemia (ALL) occurs when your body makes too many lymphocytes. These lymphocytes, called blasts, can live in your bone marrow, lymph nodes and spleen. Acute Lymphoblastic Leukemia accounts for 20% of acute leukemia in adults. The term acute means it usually develops quickly with symptoms showing up within days or weeks.

Acute Lymphoblastic Leukemia symptoms

• Low immunity
• Fatigue
• Shortness of breath
• Easy bleeding and/or bruising
• Pain in your bones
• Enlarged lymph nodes

Acute Lymphoblastic Leukemia treatment

Acute Lymphoblastic Leukemia is usually first suspected when blasts appear in the blood and then is confirmed by biopsy of the bone marrow. Acute Lymphoblastic Leukemia treatment depends on the patient’s age, overall health and test results. Standard treatment includes chemotherapy with or without immunotherapy and sometimes a blood or marrow transplant.

If you are diagnosed with Acute Lymphoblastic Leukemia and also have the Philadelphia Chromosome, you will receive one of these targeted agents in combination with chemotherapy or alone following transplant.

Acute Myeloid Leukemia (AML) is the most common type of leukemia in adults. Acute Myeloid Leukemia often develops quickly with symptoms usually showing within days or weeks. You typically will have low levels of healthy red blood cells, white blood cells and platelets. Acute Myeloid Leukemia is diagnosed through bone marrow biopsy. If you are diagnosed with AML, you will be treated as soon as possible with a plan based on your overall health, age and test results.

Acute Myeloid Leukemia symptoms

• Low immunity
• Fatigue
• Shortness of breath
• Bleeding and/or bruising

Acute Myeloid Leukemia treatment

Chemotherapy is frequently used to treat Acute Myeloid Leukemia sometimes followed by a blood or marrow transplant. If you are not a candidate for chemotherapy due to other health problems, we’ll use drugs called Hypomethylating Agents.

Acute Promyelocytic Leukemia (APL) is a unique type of Acute Myeloid Leukemia (AML) due to a cell called promyelocytes in the bone marrow and blood. While you may have severe bleeding when diagnosed, the survival rate is generally high.

Acute Promyelocytic Leukemia symptoms

• Fatigue and shortness of breath during normal physical activities
• Weakness
• Lightheadedness, dizziness or faintness
• Frequent infections
• Fever
• Unexplained weight loss
• Discomfort in bones or joints
• Fullness or swelling in the abdomen, due to an enlarged spleen or liver
• Easy bruising or bleeding
• Pinhead-sized red spots on the skin, called “petechiae”
• Frequent or severe nosebleeds
• Bleeding gums

Acute Promyelocytic Leukemia treatment

Your treatment will include a vitamin A derivative called all trans retinoic acid and arsenic, with or without chemotherapy.

Blastic Plasmocytic Dendritic Cell Neoplasm (BPDCN) is a rare form of acute leukemia. A subtype of acute myeloid leukemia (AML), BPDCN stems from an abnormal growth of the plasmacytoid dendritic cells, which interferes with your body’s immune system function properly.

Novant Health Cancer Institute has a specialized center for researching, diagnosing and treating BPDCN. Members of the Novant Health team were the first in the world to conduct human tests of a new therapy approved by the FDA to treat BPDCN. Some of these new therapies stimulate your immune system to directly attack the cancer, others target pathways that control cell growth. We continue to advance the field by offering new clinical trials to better target the disease.

Blastic Plasmocytic Dendritic Cell Neoplasm symptoms

BPDCN is often diagnosed in your 60s and 70s and is more common among men. You may first notice a swollen lymph node, but you are more likely to first discover it from a rash on your skin. Symptoms include:

• Easy bruising and bleeding
• Persistent fatigue and shortness of breath
• Unexplained fevers
• Infections
• Skin lesions
• Severe night sweats

Treatments for Blastic Plasmocytic Dendritic Cell Neoplasm

Because it is a rare type of cancer, diagnosing BPDCN can be challenging. To determine the location and phase of your cancer, you may undergo a CAT scan or PET scan, bone marrow biopsy or a skin lesion biopsy. You may also meet with a genetic counselor to help us refine your treatment options.

Your multidisciplinary team will review your results and then work closely with you to develop an individual treatment plan that may include:

• Newly approved targeted immunotherapies
• Investigational approaches such as CAR-T therapy and new oral agents
• Stem cell transplant from a donor (potentially curative)