Leukemia Treatment.

Immense progress has been made in the treatment of leukemia over the past several decades. New anticancer drugs, improved methods of radiation therapy, bone marrow transplants, and better management of the complications of both leukemia and its therapy have greatly improved the length and quality of life. Even more gratifying is the actual cure of many of the acute leukemias that had been thought to be always fatal, usually within two to four months.

One of the most promising of the therapeutic methods now being developed involves the use of monoclonal antibodies specifically directed against the leukemic cells. If these antibodies, perhaps joined with a toxin that is released into or near the cancer cell, prove effective and safe, a new hope may exist for leukemia patients. Considerable research remains to be done, but results to date are promising.

Although chemotherapy remains the basic treatment for all the leukemias, radiation, administered either by X ray or by radioactive isotopes {such as phosphorus) injected into the bloodstream to concentrate in the bone marrow, has achieved some temporary success in controlling several leukemias, particularly erythroleukemia. Radiation therapy has proved useful in quickly reducing the size of enlarged lymph nodes or spleen. It is used in preparation for bone marrow transplants and to control disease in places such as the brain where chemotherapeutic drugs cannot penetrate (see Sanctuary Organs, below). However, radiation has little to offer in the way of therapeutic benefit. Nor does surgery have a place in the treatment of leukemia, except for biopsy and the exceedingly unusual instances when removal of the spleen is necessary.

Immunotherapy, attempted in the past as a way of stimulating the patient's immune system to attack the cancer cells, showed little results and is no longer used. (This should not be confused with monoclonal antibodies, which represent a very different form of immunotherapy.) Plasma exchange (selective removal of white cells from the blood), dietary change, and other forms of alternative therapy have been of little or no benefit.