Medications

Chemotherapy is the standard treatment for many types of leukemia. Even when a cure is not possible, chemotherapy may help you live longer and feel better.

Chemotherapy for leukemia is usually a combination of drugs. This is because different drugs attack leukemia cells in different ways. The combination also helps keep the leukemia cells from becoming resistant to any one drug. Other drugs used to treat leukemia help prevent infection and help your body grow new blood cells (such as epoetin and hematopoietic stimulants).

Nausea and vomiting are the most common side effects of chemotherapy for leukemia. But having chemotherapy does not mean that you have to suffer with nausea and vomiting. Your doctor may prescribe medicines to control nausea and vomiting. There are also things you can do at home. For more information on these side effects, see:

Cancer: Controlling Nausea and Vomiting From Chemotherapy.

Medication Choices

Acute leukemia

Your treatment plan will include the kind of medicine that works best for the specific type or subtype of leukemia that you have.

• Acute lymphoblastic leukemia (ALL) medicines may include prednisone, methotrexate, l-asparaginase, vincristine, and doxorubicin or daunorubicin.
• Acute myelogenous leukemia (AML) medicines may include daunorubicin with cytarabine. Idarubicin or mitoxantrone may be used instead of daunorubicin.
• Acute promyelocytic leukemia (APL) medicines may include all-trans-retinoic acid (ATRA) and chemotherapy with arsenic trioxide, idarubicin, or daunorubicin. ATRA also helps control the risk of life-threatening bleeding from disseminated intravascular coagulation (DIC).

Chronic leukemia

Medicines used for treatments for chronic lymphocytic leukemia (CLL) are taken orally (by mouth) or given intravenously for limited periods of time. If there is relapse, medicines are given again. For chronic myelogenous leukemia (CML), medicine is usually taken by mouth for as long as needed. Treatment choices may include:

• Chemotherapy for chronic lymphocytic leukemia (CLL). This may be a single medicine or a combination of medicines. For example, you may be given a combination of cyclophosphamide, vincristine, and prednisone. Other choices may include fludarabine and chlorambucil, or the monoclonal antibodies rituximab and alemtuzumab.
• Tyrosine kinase inhibitors for chronic myelogenous leukemia (CML). These medicines include imatinib, dasatinib, or nilotinib. People with CML who cannot have stem cell transplants and are unable to take tyrosine kinase inhibitors may be given interferon alfa (with or without cytarabine), hydroxyurea, or busulfan.

Medicine for nausea and vomiting

Nausea and vomiting are common side effects of chemotherapy. These side effects usually are temporary and go away when treatment is stopped. Your doctor will prescribe medicines to help relieve nausea. These medicines include aprepitant, dimenhydrinate, phenothiazines, or serotonin antagonists.

What To Think About

There are a lot of clinical trials of new medicines for leukemia. These trials have made it possible for many people with leukemia to live longer. Ask your doctor whether you are a candidate for participation in a clinical trial. For more information, see www.cancer.gov/clinical_trials/ or http://clinicaltrials.gov.