Acute leukemia is a rapidly progressing cancer of the bone marrow and blood. According to Donna D. Ignatavicius, MS RN, and M. Linda Workman, Ph.D., authors of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care," treatments for acute leukemia center on stabilizing the patient, beginning combined therapies and protecting the patient from complications of the disease process such as severe bleeding and systemic infections.
Chemotherapy
The Leukemia and Lymphoma Society states that chemotherapy has created the greatest improvement in treating leukemia. Chemotherapy is the use of anti-cancer drugs. Doctors use two or three different chemotherapy agents and administer them in carefully-timed courses based on a patient's white blood cell (WBC) count. Chemotherapy drugs wipe out a patient's white blood cells, cancer cells and healthy cells alike. Very low WBCs make a patient vulnerable to infection. Doctors give one drug and monitor the WBC count to make sure the second chemotherapy agent is only started when the patient's WBCs have recovered to a safe level.
Immunotherapy
Immunotherapy involves use of agents that improve the effectiveness of chemotherapy drugs and boost a patient's own immune system function. One type of immunotherapy agent appropriate for acute leukemia treatment is monoclonal antibody therapies. The Leukemia and Lymphoma society explain that lab-created proteins "tagged" with nuclear isotopes are injected into the blood stream where the proteins are drawn to specific cancer cells and interfere with cancer cell division. The radiation attached to the monoclonal antibody destroys the cancer cell
Gene Therapy
Gene therapy treatment essentially disables the proteins inside of cells that signal a cell to divide. In leukemia, it is the continuous division of a cancerous cell that over-runs the bone marrow inhibiting normal development of blood cells. Turning off the cell "divide switch" stops the progression of the cancer. Gene therapy boosts the effectiveness of chemotherapy.
Stem Cell Transplant
Stem cells have the ability to become any type of cell. Stem cells are the source of all cells in the body. Stem cells travel throughout the body waiting for a specific signal to differentiate or become a specific cell. Stem cells transplanted into the bone marrow will turn into blood cells. A patient with leukemia has improperly functioning stem cells. The transplanted stem cells provide a healthy source of white blood cells, red blood cells and platelets. Patients may donate their own stem cells if they have enough healthy circulating stem cells in their blood. If not, patients may receive stem cells from a donor.
Stabilization
Treatment for acute leukemia not only involves interventions to eliminate the cancer, but medical care to protect and stabilize the patient. Already compromised and at risk for infection, antibiotics are given not only to treat any active infection, but also to prevent infection. Patients receive oxygen and possibly red blood cell transfusions to treat anemia. Patients are at risk for bleeding from low platelets and may receive transfusions of platelets as well.
References
- "Medical-Surgical Nursing: Critical Thinking for Collaborative Care"; Donna D. Ignatavicius & M. Linda Workman; 2006
- Leukemia and Lymphoma Society: "Drug and Radiation Therapy"
