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Cancer treatment is either local or systemic. Local treatments remove, destroy, or control the cancer cells in one area. Radiation therapy is an example of local treatment, when directed at one part of your body. Doctors use systemic treatments to destroy or control cancer cells throughout your entire body. Chemotherapy, when you take it by mouth or injection, is an example of systemic treatment. In most cases, treatment for leukemia is systemic. That's because cancer cells are in your bloodstream throughout your body.
You may have just one type of treatment or a combination. Different types of treatments have different goals. Following are some of the types of treatments and their goals for adults who have acute lymphocytic leukemia (ALL):
This is the main way to treat ALL. Chemotherapy uses anticancer drugs to kill cancer cells. Its goal is to kill the cancer cells, putting the cancer into remission and keeping it there. Sometimes a doctor injects chemotherapy drugs directly into your spinal fluid or brain to prevent cancer growth, or to reach cancer cells that may hide there. This is called intrathecal chemotherapy or central nervous system prophylaxis. You may also have chemotherapy combined with a stem cell transplant. Stem cells restore blood cells lost during high-dose chemotherapy treatment.
This type of therapy uses high-energy X-rays to kill cancer cells. Doctors may use radiation to kill or prevent the spread of cancer in your nervous system. They may also use it right before a stem cell transplant or, in rare cases, to shrink a tumor.
If the normal doses of chemotherapy don't work or your doctor feels you need a stem cell transplant to cure your disease, you may get very high doses of chemotherapy. These high doses can damage the stem cells in your bone marrow. Stem cells are the "starter" cells for all types of blood cells. So you may get high-dose chemotherapy (sometimes along with radiation), followed by an infusion of blood stem cells. Most often, these cells come from a donor who matches your tissue type. Sometimes, the stem cells may be taken from your blood or bone marrow before you get treatment, and frozen until you need them. Depending on where the stem cells are collected from, this is called a bone marrow transplant or peripheral blood stem cell transplant.
Some newer drugs specifically target abnormal proteins, such as those caused by the Philadelphia chromosome. Drugs such as imatinib (Gleevec), dasatinib (Sprycel), and nilotinib (Tasignal) may be helpful in treating ALL that has this chromosome. These drugs are taken daily as pills.