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Don A. Stevens, M.D., Medical Oncologist at Norton Healthcare, explains what leukemia is and how this type of blood cancer is treated.

In the case of chronic leukemias, that’s typically the more aggressive, more serious of the two diseases. I think in order to understand the treatment, it’s good to use the metaphor the garden.

If you think of your bone marrow as a garden and as I’ve already mentioned it’s the importance of constantly growing blood cells, in the case of acute leukemias, your garden is full of weeds and those weeds have in essence overgrown the normal plants so now you’re not making tomatoes, you’re not making corn, you’re not making green beans.

In a medical sense, you’re not making red cells, you’re not making platelets, and you’re not making normal white cells because the weeds are choking off the plants. The treatment for that, therefore, is to cut everything back to the ground. So we give chemotherapy drugs that we call induction. We use the word induction because we’re trying to induce a remission but these drugs that we give, at very high doses generally, in the hospital over a short amount of time, so it’s very intense therapy. But these drugs cut everything back to the ground.

What we hope for and what we pray for and what happens most of the time but unfortunately not always is that the good plants will grow back and the bed cells don’t. That’s a remission. When we have restored the production of the tomatoes, the green beans and the corn, when you’re making a normal number of red cells and normal number a platelets and a normal number of white cells, we call that a remission. Not only do we get rid of the bad cells, we’ve had a regrowth of the good cells.

That’s a bit different than when we deal with solid tumors, like breast cancer, lung cancer, and colon cancer. In those diseases a complete remission is defined by getting rid of the cancer. You don’t have to have a restoration of the normal breast tissue, you don’t have to have a restoration in the normal lung tissue. You just have to get rid of the cancer. In leukemia, you’re not in the complete remission until you’re able to say that you’ve completely gotten rid of the disease and the organ, in this case, the garden or the bone marrow, has to restore itself to normal.

In chronic leukemias the treatments are in general milder and the goal is to control the overgrowth of the abnormal cells and so those are typically less aggressive outpatient therapies or new therapies that we have that are targeting specifically the abnormal cell so it doesn’t impact the normal cells as greatly.

Learn more about leukemia https://www.nortonhealthcare.com/Leukemia

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