Leukemia is treated mainly with chemotherapy , although radiotherapy and biological therapy can play a part with some forms of the disease. Surgery has no role. The goals of therapy are to relieve symptoms and obtain a remission . Remission is the condition in which leukemia is no longer detected and the marrow is normal again.
Bone Marrow Transplantation The utility or usefulness of this procedure must be decided on an individual basis. In some cases, bone marrow transplantation is used in acute myelogenous leukemia during the period of first remission, and in acute lymphoblastic leukemia as "salvage" therapy on relapse ( see Bone Marrow Transplantation ). There are two forms of marrow transplantation.
• Autologous transplantation uses the patient's own marrow. The marrow is collected while the patient is in
remission, and it is often treated with chemotherapy agents or monoclonal antibodies before being given back.
This is an effort to eliminate the few leukemic cells that might still be present but are undetectable.
• An allogeneic bone marrow transplant uses marrow from a normal donor, preferably a brother or sister who has
the same tissue types. If a sibling is not available, a search of national and international tissue banks could be
made for a non-related normal donor.
A bone marrow transplant requires four to six weeks in a hospital and the cost is currently about $150,000
to $250,000. Not all hospitals are able to perform the procedure but it is becoming more widely accepted.
The risk of dying is higher for an allogeneic marrow transplant than for an autologous transplant. Part of the reason is the potential of a graft-versus-host reaction. Some allogeneic transplants are performed with removal of
