Chemotherapy For Acute Lymphocytic Leukemia

Leukemia is a cancer of the blood-forming tissues that initiates when there is a mutation in the single-cell DNA of bone marrow, and it fails to function properly. Acute Lymphocytic leukemia (ALL) occurs in white blood cells, known as lymphocytes in the bone marrow. It is the most familiar type of cancer in teenagers, and the treatments result in high chances of recovery.

ALL grow rapidly which can turn out to be lethal in a few months. The main treatment method, known as chemotherapy should be initiated right after the cancer diagnosis. It is the front-line treatment for acute lymphocytic leukemia. Chemotherapy kills the cancerous cells with the help of chemo drugs, helps in preventing cancer spread to other body parts, and leads a patient toward recovery. 

What is Acute Lymphocytic Leukemia

Acute lymphocytic leukemia (ALL) is also known as acute lymphoblastic leukemia. It is a cancer that initiates in the bone marrow, invades the blood, and spread to other body parts such as lymph nodes, spleen, liver, etc. ‘Acute’ means progressive growth of leukemia and ‘Lymphocytic’ means that it develops from lymphocytes, which are the type of white blood cells. 

What Are the Symptoms & Diagnosis of Acute Lymphocytic Leukemia

The signs & symptoms of acute lymphocytic leukemia are given as follows:

• fatigue
• Fever
• Infections
• Joint pain
• Enlarged liver
• Nosebleeds  
• Enlarged spleen
• Shortness of breath
• Cranial nerve palsies
• Bleeding from the gums

Several blood tests, bone marrow tests, and a full examination of the patient are necessary for the diagnosis of acute lymphocytic leukemia:

• Imaging Tests: An imaging test like a CT scan helps in identifying the location of cancer. Through this test, a doctor can determine whether the cancer has spread to the brain, spinal cord, or other body parts. Another test known as chest X-ray is done to check the widening of the middle part of the chest. 
• Blood Tests: Blood tests are done to check the blood count of people who have acute lymphocytic leukemia. As they have low platelet and hemoglobin count. A blood smear may indicate the presence of early-stage, or immature cells circulating in the blood that are generally present in the bone marrow. 
• Bone Marrow Tests: Bone marrow aspiration includes testing for rapid growth of cancer in marrow tissue, and production of red blood cells by taking a sample of bone marrow from the breastbone or pelvis. Another test called dysplasia is also prescribed by the doctor. It is the development of early-stage cells in the presence of leukocytosis. 
• Other Tests: There are various other tests that are essential for detecting cancer, its location, and the overall health of the patient. Spinal tap checks if cancerous cells have spread to the spinal fluid. Tests on live and kidney functions are done. An echocardiogram and electrocardiogram (ECG) check the left ventricular function. 

How Is Acute Lymphocytic Leukemia Treated

The treatment aims to bring the blood count to a normal level. Target drug therapy, radiation therapy, and chemotherapy are used for the treatment of this type of leukemia. A stem cell transplant is suggested when chemotherapy isn’t beneficial for the patient. 

What Is Chemotherapy

Chemotherapy refers to the usage of drugs for cancer treatment. The drugs travel through the bloodstream to reach cancerous cells present all over the body. For this treatment, a patient needs to stay in the hospital for several weeks, and most probably be put in an isolation room, and protected from other diseases. Later an individual can continue their treatment as an outpatient, and come for therapy by taking appointments for sessions. 

How Is Chemotherapy Given to the Patient

Chemotherapy treatment for acute lymphocytic leukemia is divided into three phases:

• Induction: It is an intensive, and short phase that generally lasts for a month. 
• Consolidation (intensification): It is also intensive, and lasts for a few months. 
• Maintenance (post-consolidation): It is less intensive, and lasts for around 2 years. 

Chemotherapy for Acute Lymphocytic Leukemia is given to the patient in cycles which is followed by the rest period that allows time to body for recovery. The chemo drugs enter the bloodstream and reach cancerous cells that are spread all over the body.  These specific drugs are injected into a muscle, veins, under the skin, or taken orally by the mouth. Many times the chemo drugs fail to reach the area nearby the spinal cord and the brain. In that case, the chemo drugs are injected into the cerebrospinal fluid (CSF) to eliminate the cancer cells in that area called intrathecal chemo. This chemo is given by using a special catheter called an Ommaya reservoir. Anti-cancer drugs are used for the treatment and the most commonly used drugs are:

• Methotrexate
• Prednisone
• Nelarabine 
• Azacitidine
• Cladribine
• Nelarabine
• Dexamethasone
• cyclophosphamide 
• 5-fluorouracil (5-FU)
• 6- mercaptopurine (6-MP) 

The Chemotherapy Cost in India starts from USD $1300. The monthly drug costs are comparatively high in countries like America. People there, suffer due to high-out-of-pocket medical costs. India has cutting-edge facilities and top specialists who are well-known across other countries for their knowledge and expertise. Supreme facilities, budget-friendly packages, new-age healthcare solutions, and unmatched personalized care are assured by the top hospitals in India. The price in India for ALL treatments is far more cost-effective and inexpensive. The precise cost depends upon the type of treatment, choice of hospital and room, medications and other procedures plus follow-up care and treatment. 

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Benefits of Chemotherapy – On the basis of treatment goals, chemotherapy offers several benefits:

• Kill metastatic cancer
• Reduce pain caused by a tumor
• Slow down the cancer growth
• Prevent cancer from spreading to other body parts

Side Effects of Chemotherapy:  The side effects of chemotherapy are given below:

• Infection
• Hair loss
• Fatigue
• Nausea
• Bleeding
• Anemia 
• Appetite changes

How to Prevent Acute Lymphocytic Leukemia

There are a few precautionary measures to prevent acute lymphocytic leukemia such as consumption of cigarettes, exposure to chemicals, radiation, viral infections, pesticides, gasoline, diesel fuel, and electromagnetic fields. 

References: 

• https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/chemotherapy.html
• https://www.mercy.net/service/chemotherapy/
• https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/symptoms-causes/syc-20369077