by EBSCO Medical Review Board

Chemotherapy (chemo) uses drugs to kill cancer cells. The drugs are passed through the blood through the body. It may be used alone or with radiation therapy.

There are many kinds of drugs that can be used. The care team will help find the best ones for each person. Chemo is most often given through an IV. Some leukemia has a high risk of spreading to the brain and spinal cord. In this case the chemo may be placed in the fluid around the brain and spine.

Chemo is given in cycles over a set time in 3 phases:

  • Induction—To remove all signs of leukemia.
  • Consolidation—To kill any leftover cells in the body after the first phase is done. It lowers the chances of cancer coming back.
  • Maintenance—To keep cancer from coming back once all signs of it are gone.

Chemo may not be given right away for chronic leukemias. Treatment may wait until blood cell counts change, or symptoms appear or worsen.

Side Effects and Management

Chemo is made to target cancer cells. However, it can also affect fast growing healthy cells. This can cause a range of health problems. The most common are:

  • Nausea and vomiting
  • Tiredness
  • Hair loss
  • Irritation to the tube that connects the mouth to the stomach—esophagitis
  • Infertility or premature menopause—For those who want children, there may be options for preserving fertility before treatment

Most side effects will fade once chemo has stopped. Other side effects may be long term. It can include damage to the heart and nerves, or some thinking and memory problems. Rarely, other cancers can form.

There are many ways to manage these problems. Medicines and lifestyle changes are the most common. Sometimes cycles may be changed to lower the risk of serious problems. It is important to talk to the care team as soon as side effects appear. That way they can be better controlled.

References

Eichhorst B, Robak T, et al. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021 Jan;32(1):23-33.

Initial management of acute myeloid leukemia (AML). EBSCO DynaMed website. Available at: https://www.dynamed.com/management/initial-management-of-acute-myeloid-leukemia-aml. Accessed April 15, 2022.

Initial management of chronic lymphocytic leukemia (CLL). EBSCO DynaMed website. Available at: https://www.dynamed.com/management/initial-management-of-chronic-lymphocytic-leukemia-cll. Accessed April 15, 2022.

Management of acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-lymphoblastic-leukemia-lymphoblastic-lymphoma-all-lbl-in-adults#GUID-51D8AD32-21CB-44AA-A894-5F4736B3752D. Accessed April 15, 2022.

Management of chronic myeloid leukemia in accelerated or blast phase. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-myeloid-leukemia-cml-in-accelerated-or-blast-phase. Accessed April 15, 2022.

Management of chronic myeloid leukemia in chronic phase. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/management/management-of-chronic-myeloid-leukemia-cml-in-chronic-phase. Accessed April 15, 2022.

Management of relapsed or refractory chronic lymphocytic leukemia (CLL). EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/management/management-of-relapsed-or-refractory-chronic-lymphocytic-leukemia-cll. Accessed April 15, 2022.

Overview of leukemia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hematology-and-oncology/leukemias/overview-of-leukemia. Accessed April 15, 2022.

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