If you have been diagnosed with leukemia or myeloid malignancies — myelodysplastic syndrome (MDS) or myeloproliferative neoplasms (MPN) — your treatment options will depend on:
- The type of leukemia you have (acute or chronic)
- Your age
- Specific characteristics of your cancer cells, such as mutations, DNA changes and expressions of abnormal proteins
- Whether leukemia cells were found in your cerebrospinal fluid (the fluid around your brain and spine) or in other areas of your body
Roswell Park physicians who treat leukemia meet every week with members of the Transplant and Cellular Therapies team and our research scientists to review the case of every patient who might be a candidate for a bone marrow transplant or eligible to enroll in clinical trials of new therapies. Together they will discuss all the options to help create a treatment plan that will work best for you.
The Leukemia team diagnoses and treats adult patients with the following blood cancers in the Leukemia Clinic:
- Acute myeloid leukemia (AML), including acute promyelocytic leukemia
- Acute lymphocytic leukemia (ALL)
- Chronic myeloid leukemia (CML)
- Hairy cell leukemia (HCL)
- Myelodysplastic syndrome (MDS), including chronic myelomonocytic leukemia (CMML)
- Myeloproliferative neoplasms (MPN), including myelofibrosis, polycythemia vera and essential thrombocytosis
- Blastic plasmacytoid dendritic cell neoplasm (BPDCN)
- Aplastic anemia (AA)
- Paroxysmal nocturnal hemoglobinuria (PNH)
- Other hematological disorders and cytopenias, including refractory immune thrombocytopenia (ITP), anemia, leukopenia, thrombocytopenia
- Chronic neutropenia
Nursing staff who specialize in leukemia provide care for inpatients, who stay in private rooms in the hospital’s HEPA-filtered Leukemia Unit, designed to maintain the highest standards of safety.
Treatment by Leukemia Type
People with acute leukemia need to be treated as soon as possible, given the cancer’s potential for rapid progression. The goal of treatment is to destroy signs of leukemia in the body and eliminate symptoms. This is called remission. After you go into remission, more therapy may be given to prevent the disease from coming back (relapsing). This type of therapy is called consolidation therapy or maintenance therapy. Patients whose disease is unlikely to be completely eliminated with chemotherapy may need to be evaluated for bone marrow or stem cell transplantation.
It is important to remember that many people with acute leukemia can be cured. If you have acute leukemia and would like to be seen as soon as possible, please call Patient Access at 1-800-ROSWELL (1-800-767-9355).
Because cancer treatments usually produce side effects, delaying treatment can extend the period of time before you need to deal with those side effects. During this period of delay, called active surveillance or watchful waiting, the disease is monitored closely.
When treatment for chronic leukemia is needed, it can often control the disease and its symptoms. Chronic leukemia can seldom be cured with chemotherapy, but maintenance therapy can keep the disease in remission.
Myeloid Malignancies: MDS, MPNs, CMML
- Myelodysplastic syndrome (MDS): See this page for more information.
The MDS Foundation recognizes Roswell Park as a Center of Excellence for the care of MDS patients.
Elizabeth Griffiths, MD, a member of Roswell Park’s Leukemia team, plays a national role in setting the standard of care for the treatment of MDS and anemia as a member of the MDS and Anemia Guidelines Panel of the National Comprehensive Cancer Network (NCCN). The NCCN Guidelines specify the best ways of preventing, detecting and treating different types of cancer, and are the most widely used standards in the United States.
- Myeloproliferative neoplasms (MPNs): See this page for more information.
- Chronic myelomonocytic leukemia (CMML)
There are two types of CMML — CMML1 and CMML2. Both are considered “overlap” diseases because they have features of both myelodysplastic syndrome (MDS) and myeloproliferative neoplasms (MPN). Over time, CMML can sometimes develop into acute myeloid leukemia (AML), which requires urgent management.
If you are not experiencing symptoms, you may not need treatment right away. Instead, your doctors will monitor you carefully for changes in your health.
If you do develop symptoms, the treatment you receive will depend on the type of CMML you have, its severity, and your age and overall health. At this time, the only potential cure for patients with CMML is an allogeneic blood or marrow transplant (involving a donor).
Because CMML causes both high and very low levels of different types of blood cells, in addition to any other treatment you receive, you may need infusions of red blood cells to treat fatigue, or platelets to control bleeding.