Chemotherapy is the standard treatment for many types of leukemia. Even when a cure isn't possible, chemotherapy may help you live longer and feel better.

Chemotherapy for leukemia is usually a combination of drugs. This is because different drugs attack leukemia cells in different ways. The combination also helps keep the leukemia cells from becoming resistant to any one drug.

Along with the chemotherapy drugs, other medicines may be given to help the chemotherapy drugs work better and prevent infection or bleeding. These drugs include epoetin and hematopoietic stimulants.

Medication choices

For acute leukemia

Your treatment plan will include the kind of medicine that works best for the specific type or subtype of leukemia that you have.

• Acute lymphoblastic leukemia (ALL) medicines may include prednisone, methotrexate, l-asparaginase, vincristine, and doxorubicin or daunorubicin.
• Acute myelogenous leukemia (AML) medicines may include daunorubicin with cytarabine. Idarubicin or mitoxantrone may be used instead of daunorubicin.
• Acute promyelocytic leukemia (APL) medicines may include all-trans-retinoic acid (ATRA) and chemotherapy with arsenic trioxide, idarubicin, or daunorubicin. ATRA also helps control the risk of life-threatening bleeding from disseminated intravascular coagulation (DIC).

Some types of acute leukemia spread to the brain and spinal cord. Regular chemotherapy can't reach those areas, because your body puts up a special barrier to protect them. A different way of giving chemotherapy, called intrathecal chemotherapy, treats these areas by injecting the drugs directly into your spinal canal to attack any leukemia cells there.

For chronic leukemia

• Chronic lymphocytic leukemia (CLL) medicines may include cyclophosphamide, vincristine, and prednisone. Other choices may include fludarabine and chlorambucil. The monoclonal antibodies rituximab and alemtuzumab may also be used.
• Chronic myelogenous leukemia (CML) medicines include the chemotherapy medicines cyclophosphamide and cytarabine. Other medicines include tyrosine kinase inhibitors. These include imatinib, dasatinib, and nilotinib.
  • People with CML who cannot have stem cell transplants and are unable to take tyrosine kinase inhibitors may be given interferon alfa (with or without cytarabine), hydroxyurea, or busulfan.

Medicines used for treatments for chronic lymphocytic leukemia (CLL) are taken orally (by mouth) or given intravenously for limited periods of time. If there is relapse, medicines are given again.

For chronic myelogenous leukemia (CML), medicine is usually taken by mouth for as long as needed.

Medicine for nausea and vomiting

Nausea and vomiting are common side effects of chemotherapy. They usually go away when treatment stops. Your doctor will prescribe medicines to help relieve nausea.

Medicines to control nausea and vomiting include:

• Aprepitant.
• Dimenhydrinate.
• Phenothiazines.
• Serotonin antagonists.

Cancer: Controlling Nausea and Vomiting From Chemotherapy