Supportive therapy for leukemia

Supportive therapy is an important part of treatment for leukemia. It is given to treat complications from treatments and the leukemia itself. Some of these complications can include infection, bleeding and low blood cell counts.

Your healthcare team will check your blood cell counts during treatment. You will be given blood transfusions when needed to replace the blood cells you may have lost. The types of replacement transfusions used include:

• red blood cells
• platelets
• fresh frozen plasma
• cryoprecipitate (a product that replaces clotting factors)

Find out more about blood transfusions.

Growth factors (granulocyte colony-stimulating factors, or G-CSFs) may be used to stimulate the production of white blood cells. This shortens the length of time you will have a low white blood cell count and lowers the risk of infection.

Growth factors used in supportive therapy for leukemia may include filgrastim (Neupogen) and pegfilgrastim (Neulasta). These drugs may be given as a subcutaneous injection (just under the skin) or intravenously.

Tumour lysis syndrome (TLS) can be life-threatening and needs to be treated right away. It usually occurs at the start of chemotherapy when many tumour cells are destroyed rapidly. When the cells die, their contents are released into the bloodstream. This can create abnormally high levels of uric acid, potassium and phosphorus. TLS occurs when cancer cells break down so quickly that kidneys can't remove these substances from the blood fast enough.

The following treatments are used to lower the levels of these substances in the blood. These treatments may be given orally as a tablet or intravenously.

• increased intravenous fluids
• allopurinol (Zyloprim)
• sodium bicarbonate
• rasburicase (Fasturtec)

Find out more about tumour lysis syndrome.

Leukapheresis is a procedure that uses a special machine to remove large numbers of white blood cells from a sample of blood. The blood is then given back to the person. This may be done to lower a very high white blood cell count in people with leukemia.

To make the decisions that are right for you, ask your healthcare team questions about treatment. For more detailed information on specific drugs, go to sources of drug information.