Supportive therapy

Supportive therapy is an important part of treatment for leukemia. It is given to treat the complications that usually happen with treatments for leukemia and the disease itself. These complications can include infection, bleeding and low blood cell counts. Other complications can include changes to the chemical processes in the body, such as breathing, eliminating wastes and toxin and circulating blood as a result of the leukemia or treatment.

Antibiotics, antivirals and antifungals

Infection is a serious complication in people with leukemia. Infections can be caused by the disease itself and its treatments. Different types of drugs are used to treat different types of infections.

Common sites of infection include:

  • pharynx, esophagus and sinuses
  • anus and rectum
  • lungs
  • skin

Blood products

The healthcare team will monitor your blood cell counts during treatment. You will be given replacement therapy with blood transfusions when needed. The types of replacement transfusions used include:

  • packed 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 (G-CSFs), such as filgrastim (Neupogen) and pegfilgrastim (Neulasta), 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.

Treatment for tumour lysis syndrome

The start of chemotherapy causes rapid cell death, which can result in an urgent situation called tumour lysis syndrome. When the cells die, their contents are released into the bloodstream. This creates abnormally high levels of uric acid, potassium and phosphorus.

The following treatments are used to lower the levels of these substances in the blood:

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

Find out more about tumour lysis syndrome.

Leukapheresis

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.

Questions to ask about treatment

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.

Expert review and references

  • American Society of Clinical Oncology (ASCO). Leukemia - Acute Lymphocytic - ALL: Treatment Options. Alexandria, VA.: American Society of Clinical Oncology (ASCO); 2013: http://www.cancer.net/cancer-types/leukemia-acute-lymphocytic-all/treatment-options.
  • Borthakur G, O'Brien S . Treatment of chronic lymphocytic leukemia and related disorders. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 9: pp. 121-119.
  • Druker BJ, Lee SJ . Chronic myelogenous leukemia. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014: 133: pp. 1962-1972.
  • Goekbuget N, Hoelzer D . Diagnosis and Treatment of adult acute lymphoblastic leukemia. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 20: pp. 331-354.
  • Kebriaei P, Champlin R, de Lima M, et al . Management of acute leukemias. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014: 131: pp. 1928-1954.
  • Kurtin SE . Leukemia and myelodysplastic syndromes. Yarbro, CH, Wujcki D, & Holmes Gobel B. (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 57: pp. 1369-1398.
  • National Cancer Institute. Adult Acute Lymphoblastic Leukemia Treatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2014.
  • National Cancer Institute. Adult Acute Myeloid Leukemia Treatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2014: http://www.cancer.gov.
  • O'Brien SG, Goldman JM . Diagnosis and treatment of chronic myeloid leukemia. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 5: pp. 45-62.
  • Seiter K . Acute myelogenous leukemia treatment & management. eMedicine.Medscape.com. WebMD LLC; 2014.
  • Wierda WG, O'Brien S . Chronic lymphocytic leukemia. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014: 134: pp. 1973-1987.