Leukaemia Treatment

How is Leukaemia Diagnosed?

Diagnosis of leukaemia is made by evaluating symptoms, examining the patient, and confirming the disease through blood and bone marrow tests. Early diagnosis enables early treatment initiation and a higher likelihood of achieving remission. Methods of diagnosis include:

• Complete blood count 

• Peripheral blood smear

• Bone marrow aspiration and biopsy 

• Flow cytometry 

• Genetic testing 

• Lumbar puncture

• Imaging studies

How is Leukaemia Treated Based on Severity?

Recommended leukaemia treatment based on severity is as follows:

Types of Leukaemia and Their Treatment

Various types of leukaemia and their treatments are as follows:

Other Treatments for Leukaemia

Other ways to treat leukaemia include the following:

• A stem cell transplant involves replacing diseased bone marrow with healthy stem cells.

• Targeted therapy targets the genetic characteristics of leukaemia cells.

• Immunotherapy helps the immune system identify and kill cancer cells.

• CAR-T cell therapy involves engineering immune cells from the body to target leukaemia.

• Radiation therapy is sometimes used in certain situations, like before a stem cell transplant.

• Supportive care includes blood transfusions and growth factors.

Oral Medications for Leukaemia

Oral medications play a major role in managing chronic leukaemia. Since these drugs are taken long-term, patients require regular monitoring to stay on track. Some oral medications for leukaemia include:

• Imatinib: Targeted therapy that manages chronic myeloid leukaemia (CML).

• Bosutinib: Prescribed for certain patients with chronic myeloid leukaemia.

• Ponatinib: Advanced targeted therapy for CML and Ph+ ALL, particularly for resistant cases.

• Dasatinib and Nilotinib: Newer targeted therapies for CML.

• Venetoclax: Targeted therapy for AML and CLL.

• Ibrutinib: Targeted therapy for chronic lymphocytic leukaemia (CLL).

• Hydroxyurea: Used to reduce extremely high white blood cell counts.

• Methotrexate and/or Mercaptopurine (6-MP): Used orally as part of maintenance treatment for acute lymphoblastic leukaemia.

• Asciminib: Used to treat chronic myeloid leukaemia in selected patients, particularly after previous targeted therapies.

• Bosutinib: May be prescribed for certain patients with chronic myeloid leukaemia. 

Ayurvedic and Alternative Treatments for Leukaemia

While standard medical treatments fight the cancer, complementary therapies can help ease side effects and boost your overall well-being. However, these should never be a substitute for evidence-based medicine. 

Some of the popular complementary therapies for leukaemia are:

• Ashwagandha can be used for relieving fatigue.

• Turmeric is considered for its anti-inflammatory action.

• Yoga and meditation help in managing stress during treatment.

• Consuming a healthy diet helps one maintain their strength.

Disclaimer: All these alternatives must be done under the guidance of the treating oncologist. 

Home Care for Managing Leukaemia

Proper care at home ensures that the patient is safe during leukaemia treatment and recovery as well. Some home care tips to manage leukaemia include:

• Wash your hands regularly and stay away from crowds and ill people.

• Consume fresh and hygienic food.

• Follow your medication plan precisely.

• Go to every test appointment.

• Combine rest and physical activities throughout the day.

• Contact your physician immediately if you experience any symptoms, such as fever, bleeding, or bruising.

• Visit a counsellor or attend a support group, if required, for emotional support.

Latest Treatment for Leukaemia

There have been enormous developments in the treatment of leukaemia, with targeted therapies and cellular therapies emerging. One significant recent development in India was the approval of NexCAR19, the first-ever CAR T-cell therapy developed in India, in October 2023. The therapy is used to treat B-cell ALL that has recurred. These advances offer hope even in relapsed cases.

How Long Does Leukaemia Treatment Take?

Treatment duration may vary depending on the type of leukaemia, the genetic changes involved, the patient’s age and how well the disease responds. The table below shows approximate timelines:

Leukaemia Treatment Side Effects

Because leukaemia treatments are intensive, side effects are common and need to be closely monitored. Some of these side effects include:

• Feeling sick and vomiting

• Hair loss

• Low blood levels

• Infection

• Tiredness

• Sore mouth

• Skin rashes

• Water retention

• Cytokine release syndrome after CAR T-cell therapy

• Graft-versus-host disease following stem cell transplantation

Immediate medical care is advisable when someone experiences fever, bleeding, breathing difficulties or sudden confusion.

Lifestyle Changes for Managing Leukaemia

A few simple steps can help you manage the treatment of leukaemia more easily. Here are some helpful tips:

• Eat a healthy, well-prepared meal to maintain stamina.

• Maintain hygiene and avoid contact with infected people.

• Exercise daily as recommended by your physician.

• Avoid smoking in any form.

• Restrict yourself from alcohol consumption during the period of treatment.

• Stress should be managed with proper relaxation techniques.

• Take adequate rest and sleep during intervals of treatment.

Triggers That Can Worsen Leukaemia Symptoms

The following factors may worsen symptoms or increase the risk of complications in people with leukaemia:

• Delaying or stopping treatment

• Missing follow-up appointments

• Infections due to a weakened immune system

• Not taking prescribed medicines as directed

• Poor nutrition or dehydration

• Severe anaemia or low blood cell counts

• Physical or emotional stress

• Other uncontrolled medical conditions

• Recurrence or progression of leukaemia

• Not reporting new symptoms such as fever, unusual bleeding or severe fatigue promptly

Leukaemia Treatment Cost in India

The cost of leukaemia treatment in India depends on the type of leukaemia and its treatment method. Generally, the cost lies between ₹5,00,000 and ₹30,00,000. The cost of chemotherapy is ₹25,000 for each cycle. Bone marrow transplantation is ₹12,60,000 or above. The cost of CAR T-cell therapy with NexCAR19 is between ₹30 lakh to ₹42 lakh, which is much lower than in other countries. The cost is higher in private hospitals in urban areas. However, government and charitable hospitals offer lower-cost care.

Does Health Insurance Cover Leukaemia Treatment in India?

Yes. Most health insurance plans cover leukaemia treatment in India, as it is one of the most significant forms of cancer. Coverage for hospitalisation, chemotherapy, targeted therapy, and transplantation are usually available under most plans after a waiting period. Moreover, a waiting period for pre-existing diseases will also apply if leukaemia was diagnosed before purchasing the insurance plan. 

Leukaemia is also covered as one of the critical illnesses under critical illness insurance plans. These plans give a lump sum amount on diagnosis, and come with up to a 90-day waiting period and up to 30 days survival period. Specific cancer insurance plans are also available for leukaemia patients that offer a lump sum amount or a staggered payment as per the terms and conditions.