Advances in Treating Leukemia

Leukemia is a cancer of the bone marrow, typically characterized by rapid growth of abnormal white blood cells. It accounts for about 5% of all cancers, and its exact cause remains unknown. As explained by Ehab Atallah, MD, Medical College of Wisconsin researchers are discovering new treatments and better ways to care for people living with leukemia.

What are the most common forms of leukemia? 

Dr. Atallah: The main forms are chronic and acute leukemia. Chronic leukemia is a slow-growing form that patients often can live with — and they may not even need treatment. Acute leukemia is a rapid-growing form that requires urgent treatment. The main subtypes of leukemia are chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL).

Is leukemia hereditary?

Dr. Atallah: It can be but inherited leukemia is rare. In terms of predisposing factors, we don’t always know what causes it. We know exposure to chemicals or to prior radiation treatment can play a role. We think leukemia is caused by a combination of hereditary and environmental factors.

What treatments are available? 

Dr. Atallah: For acute leukemia, such as ALL, the first option is chemotherapy, which affects the DNA of abnormal cells and kills them. Some patients may require a stem cell transplant. For CML, people take a daily pill that blocks abnormal signaling in the cell. These patients live about as long as the general population. For a select group of patients who have a sustained, deep remission, about 60% are considered cured and can stop taking the drug. For AML patients who can tolerate it, intensive chemotherapy, which requires a several-week hospital stay, is an option. Most patients will require a stem cell transplant to achieve a cure. And CLL, which had been treated with chemotherapy, is now treated with immunotherapy and/or targeted therapy. Immunotherapy strengthens a person’s own immune system to fight their cancer, and targeted therapy is designed to block specific molecules on a cancer cell and keep them from growing or spreading.

Is MCW research yielding new treatments?

Dr. Atallah: For younger patients who can tolerate intensive chemotherapy, my colleague, Sameem Abedin, MD, is investigating the use of an antibody drug called lintuzumab Ac225 combined with intensive chemotherapy. The initial results from a Phase I clinical trial led by MCW researchers are promising. We recently presented the results at the annual scientific meeting of the American Society of Hematology, and this immunotherapy treatment will undergo further study in a national clinical trial.

Should people with leukemia and other types of cancer consider participating in clinical trials? 

Dr. Atallah: Yes. Clinical trials are the only way we can improve outcomes for people with leukemia and other cancers, including rare diseases. The advanced treatments we use today were made possible by people participating in clinical trials.

What should patients know about your team?

Dr. Atallah: Our specialty team includes doctors, nurses and advanced practice providers who specialize in the management of leukemia. As a premier research organization, we’re active in research for all types of leukemia and blood and marrow disorders.

Is a cure for leukemia possible?

Dr. Atallah: Yes. We already have CML patients who are functionally cured. Some remain in remission even without the lifelong medications that are often needed to keep CML at bay. And some patients with AML and ALL are cured. We’re making progress. I think we’ll be able to cure around 80% of leukemias within 10 to 15 years.