Leukemia treatment | Hematologic System Diseases | NCLEX-RN | Khan Academy

Voiceover: So let’s talk
about leukemia treatment. And generally speaking, we treat leukemia with chemotherapy with different types
of chemo, chemotherapy. And what chemotherapy is, is chemicals so that’s where chemo comes from or chemicals that kill cells. And specifically chemotherapy targets rapidly dividing cells. So cancer cells, leukemia
cells are very rapidly dividing cells as we know, and that’s how chemotherapy is able to target the leukemia cells. Now something to keep in mind is that, the cancer cells, leukemia cells are not the only rapidly
dividing cells inside the body, there are other rapidly dividing cells. And that’s something that we’ll talk about at greater lengths later on. So the way we administer chemotherapy is actually in three different phases. And the way I like to think
of this is kind of like a black ops mission. Something that’s very organized and well thought out and very efficient. So the first phase of
chemotherapy treatment is called the induction phase. The induction phase. And the induction phase usually last somewhere around four weeks, and the goal of induction,
the goal of induction is to kill as many
leukemia cells as possible. The goal is to kill all
of the leukemia cells. And does this happen in four weeks? Well not necessarily all of the time, but that’s our goal. Now, at the end of the four weeks, we don’t just assume that
we’ve been successful in killing all of the leukemia cells. We, we double check to see
if we’ve been successful. And the way that we do
that is by taking a look inside the bone marrow. So if this is the bone,
we’ll take a needle, we’ll insert it inside the bone, and you guys know where
I’m going with this, and we’ll draw out some fluid. So we’ll do a bone marrow aspiration, and what we hope to see is
that all of the cells inside the bone marrow are normal cells, there are no more leukemia cells left, that there are only normal blood cells inside the bone marrow. And if that’s the case,
if we’ve killed off all of the leukemia cells, we say that the patient
has gone into remission. And something that you
should keep in mind is that remission is not the same thing as a cure. So that’s because that, if we, if a patient is in remission, the cancer cells are gone, but they can still come back, they can still recur, and that’s why remission is not the same thing as a cure. So that’s the first phase
of chemotherapy treatment. The second phase of chemotherapy treatment is called the consolidation,
consolidation phase. And the consolidation phase has two goals, the first goal is to kill
off any of the remaining leukemia cells. So if there are any
leukemia cells left behind from the induction phase, we aim to kill them off. And the second goal is to prevent the spread of the leukemia into the brain. So to prevent the leukemia cells from traveling to the brain, and the way we do that is by specifically injecting the chemotherapy, injecting the chemotherapy into the CSF, which is the fluid that’s
surrounds the brain. And the reason why we have
to inject it into theirs because when we, the way
we normally administer chemotherapy into the blood, it doesn’t readily
penetrate into the brain. So we have to specifically
inject it in into the CSF, and hopes that it will
reach the brain in that way. Okay, so that’s the consolidation phase. And the last phase of
chemotherapy is called the maintenance, maintenance phase. And the maintenance phase
usually last between two or three years and
in the maintenance phase we usually use the same
chemotherapy agents as in the induction phase, but we administer them at a low dose. So administer at a low dose. And the goal over here is to prevent the leukemia from coming back, so prevent it from growing. So chemotherapy is usually the main way, the main method that we
use to treat leukemia. If however we know that we have a patient that is at high risk of
leukemia traveling to the brain, or if the patient already has
leukemia inside the brain, we use radiation, radiation specifically to the
brain to kill off those cells. So if, for example if this
is a patient over here I’m going to draw a stick
figure of a patient. We’re going to use some
external beam radiation. So that’s my external beam, and it’s radiating the brain to kill off any leukemia cells in the brain. And something really important with this is that we never give this to kids who are under five years old. And that’s because under the age of five the brain is still growing and administering radiation to the brain in a patient that young prevents the brain from growing the way that it should and it can lead to cognitive and psychological impairment. So that’s, that’s
something to be mindful of. Now if we have a patient
who has a leukemia that’s resistant to
chemotherapy or radiation, or if we know that the
patient has a leukemia that tends to be very
resistant or hard to treat. We can try bone marrow transplantation, we can try bone marrow transplantation as a last ditch effort. So what we do over there
is we use the bone marrow from a donor and we can use that to replace the patients bone marrow. And so that in a nutshell
is how we treat leukemia.