Leukemia Treatment in Bangalore
Leukaemia is a cancer of the blood-forming tissues. It develops when abnormal blood-forming cells grow and accumulate in the bone marrow and, in many cases, the bloodstream. As these abnormal cells increase, they can interfere with the production of healthy red blood cells, white blood cells and platelets.
ALL, AML, CLL & CML Care
At Athira, evaluation of suspected leukaemia focuses on establishing the precise subtype and risk category, using blood tests, bone marrow examination, immunophenotyping, cytogenetic studies and molecular testing when appropriate.
Understanding Leukaemia
Leukaemia is broadly classified according to how quickly it progresses (acute or chronic) and the type of blood-forming cell involved (lymphoid or myeloid). These differences are important because treatment and the urgency of treatment vary considerably between subtypes.
Acute leukaemias generally progress rapidly and usually require prompt treatment. Chronic leukaemias may progress more slowly and are sometimes discovered incidentally during routine blood tests.
Four Major Types of Leukaemia
Acute Lymphoblastic Leukaemia (ALL)
ALL develops from immature lymphoid cells. It can occur in both children and adults and is the most common type of leukaemia in children.
Because ALL can involve the central nervous system, treatment commonly includes therapy directed at preventing or treating disease in the brain and spinal cord.
Acute Myeloid Leukaemia (AML)
AML develops from abnormal myeloid cells in the bone marrow. These abnormal cells interfere with normal blood-cell production, which can lead to anaemia, infections and bleeding or bruising.
AML can develop rapidly and generally requires prompt assessment and treatment.
Chronic Lymphocytic Leukaemia (CLL)
CLL is usually a slower-growing leukaemia involving abnormal lymphocytes. Many people have few or no symptoms when it is first diagnosed, and the condition may be discovered during a routine complete blood count.
Not everyone with CLL needs immediate treatment. In people without treatment indications, watchful waiting or active surveillance is an established approach.
Chronic Myeloid Leukaemia (CML)
CML is a myeloid blood cancer characterised by the BCR::ABL1 fusion gene, which results from a chromosomal rearrangement known as the Philadelphia chromosome.
This molecular abnormality is important because it provides a specific target for treatment with tyrosine kinase inhibitors (TKIs).
When Is Leukaemia Treatment Recommended?
The timing and type of treatment depend on the specific form of leukaemia.
Acute Leukaemia
Once AML or ALL has been confirmed, treatment is generally started promptly because these diseases can progress quickly.
Treatment commonly involves different phases. In acute leukaemia, these may include induction and consolidation, with treatment modified according to the subtype, genetic findings, age, overall health and response to treatment.
In ALL, treatment also includes therapy to prevent or treat involvement of the central nervous system.
Chronic Myeloid Leukaemia
For most patients with newly diagnosed CML, treatment with a tyrosine kinase inhibitor is the standard initial approach.
Molecular monitoring of BCR::ABL1 levels is an important part of assessing response.
Chronic Lymphocytic Leukaemia
Many people with CLL do not require treatment immediately.
Treatment is considered when the disease causes significant symptoms, progressive impairment of normal blood-cell production, rapidly progressive disease or other established treatment indications.
Accurate Subtyping Is Essential
Accurate subtyping is essential because the treatment of leukaemia can vary substantially between different subtypes.
Complete Blood Count
A CBC measures the levels of red blood cells, white blood cells and platelets and is usually one of the first investigations performed.
Peripheral Blood Smear
A blood smear allows the cells to be examined under a microscope and can identify abnormal or immature cells.
Bone Marrow Aspiration and Biopsy
A bone marrow examination may be required to establish the diagnosis and assess the extent and characteristics of the disease. The sample may undergo morphology, flow cytometry, cytogenetic and molecular testing.
Flow Cytometry
Flow cytometry identifies proteins and other markers on abnormal cells. It helps determine the cell lineage and subtype of the leukaemia.
Cytogenetic Testing
Cytogenetic studies examine chromosomes for abnormalities that can help establish the diagnosis and provide prognostic or treatment information.
Molecular Testing
Molecular tests identify specific genetic abnormalities or mutations. In some leukaemias, these findings directly influence treatment selection.
For example, detection and measurement of BCR::ABL1 are central to the diagnosis and monitoring of CML.
Additional Investigations
Depending on the type of leukaemia and the clinical situation, evaluation may also include imaging, lumbar puncture, infection screening and assessment of kidney, liver and cardiac function.
Treatment Approaches
Treatment is individualised according to the subtype of leukaemia, genetic and molecular findings, risk category, age, overall health and treatment response.
Chemotherapy
Chemotherapy remains an important component of treatment for many acute leukaemias. Treatment is usually organised into defined phases, with the exact regimen depending on the disease subtype and patient factors.
Targeted Therapy
Targeted medicines act on specific molecular abnormalities involved in the growth or survival of leukaemia cells. Tyrosine kinase inhibitors are the foundation of treatment for CML. Targeted medicines are also available for selected patients with AML and CLL based on the molecular and clinical characteristics of the disease.
Immunotherapy
Immunotherapy includes treatments that help the immune system recognise or eliminate abnormal cells. Antibody-based treatments are used in several blood cancers.
More specialised cellular therapies, including CAR T-cell therapy, may be considered for selected patients with specific relapsed or refractory blood cancers where appropriate.
Stem-Cell Transplantation
Stem-cell transplantation may be considered for selected patients, particularly in certain higher-risk acute leukaemias or when disease has returned after previous treatment.
It is not required for every patient. The decision depends on disease risk, treatment response, overall health and the expected balance between potential benefit and transplant-related risks.
Supportive Care
Supportive treatment is an important part of leukaemia care and may include:
- Blood and platelet transfusions when required
- Prevention and treatment of infections
- Management of treatment-related complications
- Nutritional and symptom support
- Close monitoring during periods when blood counts are low
Personalised Leukaemia Care at Athira
Leukaemia treatment is particularly dependent on the details of the diagnosis.
Two patients with the same broad diagnosis, such as AML, may have different chromosomal or molecular findings and therefore require different treatment strategies.
At Athira, treatment planning may incorporate:
Morphological assessment
Flow cytometry
Cytogenetic findings
Molecular and genomic results
Disease-risk classification
Patient age, fitness and other medical conditions
Response to treatment
The aim is to select treatment that is appropriate for both the biology of the disease and the individual patient.
What Patients Can Expect
Consultation
Your symptoms, blood counts, previous reports and medical history are reviewed.
Evaluation
Blood tests, peripheral smear examination and, where indicated, bone marrow aspiration and biopsy are performed.
Diagnosis
Flow cytometry, cytogenetic and molecular results are combined with the clinical and morphological findings to establish the subtype and risk category.
Treatment Planning
The recommended treatment, its different phases, expected duration, potential side effects and alternatives are discussed with you.
Treatment
Treatment may be given in phases, through intravenous medicines, oral medicines or a combination, depending on the type of leukaemia.
Monitoring
Response may be assessed using blood counts, repeat bone marrow examinations or molecular monitoring. For example, BCR::ABL1 levels are used to monitor response in CML.
Follow-up
After treatment, continued monitoring is important to detect recurrence, manage late effects and address long-term health needs.
Frequently Asked Questions
How quickly does leukaemia need to be treated?
It depends on the type.
Acute leukaemias, such as AML and ALL, generally require prompt treatment because they can progress rapidly.
CML is usually treated with targeted therapy soon after diagnosis.
People with asymptomatic CLL may not need immediate treatment and can instead be monitored until treatment becomes appropriate.
My CLL was found on a routine blood test and I feel well. Why is no treatment being started?
Not every person with CLL benefits from immediate treatment.
When CLL is asymptomatic and does not meet established treatment criteria, active surveillance is commonly recommended. Starting treatment before it is needed may expose a person to side effects without providing additional benefit.
Regular monitoring allows treatment to begin if the disease becomes more active or symptoms develop.
Is leukaemia curable?
The outlook varies considerably between the different types of leukaemia.
Some forms can be cured in a substantial proportion of patients, while others can often be controlled for many years with modern treatment.
Your prognosis depends on the specific subtype, genetic and molecular characteristics, age, overall health and response to treatment.
Does leukaemia run in families?
Most leukaemias are not inherited directly.
They usually arise from genetic changes acquired during a person's lifetime. However, certain inherited conditions can increase the risk of developing blood cancers. A detailed personal and family history can help determine whether genetic counselling is appropriate.
What causes AML?
In many patients, no single cause can be identified.
Recognised risk factors include previous chemotherapy or radiation therapy, certain chemical exposures such as benzene, smoking and some pre-existing bone-marrow disorders. Having a risk factor does not mean that a person will necessarily develop AML.
What is the Philadelphia chromosome?
The Philadelphia chromosome is a chromosomal abnormality associated with CML.
A rearrangement involving chromosomes 9 and 22 produces the BCR::ABL1 fusion gene. This abnormal protein drives the growth of CML cells and is specifically targeted by tyrosine kinase inhibitors.
Will I need a bone marrow transplant for leukaemia?
Not necessarily.
Transplant is considered for selected patients based on the type and risk of leukaemia, response to initial treatment, likelihood of relapse and overall health.
Many patients are treated successfully without transplantation.
Can leukaemia be treated with tablets rather than intravenous chemotherapy?
In some types, yes.
CML is generally treated initially with oral tyrosine kinase inhibitors. Several treatments for CLL are also available as oral medicines.
Acute leukaemias often require more intensive treatment, although the exact approach varies by subtype and molecular characteristics.
Can I get a second opinion?
Yes.
A second opinion can be particularly valuable in leukaemia because treatment decisions may depend on flow cytometry, cytogenetic and molecular findings.
Bringing the original pathology, blood, marrow, cytogenetic and molecular reports allows the diagnosis and treatment plan to be reviewed more completely.
Start With the Right Diagnosis
If you have an unexplained abnormal blood count, a recent leukaemia diagnosis or a treatment plan you would like reviewed, a specialist hemato-oncology consultation can help clarify the diagnosis and available treatment options.
