Leukaemia tests and investigations
Various tests are used to diagnose leukaemia, to assess the effectiveness of treatment and check for recurrence. A leukaemia diagnosis is usually first suggested from...
Two men we spoke to had a rare type of leukaemia called ‘hairy cell’ leukaemia. Mike attended hospital on five days in a row, for an intravenous infusion of a chemotherapy drug called cladribine or Leustat. Luke attended hospital once a week for six weeks for an infusion of a drug called pentostatin or Nipent. In both cases the infusions took about 2 hours each and no further treatment was needed.
Some people with acute leukaemia received chemotherapy intrathecally alongside other treatments. This is necessary when doctors think that leukaemia cells have entered the brain, as chemotherapy given by injection into a vein or via a central line does not reach the brain. After giving a local anaesthetic a hollow needle is inserted into the spinal canal (lumbar puncture) and the chemotherapy injected. It is important to stay as still as possible during the procedure and people must lie flat for one or more hours afterwards to avoid headaches. Several people had this type of chemotherapy and most found the procedure bearable but Frances found it the most distressing part of her treatment and developed a phobia about it. Some had problems with pain and headache afterwards.
Several people with acute leukaemia followed their intensive treatment with so-called ‘maintenance’ chemotherapy in tablet form (oral) and were grateful for the sense of freedom it gave them to be treated at home.
Gentle oral chemotherapy is often used in chronic leukaemias, which need much less aggressive treatment. Two people with chronic myeloid leukaemia (CML) had a mild oral chemotherapy drug called hydroxyurea immediately after diagnosis to tide them over until more aggressive treatment could be started.
Currently the standard first-line treatment for CLL is fludarabine and cyclophosphamide combined with an intravenous infusion (through a drip) of the biological therapy, rituximab (see ‘Biological therapies‘); this combination treatment is known as FCR. FCR may not be suitable for people with other health issues, who may be given alternatives instead. We have not yet interviewed anyone who has had FCR.
Newer drugs for the treatment of CLL are being developed which target the signalling pathways inside the leukaemia cells. These are proving to be very effective, safe are now being widely used.
One woman had a problem getting her chemotherapy pills. Having seen her consultant late in the day, the pharmacy had closed so she had to return on another day to collect them, only to find that the consultant had not specified the dose or signed the prescription, causing further delays.
In addition to taking chemotherapy tablets, people may be given steroids, anti-sickness drugs, antibiotics and antivirals, all in tablet form. This meant having to take many pills on some days and different numbers of pills on different days at different times, which could be complicated to keep track of, especially for people already taking medicines for other conditions. For a long time after her treatment Deirdre had an aversion to drinking water because she associated it with taking tablets. Despite the large number of tablets they had to take, some felt it was preferable and much easier than attending hospital for intravenous chemotherapy.
Various tests are used to diagnose leukaemia, to assess the effectiveness of treatment and check for recurrence. A leukaemia diagnosis is usually first suggested from...
People with acute leukaemia begin their treatment by having so-called Intensive chemotherapy, involving daily intravenous infusions of chemotherapy drugs while staying in hospital'. To avoid...