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Questions to Ask Your Doctor About Leukemia
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Chemotherapy

Chemotherapy uses powerful drugs to destroy cancer cells. These drugs can be given intravenously (IV, through a vein), orally (by mouth), subcutaneously (injected under the skin), intramuscularly (injected into muscle), or intrathecally (injected into cerebrospinal fluid [CSF]).

Chemotherapy used to treat leukemia varies, because there are many different forms of this disease. In general, leukemia treatment combines chemotherapy with a number of different anticancer drugs, which destroy cancer cells by preventing them from growing and dividing rapidly.

Unfortunately, a number of the body's normal, noncancerous cells (e.g., hair cells, red and white blood cells, blood-clotting platelets, cells that line the gastrointestinal tract) also divide rapidly, and are harmed by chemotherapy. Damage to these cells cause side effects, which depend upon the type and dose of the drugs, as well as the length of time that they are used.

Chemotherapy side effects may include the following:

• Temporary hair loss
• Mouth sores
• Anemia (decreased numbers of red blood cells; may cause fatigue, dizziness, and shortness of breath)
• Leukopenia (decreased numbers of white blood cells; may lower resistance to infection)
• Thrombocytopenia (decreased numbers of platelets; may lead to easy bleeding or bruising)
• Gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea)

Tumor lysis syndrome is a specific side effect of leukemia therapy that occurs when there is a rapid breakdown of leukemia cells caused by chemotherapy drugs. The cells split apart and release cell fragments, metabolic byproducts, and minerals into the bloodstream. These substances can damage the kidneys, heart, and nervous system. Therefore, physicians often monitor acute leukemia patients for this syndrome. They may prescribe extra fluids, sodium bicarbonate, and allopurinol (drug used to reduce uric acid in the blood) to rid the body of unwanted chemicals and cell remains.

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