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Leukemia

Our Approach

Hagop Kantarjian, M.D.

Hagop Kantarjian, M.D. leads the world’s largest leukemia program, known for innovative approaches, leading-edge research and personalized care.

With 25 world-renowned and highly experienced physicians dedicated to the treatment of leukemia, MD Anderson's Leukemia Center is proud to be the largest practice of leukemia experts in the world. Using a comprehensive team approach, we work together to give you customized care that includes the most-advanced diagnostic methods and treatments.

As a foremost treatment program for leukemia, we offer access to numerous innovative new therapies and investigational agents that may help increase your chances for successful treatment. Many of these are not found in other centers. We have the full range of services needed to ensure comprehensive, yet specialized care.

Care Designed Specifically for You

Successful leukemia treatment begins with accurate and precise diagnosis. As many as 15% of leukemia patients have been misdiagnosed before they come to MD Anderson. We have the expertise and experience gained from being one of the most active programs in the world, and our specialized pathologists are highly experienced in diagnosing leukemia.

Our approach to leukemia is customized especially for you; we do not take a one-size-fits-all approach. Our first step is to carefully evaluate your risk factors to determine if treatment is necessary. If it is, we recommend the most advanced therapy with the least impact on your body.

Whether you are treated as an in-patient or out-patient, our comprehensive program offers all the services needed to care for leukemia and its impact on your body, such as infections and bleeding issues. We strive to accomplish as much care as possible on an out-patient basis. Because we know your time is valuable, we offer a complete on-site lab and “fast track” clinic for timely and efficient outpatient care. If hospitalization is needed, our expert staff is specially trained to take care of complexities that may arise.

Researching the Future

MD Anderson is known internationally for developments in the treatment of leukemia. In fact, we have helped pioneer many treatments, including decitabine (Dacogen®), dasatinib (Sprycel®), nilotinib (Tasigna®), imatinib mesylate (Gleevec) and clofarabine (Clolar®).

And we are constantly striving to find new and better ways to fight leukemia. We are one of the few cancer centers in the nation to house a prestigious federally funded SPORE (Specialized Program of Research Excellence) program. This means we are able to offer a wide range of clinical trials for leukemia treatment.

If you have been diagnosed with leukemia, we're here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

Why Choose MD Anderson?

  • Largest leukemia program in the world
  • Internationally known, highly experienced leukemia physicians
  • New approaches that may increase chances for successful leukemia treatment
  • More than 150 active clinical trials for leukemia, many not available elsewhere
  • Access to investigational agents, including targeted therapies, vaccines and “mini” stem cell transplants
  • On-site hematopathology lab and bone marrow aspiration
  • “Fast track” leukemia clinic makes check-ups fast and efficient
  • AML and CLL are part of MD Anderson's Moon Shots Program: an ambitious effort to reduce cancer deaths through the rapid discovery of new treatments

Leukemia Knowledge Center

Treatment at MD Anderson

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"Without MD Anderson, I couldn't have done it, and because of them, I truly have a brand-new life."

Leukemia Survivor Linda Hall

Leukemia Facts

According to the American Cancer Society, some 43,000 people in the United States are diagnosed with leukemia each year. This includes about:

  • 15,000 cases of chronic lymphocytic leukemia (CLL), most in older adults
  • 13,500 cases of acute myeloid leukemia (AML), most in adults
  • 6,000 cases of acute lymphocytic leukemia (ALL), about one in three in adults
  • 5,000 cases of chronic myeloid leukemia (CML), most in older adults

Leukemia is cancer of blood-forming tissue such as the bone marrow, the sponge-like material inside some bones. In healthy bone marrow, blood cells form and mature, then move into the bloodstream. To understand what happens to your blood when you have leukemia, it helps to know what makes up normal blood and bone marrow.

Red Blood Cells (RBCs), the major part of your blood, carry oxygen and carbon dioxide throughout your body. The percentage of RBCs in the blood is called hematocrit. The part of the RBC that carries oxygen is a protein called hemoglobin. All body tissues need oxygen to work properly. When the bone marrow is working normally, the RBC count remains stable. Anemia occurs when there are too few RBCs in the body. Leukemia, or the chemotherapy used to treat it, can cause anemia. Symptoms of anemia include shortness of breath, headache, weakness and fatigue.

White Blood Cells (WBCs) include several different types. Each has its own role in protecting the body from germs. The three major types are neutrophils, monocytes and lymphocytes:

  • Neutrophils (also known as granulocytes or polys) destroy most bacteria
  • Monocytes destroy germs such as tuberculosis
  • Lymphocytes are responsible for destroying viruses and for overall management of the immune system. When lymphocytes see foreign material, they increase the body’s resistance to infection

WBCs play a major role in fighting infection. Infections are more likely to occur when there are too few normal WBCs in the body.

Absolute Neutrophil Count (ANC) is a measure of the number of WBCs you have to fight infections. You can figure out your ANC by multiplying the total number of WBCs by the percentage of neutrophils (“neuts”). The K in the report means thousands. For example:

WBC = 1000 = 1.0K
Neuts = 50% (0.5)
1000 X 0.5 = 500 neutrophils

While anyone can catch a cold or other infections, this is more likely to occur if your ANC falls below 500. Your WBC count generally will fall within the first week you start chemotherapy, but it should be back to normal between 21 to 28 days after starting chemotherapy.

Platelets are the cells that help control bleeding. When you cut yourself, the platelets collect at the site of the injury and form a plug to stop the bleeding.

Bone marrow is the soft tissue within the bones where blood cells are made. All blood cells begin in the bone marrow as stem cells.

The bone marrow is made up of blood cells at different stages of maturity. As each cell fully matures, it is released from the bone marrow to circulate in the bloodstream. The blood circulating outside of the bone marrow in the heart, veins and arteries is called peripheral blood.

Stem cells are very immature cells. When there is a need, the stem cells are signaled to develop into mature RBCs, WBCs or platelets. This signaling is done with “growth factors.”

In leukemia, the normal production of blood cells changes. The bone marrow starts making too many abnormal, immature cells, called blasts or lymphoblasts, which crowd out other blood cells in the blood marrow, blood stream and lymph system. They can travel to other places in the body, including lymph glands and the spleen.

Leukemia Types

Types of leukemia are grouped by the type of cell affected and by the rate of cell growth. Leukemia can be either acute or chronic.

Acute leukemia involves an overgrowth of very immature blood cells. This condition is life threatening because there are not enough mature blood cells to prevent anemia, infection and bleeding. A diagnosis of acute leukemia is made when there are 20% or more blasts or immature cells in the bone marrow.

There are two main types of acute leukemia:

  • Acute lymphocyte leukemia (ALL) is most prevalent during childhood and early adulthood, but it also is found in adults
  • Acute myeloid (or myelogenous) leukemia (AML) occurs more often in adults

Myelodysplastic Syndrome (MDS) is a condition in which the bone marrow does not produce enough normal blood cells. Some cases of MDS may, over time, progress to acute leukemia.

Myeloproliferative Disease (MPD), also known as myeloproliferative neoplasia (MPN), is a condition in which the bone marrow makes too many blood cells. Sometimes the disease progresses slowly and requires little treatment; other times it develops into acute myeloid leukemia (AML).

Chronic leukemia involves an overgrowth of mature blood cells. Usually, people with chronic leukemia have enough mature blood cells to prevent serious bleeding and infection. Chronic leukemia is found more often in people between ages 40 and 70. The main types of chronic leukemia are:

  • Chronic lymphoblastic leukemia (CLL)
  • Chronic myeloid (or myelogenous) leukemia (CML)  

To look for specific types of leukemia, your doctor will examine features on the bone marrow cell surface and the appearance of the bone marrow cells under a microscope, as well as analyze chromosome number and appearance.

If you have been diagnosed with leukemia, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center