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Leukemia

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Leukemia is cancer of the blood cells. Cells not working correctly begin to crowd out healthy blood cells in the bone marrow. Leukemia mostly occurs in adults over age 55, but it is also the most common childhood cancer. Every day in the United States, 148 people are diagnosed with leukemia. More than 327,520 Americans are living with leukemia.

There are several kinds of leukemia:

  • Acute lymphoblastic leukemia (ALL): This is an aggressive type of leukemia. It occurs when you have too many lymphoblasts (immature white blood cells) in the blood and bone marrow.
  • Acute myeloid or myeloblastic leukemia (AML): Also an aggressive, fast-growing disease, AML differs from ALL in that too many myeloblasts are found in the bone marrow and blood.
  • Chronic lymphocytic leukemia (CLL): This is more slow-growing than AML and ALL. In later stages of the disease, it can produce cancer cells in the lymph nodes, which is called small lymphocytic lymphoma. Because of that, if you have CLL, you are managed by a lymphoma specialist.
  • Chronic myeloid leukemia (CML): This slowly progressing disease produces too many myelocytes in the bone marrow. The Philadelphia chromosome, a genetic mutation, is often responsible. This mutation is not passed from parent to child.
  • Chronic myelomonocytic leukemia (CMML): This diagnosis is considered a type of myelodysplastic syndrome that affects mainly older adults. CMML patients have more monocytes (large white blood cells) in their blood than is healthy. Many patients have enlarged spleens. The spleen is an organ under the ribcage and above the stomach. It works as a type of filter for the blood and immune system. About 15 to 30 percent of CMML patients go on to develop acute myeloid leukemia.
  • Hairy cell leukemia (HCL): This cancer is slow growing and can happen if your bone marrow makes too many B cells (lymphocytes). Lymphocytes fight infection. The excess B cells look hairy when viewed under a microscope. If diagnosed with HLL, your care will be managed by a lymphoma specialist.
  • Large granular lymphocytic leukemia (LGL): This rare form of leukemia, also managed by a lymphoma specialist, is chronic and slow growing.
  • Myelodysplastic syndrome (MDS): In MDS, some of the cells in the bone marrow are damaged and have problems making new blood cells. Of those made, many of the blood cells formed by the damaged bone marrow cells are defective, leaving the patient with low blood counts because there aren’t enough normal blood cells. In about one-third of patients, MDS can progress to acute myeloid leukemia.

 

Why Choose Sylvester Comprehensive Cancer Center?

Our hematology team has successfully treated more leukemia patients than any other South Florida provider. More experience in your exact cancer offers you better potential outcomes.

More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with the very newest ways to treat and potentially cure your cancer.

Controlled, consistent bone marrow samples for diagnosis and treatment monitoring. We’ll get it right the first time. With our OnControl bone marrow hand-held sampling device, developed by one of our oncologists, we can take bone marrow samples in less than five minutes with less pain to you. As a result, you get a more accurate diagnosis.

Multidisciplinary care teams with nationally recognized expertise. Your care team is made up of experts in every single aspect of your disease.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Treatments

  • Chemotherapy (Medical Therapy)

    This is the main way to treat leukemia. The treatment uses medicines to kill cancer cells, with the goal of putting cancer into remission. Chemotherapy drugs may be injected into your cerebrospinal fluid (CSF). This is called intrathecal chemotherapy, or central nervous system prophylaxis. It helps to prevent cancer growth. It can reach cancer cells around the brain and nervous system.

    We offer intravenous (infusion) chemotherapy at the Comprehensive Treatment Unit (CTU) at Sylvester's Miami location. This 12,000-square-foot unit includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, Coral Gables, and Deerfield Beach locations.

  • Targeted Therapy

    These treatments are designed to attack the molecular changes that make the cancer cell grow and spread. They target abnormal proteins, such as those caused by the Philadelphia chromosome, and may be helpful in treating ALL that has this chromosome. They also have the potential to be more effective and with fewer side effects than chemotherapy. These medicines are taken daily as pills.

  • Immunotherapy

    Also called biologic therapy, this type of therapy available in clinical trials makes cancer more visible to your immune system. Your Sylvester oncologist will advise you if a clinical trial or immunotherapy may be appropriate for your leukemia.

    • Checkpoint blockade therapy: This immune-based cancer treatment takes advantage of immune T cells. Immune T cells are present in many tumors but have been shut off by cancer cells. The checkpoint system prevents immune cells from attacking cancer cells. Checkpoint blockade drugs disable that safety mechanism, allowing your immune T cells to use their destructive capabilities on the tumors.

       

    • Adoptive cell transfer (ACT): This therapy has been compared to giving a living drug. ACT uses immune cells called T cells collected from your blood. The T cells are genetically engineered to recognize a specific protein (antigen) on tumor cells. Billions of the new cells are then grown in the laboratory and infused back into you. The T cells then multiply in your body, recognize and kill cancer cells.

       

  • Stem Cell Transplant with High-Dose Chemotherapy

    If the usual doses of chemotherapy do not fight your cancer, your doctor may recommend very high doses of chemotherapy and a stem cell transplant. High-dose chemotherapy can remove the damaged cells from your system and bone marrow. Healthy "starter" cells for new blood cells are then injected back into your body to restore your body's lost blood cells. Stem cells may be drawn from you or a donor.

  • Supportive Care

    Psychologists and palliative care specialists are available to help you fit cancer treatment into your life and to ease the burden and stress of treatment. Complementary therapies such as acupuncture and massage are also available.

     


Tests

 

Following a medical history and physical examination, procedures for diagnosing leukemia may include:

  • Complete Blood Count (CBC)

    A blood sample is taken to check for the number and percentage of red blood cells, white blood cells, and platelets. We will also check the amount of hemoglobin, a protein that carries oxygen.

  • Peripheral Blood Smear

    A blood sample is checked for cells that appear "hairy." We will also review the number and kinds of white blood cells, and changes in the shape of blood cells.

  • Blood Chemistry Studies

    These tests are used for screening a blood sample for the amounts of substances released into the blood by organs and tissues.

  • Bone Marrow Biopsy

    During this test, a specialist removes a small amount of bone marrow, blood, and bone (from the hip or breastbone). We will look for microscopic signs of cancer.

  • Immunophenotyping

    This is used to examine the antigens or markers on the surface of blood or bone marrow cells. It helps us to diagnose the specific type of leukemia by comparing the cancer cells to normal cells of the immune system.

  • Flow Cytometry

    Flow cytometry measures the number and percentage of live cells and certain cell characteristics in a blood sample. These include size, shape, and the presence of markers on the cell surface related to cancers.

  • Cytogenetic Analysis

    This lab test is used to look at cells under a microscope for chromosome changes in blood or bone marrow. Fluorescent in situ hybridization (FISH) is one type of cytogenetic test. It uses a fluorescent dye that only attaches to certain parts of chromosomes.

  • Multigene Tests

    Because no tumor has a single mutation, genomic profiling allows the pathologist to identify groups of mutations in your blood sample and create a tumor profile for you. That profile can be used to determine what type of treatment would be the most effective and how long you should have treatments like chemotherapy. Your profile may also help predict whether the leukemia is likely to recur and guide treatment accordingly.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care