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Leukemia

Leukemia refers to a group of blood cancers. Leukemia arises when blood cells — including red blood cells, white blood cells and platelets — become abnormal and malignant. These cancerous cells then multiply uncontrollably and spread throughout the bone marrow and bloodstream.
 
Nationally Ranked Cancer Center
 
City of Hope, a National Cancer Institute Comprehensive Cancer Center, is recognized internationally for its leukemia breakthrough treatments and research. It is also one of the largest transplant centers in the country for the treatment of leukemia and has had some of the consistently best outcomes for the last five years. City of Hope’s hematopoietic cell transplant program has been designated a Center of Excellence by the National Marrow Donor Program.
 
With our decades of experience, specialized therapy protocols and extensive program of leukemia clinical trials, City of Hope provides newly diagnosed or relapsed leukemia patients with treatment programs tailored to their disease and giving them the best chance for survival.
 
Leukemia Types
 
The major types of leukemia are classified by two factors:
 
  1. How quickly the cancer develops – acute leukemia (rapidly progressing) or chronic leukemia (slowly progressing)
  2. The types of cells affected – myeloid leukemia (also called myelogenous or myeloblastic) or lymphoid leukemia (also called lymphocytic or lymphoblastic)
 
 
City of Hope physicians have created new treatment protocols for many types of leukemia including some rarer leukemias that have not been formally classified:
 
  • Acute myeloid leukemia (AML)
  • Acute lymphoblastic leukemia (ALL)
  • Chronic myelogenous leukemia (CML)
  • Chronic lymphocytic leukemia (CLL)
    • Hairy Cell Leukemia
  • Adult T-cell Leukemia/Lymphoma
     
Treatment options include transplant and non-transplant therapies. We offer the broadest range of therapeutic options available (adoptive T cell immunotherapy, monoclonal antibody targeted therapy and radioimmunotherapy), including protocols developed here at City of Hope and funded in part by the National Institutes of Health.
 
In 1976, City of Hope launched the Bone Marrow Transplant Program with the intention to help those stricken with the seemingly incurable blood cancer leukemia. Beginning with only six patients that year, the program since has grown into one of the most successful of its kind and has helped save the lives of countless people all over the world.
 
Now our Hematopoietic Cell Transplantation program treats patients that previously did not qualify for the procedure including the very old (nearly 80 years old), the very young (less than 1 year old) and those previously thought too frail to withstand treatment.
 
 
In collaboration with other departments and cancer centers, City of Hope’s leukemia program has an active portfolio of clinical trials studying novel treatments against the cancer, including trials of new chemotherapy and immunotherapy drugs that are more effective against the disease and/or less toxic to the patient. Many of these promising therapies are only available to patients being treated at the City of Hope.
 
We are also actively involved in survivorship research to ensure that our leukemia patients have a minimal chance of developing long-term effects from their disease or treatment.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Leukemia Team

Acute Myeloid Leukemia (AML)

Acute myeloid leukemia (AML) is characterized by a rapidly-developing cancer in the myeloid line of blood cells, which is responsible for producing red blood cells, platelets and several types of white blood cells called granulocytes.
 
Because AML grows rapidly, it can quickly crowd out normal blood cells, leading to anemia, susceptibility to infections and uncontrolled bleeding.
 
Due to the aggressive nature of AML, this disease usually requires intensive treatment, which may include chemotherapy, radiation therapy, immunotherapy and stem cell transplantation.
 
Signs and Symptoms of Acute Myeloid Leukemia
 
The following represent symptoms typical for AML:
 
  • Fever with or without an infection
  • Frequent bruising or bleeds that do not clot
  • Leukemia cutis (multiple lesions with a firm or rubbery consistency that may be pink, red, red-brown or blue-violet in color)
  • Night sweats
  • Pain in the bones or joints
  • Pain or feeling of fullness below the ribs
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Shortness of breath
  • Weakness or feeling tired
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Acute Myeloid Leukemia
 
Risk factors associated with AML include the following:
 
  • Family history: Having a brother or sister, especially a twin, with leukemia
  • Hispanic descent
  • Cigarette smoke or alcohol exposure before birth
  • Smoking
  • History of blood disorders: Including myelodysplastic syndrome (also called preleukemia) or aplastic anemia
  • Previous chemotherapy or radiation therapy
  • Radiation or benzene exposure
  • Genetic disorders: Those with Down syndrome, Klinefelter syndrome, Fanconi anemia, neurofibromatosis or Noonan's syndrome are at a higher risk for AML

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop AML. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.
 
If you suspect that you or a loved one may have AML, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Acute Lymphoblastic Leukemia (ALL)

Acute lymphoblastic leukemia (ALL) is characterized by a rapidly-developing cancer involving overproduction of cancerous white blood cells called lymphoblasts.
 
Because ALL grows rapidly, it can quickly crowd out normal blood cells in the bone marrow and bloodstream, leading to anemia, susceptibility to infections and uncontrolled bleeding.
 
Although ALL can be aggressive, it is also a highly treatable disease, thanks to advances in treatment protocols. Remission is usually achieve in the majority of ALL patients with intensive therapy, which can include chemotherapy, radiation therapy, immunotherapy and stem cell transplantation.
 
Signs and Symptoms of Acute Lymphoblastic Leukemia
 
The following represent symptoms typical for ALL:
 
  • Bone or joint pain
  • Fatigue
  • Fever
  • Frequent bruises or bleeds that do not clot
  • Leukemia cutis (multiple lesions with a firm or rubbery consistency that may be pink, red, red-brown or blue-violet in color)
  • Pain or feeling of fullness below the ribs
  • Painless lumps in the neck, underarm, stomach, or groin
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Shortness of breath
  • Weight loss or loss of appetite
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Acute Lymphoblastic Leukemia
 
Risk factors associated with ALL include the following:
 
  • Family history of leukemia
  • Age: ALL is more common for those older than 70
  • Caucasian descent
  • Exposure to radiation: Particularly X-rays before birth
  • Previous treatment with radiation or chemotherapy
  • Treatment with Thorotrast (a commonly used contrast medium for diagnostic X-rays from the 1930s through the 1950s).
  • Genetic disorders: Those with Down syndrome, Klinefelter syndrome, Fanconi anemia, Bloom syndrome or neurofibromatosis are at a greater risk for ALL

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop ALL. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.

If you suspect that you or a loved one may have ALL, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Chronic Myelogenous Leukemia (CML)

Chronic myelogenous leukemia (CML) is a disease characterized by increased, unregulated growth and accumulation of abnormal granulocytes, a type of white blood cells. These cancerous granulocytes do not function like normal cells, and their increased production and buildup in the bone marrow and bloodstream can crowd out normal red blood cells, white blood cells and platelets, leading the person to be susceptible to anemia, infection and bleeds that do not clot.
 
Although CML typically develops slowly with little or no symptoms, it can accelerate to a "blast crisis", characterized by rapid growth and buildup of cancer cells—similar to acute myeloid leukemia—that requires immediate and intensive treatment.
 
Thanks to developments in cancer therapy, CML is a highly treatable disease. Depending on the phase of CML upon diagnosis, treatment may include chemotherapy, radiation therapy, immunotherapy, stem cell transplantation and, in some cases, surgery.
 
Signs and Symptoms of Chronic Myelogenous Leukemia
 
Symptoms associated with CML include:
 
  • Fatigue
  • Fever
  • Night sweats
  • Pain or feeling of fullness below the ribs
  • Unexplained weight loss
 
Because CML develops slowly, some patients may not experience symptoms at all and may be diagnosed as a result of a routine blood test.
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Chronic Myelogenous Leukemia
 
Risk factors associated with CML include the following:
 
  • Age: Likelihood of developing CML increases with age
  • Gender: Men are slightly more likely to be diagnosed with CML than women
  • Radiation exposure
  • Philadelphia chromosome: A genetic abnormality involving portions of chromosome 9 and 22 to be swapped. Most patients with CML have this abnormality, but it is also found in patients with other blood cancers.

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop CML. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.
 
If you suspect that you or a loved one may have CML, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a slowly progressing disease characterized by increased, unregulated growth in lymphocytes, a type of white blood cells. These cancerous lymphocytes do not function like normal cells, and their increased production and buildup in the bone marrow and bloodstream can crowd out normal red blood cells, white blood cells and platelets, leading the person to be susceptible to anemia, infection and bleeds that do not clot.
 
One commonly recognized subset of CLL is Hairy Cell Leukemia, named for the cancerous B-cell lymphocytes that have an abnormally "hairy" appearance when viewed under a microscope. Although most hairy cell leukemia is slow-growing, there is a variant (called HCL-V) that is aggressive.
 
Treatment options for patients with CLL include chemotherapy, radiation therapy, active surveillance (regular monitoring until symptoms show) and, in some cases, surgery.
 
Signs and Symptoms of Chronic Lymphocytic Leukemia
 
Symptoms associated with CLL include:
 
  • Weakness or fatigue
  • Unexplained weight loss
  • Fever
  • Night sweats
  • Enlarged lymph nodes (often felt as lumps under the skin)
 
Because CLL develops slowly, some patients may not experience symptoms at all and may be diagnosed as a result of a routine blood test.
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Chronic Lymphocytic Leukemia
 
Risk factors associated with CLL include the following:
 
  • Age: Average age of diagnosis is 65-70
  • Gender: CML is more commonly diagnosed in males
  • Caucasian descent: Particularly those who with Russian or Eastern European Jewish heritage
  • Family history of blood cancers
  • Agent Orange exposure

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop CLL. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.

If you suspect that you or a loved one may have CLL, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Diagnosing and Staging Leukemia

To accurately diagnose leukemia, the City of Hope care team may need to perform several tests to determine the leukemia type and stage, or how advanced the disease is. In addition to a routine physical exam and taking a patient’s medical and family history information, City of Hope staff may also perform the following diagnostic procedures.

Complete blood count
This basic test obtains an accurate count of all the different types of blood cells. The hallmark of leukemia is an overabundance of white blood cells (leukocytes) and this may be the first sign that alerts the doctor to the presence of leukemia.

Bone marrow aspirate and biopsy
Bone marrow tissue is extracted and examined by a pathologist under a microscope to determine if the suspected tissue is cancerous and, if so, classify the leukemia according to cell type and other parameters.

Lumbar puncture (spinal tap)
In some types of leukemia, doctors need to look for leukemia cells in cerebrospinal fluid surrounding the brain and spinal cord. In this procedure, the lower back is numbed and some of the spinal cord fluid is withdrawn using a needle. The fluid is then examined microscopically.

Cytochemistry and immunocytochemistry
Cytochemistry refers to using special stains and chemical reactions to differentiate between types of leukemia. Immunocytochemistry uses the same principle, employing antibodies to produce distinct color changes in the cell sample. Both of these techniques allow the pathologist to identify the type of leukemia present.

Immunophenotyping
Immunophenotyping classifies cells according to their immunity characteristics. The presence or absence of certain antigens and cell surface markers are very useful in determining the leukemia’s cell origin, as well as in predicting whether the leukemia is likely to be aggressive or slow-growing.

Cytogenetics (chromosome analysis)
Since some leukemias are caused by chromosome abnormalities, getting a complete chromosome analysis may provide important diagnostic information that can guide treatment.

Molecular testing, including polymerase chain reaction testing
This test examines genes in the leukemia cell. The presence of certain genes, called oncogenes, can help diagnose precisely what form of leukemia is present. For example, in chronic myelogenous leukemia, an oncogene called bcr-abl is often the determining factor in making a diagnosis.
 
Stages of Leukemia
 
Leukemia is described or staged according to its subtype. Currently, acute myeloid or lymphoblastic leukemia (AML/ALL) do not have a standard staging system and are described as untreated, in remission or recurrent.
 
Chronic leukemia are staged according to how widespread the abnormal cells are in the bone marrow and bloodstream.
 
By accurately describing or staging the leukemia, the care team can then properly plan for appropriate treatments in accordance to how aggressive or advanced the disease is.
 
Staging Chronic Myelogenuous Leukemia (CML):
 
  • Chronic phase: In chronic phase CML, fewer than 10% of the cells in the blood and bone marrow are blast cells.
  • Accelerated phase: In accelerated phase CML, 10% to 19% of the cells in the blood and bone marrow are blast cells.
  • Blastic phase: In blastic phase CML, 20% or more of the cells in the blood or bone marrow are blast cells. When tiredness, fever, and an enlarged spleen occur during the blastic phase, it is called blast crisis.
 
Staging Chronic Lymphocytic Leukemia (CLL):
 
  • Stage 0: Lymphocytosis and no enlargement of the lymph nodes, spleen, or liver, and with near normal red blood cell and platelet counts.
  • Stage I: Lymphocytosis plus enlarged lymph nodes. The spleen and liver are not enlarged and the red blood cell and platelet counts are near normal.
  • Stage II: Lymphocytosis plus an enlarged spleen (and possibly an enlarged liver), with or without enlarged lymph nodes. The red blood cell and platelet counts are near normal.
  • Stage III: Lymphocytosis plus anemia (too few red blood cells), with or without enlarged lymph nodes, spleen, or liver. Platelet counts are near normal.
  • Stage IV: Lymphocytosis plus thrombocytopenia (too few blood platelets), with or without anemia, enlarged lymph nodes, spleen, or liver.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Leukemia Treatment Approaches

Patients with diagnosed leukemia are cared for at City of Hope by a multidisciplinary team of professionals, including hematologists, oncologists, pathologists, specially trained transplant physicians, radiation oncologists, nurses, supportive care specialists, dieticians, therapists, social workers, psychiatrists, psychologists and pharmacists. Each member of the team focuses on individual treatment plans designed to extend life, as well as supportive care to improve the quality of life for patients and their families during the treatment period.

Because our program offers both transplant and non-transplant therapies, there is a smoother transition and expedited treatment for patients who ultimately require a stem cell transplant.

At City of Hope, patients are provided treatments based on the latest evidence and clinical guidelines. Factors that determine the therapy regimen include:

  • Type of leukemia
  • Stage of leukemia
  • Prior therapies, if any
  • Patient’s characteristics, such as age and overall health
  • Choice of the patient and care provider, if multiple treatment options are available

Based on these factors, the leukemia treatment regimen may include one or more of the following:

  • Chemotherapy
  • Immunotherapy
  • Stem cell transplantation
  • Radiation therapy
  • Surgery
  • Supportive Care

Due to the aggressive nature of acute leukemias, ALL or AML patients will usually require hospitalization and more intensive treatments. Those with slower-progressing CML or CLL may be treated in an outpatient setting.

Chemotherapy

Chemotherapy, or the use of cancer-fighting drugs, is often the main treatment for all forms of leukemia. Because leukemia is a cancer of the blood, surgery is usually not an option as it is with solid tumors. As a result, chemotherapy uses powerful drugs to kill leukemic cancerous cells in the bone marrow and throughout the bloodstream. Chemotherapy is usually given in cycles, with breaks in between to allow patients to recover from side effects.

Standard chemotherapy drugs used for leukemia may include one or more of the following:
 
  • Cytarabine, also known as cytosine arabinoside or ara-C (Cytosar®)
  • Dasatinib
  • Daunorubicin, also known as daunomycin (Cerubidine®) or idarubicin (Idamycin®)
  • Imatinib (Gleevec®)
  • L-asparaginase (Elspar®) or PEG-L-as
  • paraginase (Oncaspar®)
  • Nilotinib
  • Prednisone
  • Vincristine (Oncovin®)
 
Additionally, City of Hope researchers and clinicians are constantly developing new regimens to improve the effectiveness of existing drugs or building new drugs that are more powerful against leukemia. In particular, City of Hope’s leukemia researchers and clinicians are studying ways to target and kill leukemia stem cells, rather than just the mature leukemia cells that are targeted by conventional therapy. By eliminating these “cancer stem cells”, leukemia can be curable by destroying the disease at its source.
 

Immunotherapy

By modifying the immune system, the patient’s own disease-fighting cells can be used to track and attack leukemia cells throughout the body. This can dramatically enhance other leukemia therapies and lead to better outcomes.
 
Immunotherapy approaches being used or studied at City of Hope include:
 
Radioimmunotherapy
 
City of Hope has developed novel ways of delivering radiation utilizing monoclonal antibodies that have been combined with small amounts of radioactive substances. These radio-labeled antibodies allow doctors to target leukemia cells directly while minimizing damage to normal tissues.
 
City of Hope was one of the first programs to use radioimmunotherapy as part of a transplant regimen to improve the safety and effectiveness of the treatment.
 
Adoptive T-Cell Therapy
 
T-cells are a powerful part of the immune system, and a new approach being studied at City of Hope involves redirecting T-cells to recognize cancer cells specific to leukemia. T-cells are extracted and then genetically modified so they can recognize, target and destroy the cancer cells. Studies are ongoing for this novel approach for a number of leukemias, particularly ones that are recurrent, relapsed or refractory.
 

Stem Cell Transplantation

City of Hope is a leader in the use of stem cell transplantation to treat leukemia and other blood cancers. Since the program began in 1976, more than 12,000 transplants have been performed. City of Hope has been recognized for superior survival outcomes for nine consecutive years—the only transplant center in the United States with such an achievement. Our transplant program is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT), the standard of excellence for blood and bone marrow transplant programs in the United States.
 
Transplants are sometimes performed early in the course of treatment to improve long-term results or it may be utilized when other treatments are not working.
In this procedure, a patient undergoes intensive chemotherapy, and sometimes radiation therapy, to destroy the cancer-causing cells followed by an infusion of healthy new stem cells. The stem cell transplant may be either autologous (extracted from the patient’s own body) or allogeneic (using stem cells taken from another person.)

One known complication of allogeneic transplants is graft versus host disease (GvHD), in which the newly transplanted cells does not recognize the recipient’s body as their own and forms an immune response against it. City of Hope is on the forefront of tackling this side effect and is constantly improving allogeneic transplant protocols to reduce GvHD risk and minimizing its impact if it does occur.
 
Nonmyeloablative (Mini) Transplants
 
City of Hope physicians also specialize in “mini” stem cell transplants for patients who cannot tolerate the side effects associated with a standard stem cell transplantation. These transplants rely less on the heavy doses of chemotherapy and radiation and more on the antitumor effects of the graft itself. This novel approachallows patients who are otherwise ineligible, including patients in their 70s, to be treated with this lifesaving procedure. Thus, this is particularly beneficial for CLL patients, who are usually in this age range upon diagnosis.
 

Radiation Therapy

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. City of Hope is the first in the western United States to treat leukemia using the Helical TomoTherapy System®, which reduces the unwanted exposure of normal tissues and reduces potential complications. The system combines radiation delivery with real-time imaging, allowing doctors to deliver a higher dose of radiation with greater precision. This significantly improves outcomes and reduces side effects compared to traditional whole-body irradiation, which unnecessarily exposes healthy tissues to radiation.

Surgery

Because leukemia spreads throughout the bone marrow and bloodstream, surgery plays a limited role in treatment.  However, surgery may be needed to treat localized, leukemia-related conditions.

How to Become a Patient

If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.

Leukemia Research and Clinical Trials

City of Hope is a recognized leader in leukemia research.  Our scientists are gaining crucial insight into the stem cells that give rise to leukemia. Their goal: find new therapies that can eliminate these leukemia stem cells and abolish the disease completely.

Current leukemia research projects include:
 
  • City of Hope researchers are studying specially designed proteins called monoclonal antibodies, which can bombard leukemia cells with lethal doses of therapy while leaving healthy tissues untouched.
  • Immune system cells called T cells guard against disease; they can detect invader such as bacteria and viruses and destroy them. City of Hope scientists are currently investigating to see how these cells can be reprogrammed to recognize and attack leukemia as well.
  • While stem cell transplants can be a lifesaving procedure for patients with leukemia and other blood disorders, it also carries a risk of graft versus host disease (GvHD), in which the newly transplanted stem cells do not recognize the recipient’s body as their own and start producing an immune response against it, leading to chronic and potentially serious complications. To reduce the likelihood of GvHD and to improve transplant outcomes, City of Hope is researching new ways to classify and match stem cell donors and recipients.
  • The Division of Stem Cell and Leukemia Research is currently investigating leukemia stem cells, which several studies have suggested to cause leukemia. By identifying and eradicating these cancerous stem cells — instead of just the mature leukemia cells that conventional therapies target — a definitive cure for this disease can be achieved. (Learn more about leukemia stem cells.)
 
Leukemia Clinical Trials
 
With our extensive program of leukemia clinical trials, City of Hope can provide our patients access to novel therapies, including many that are not available elsewhere.

Our Developmental Therapeutics Program has an active portfolio of trials for patients with recurrent leukemia, including trials of new chemotherapy and immunotherapy drugs. We are also actively involved in survivorship research.
 

Living with Leukemia

In addition to curative treatments, City of Hope leukemia patients can also access the broad range of services offered by our Department of Supportive Care Medicine. The department’s staff of professionals can help with patients and loved ones with a variety of wellness issues, including managing side effects, maintaining emotional/social/spiritual well being, staying healthy during/after treatment and building caregivers’ skills.
 
 
The center’s staff is dedicated to reducing burden and promoting wellness for the patient and loved ones by providing professional services, educational programs and resource materials.
 
At the Biller Resource Center, a coordinated group of supportive care specialists will work with patients and caregivers to address their well-being concerns. This can include social workers, psychiatrists, psychologists, patient navigators, pain management specialists and spiritual care providers at the center, and programs such as music therapy, meditation and yoga.
 
The Biller Resource Center staff may be reached at 626-256-4673 ext. 32273 (3CARE).
 
Additional Leukemia Resources
 
 
 
 
 
Childhood Leukemia Foundation
 

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.


For more information on supporting this specific program, please contact us below.

Tina Pakfar, Ph.D.
Vice President
Direct: 213-241-7216
Email: tpakfar@coh.org

 
 

Leukemia

Leukemia

Leukemia refers to a group of blood cancers. Leukemia arises when blood cells — including red blood cells, white blood cells and platelets — become abnormal and malignant. These cancerous cells then multiply uncontrollably and spread throughout the bone marrow and bloodstream.
 
Nationally Ranked Cancer Center
 
City of Hope, a National Cancer Institute Comprehensive Cancer Center, is recognized internationally for its leukemia breakthrough treatments and research. It is also one of the largest transplant centers in the country for the treatment of leukemia and has had some of the consistently best outcomes for the last five years. City of Hope’s hematopoietic cell transplant program has been designated a Center of Excellence by the National Marrow Donor Program.
 
With our decades of experience, specialized therapy protocols and extensive program of leukemia clinical trials, City of Hope provides newly diagnosed or relapsed leukemia patients with treatment programs tailored to their disease and giving them the best chance for survival.
 
Leukemia Types
 
The major types of leukemia are classified by two factors:
 
  1. How quickly the cancer develops – acute leukemia (rapidly progressing) or chronic leukemia (slowly progressing)
  2. The types of cells affected – myeloid leukemia (also called myelogenous or myeloblastic) or lymphoid leukemia (also called lymphocytic or lymphoblastic)
 
 
City of Hope physicians have created new treatment protocols for many types of leukemia including some rarer leukemias that have not been formally classified:
 
  • Acute myeloid leukemia (AML)
  • Acute lymphoblastic leukemia (ALL)
  • Chronic myelogenous leukemia (CML)
  • Chronic lymphocytic leukemia (CLL)
    • Hairy Cell Leukemia
  • Adult T-cell Leukemia/Lymphoma
     
Treatment options include transplant and non-transplant therapies. We offer the broadest range of therapeutic options available (adoptive T cell immunotherapy, monoclonal antibody targeted therapy and radioimmunotherapy), including protocols developed here at City of Hope and funded in part by the National Institutes of Health.
 
In 1976, City of Hope launched the Bone Marrow Transplant Program with the intention to help those stricken with the seemingly incurable blood cancer leukemia. Beginning with only six patients that year, the program since has grown into one of the most successful of its kind and has helped save the lives of countless people all over the world.
 
Now our Hematopoietic Cell Transplantation program treats patients that previously did not qualify for the procedure including the very old (nearly 80 years old), the very young (less than 1 year old) and those previously thought too frail to withstand treatment.
 
 
In collaboration with other departments and cancer centers, City of Hope’s leukemia program has an active portfolio of clinical trials studying novel treatments against the cancer, including trials of new chemotherapy and immunotherapy drugs that are more effective against the disease and/or less toxic to the patient. Many of these promising therapies are only available to patients being treated at the City of Hope.
 
We are also actively involved in survivorship research to ensure that our leukemia patients have a minimal chance of developing long-term effects from their disease or treatment.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Leukemia Team

Leukemia Team

Acute Myeloid Leukemia

Acute Myeloid Leukemia (AML)

Acute myeloid leukemia (AML) is characterized by a rapidly-developing cancer in the myeloid line of blood cells, which is responsible for producing red blood cells, platelets and several types of white blood cells called granulocytes.
 
Because AML grows rapidly, it can quickly crowd out normal blood cells, leading to anemia, susceptibility to infections and uncontrolled bleeding.
 
Due to the aggressive nature of AML, this disease usually requires intensive treatment, which may include chemotherapy, radiation therapy, immunotherapy and stem cell transplantation.
 
Signs and Symptoms of Acute Myeloid Leukemia
 
The following represent symptoms typical for AML:
 
  • Fever with or without an infection
  • Frequent bruising or bleeds that do not clot
  • Leukemia cutis (multiple lesions with a firm or rubbery consistency that may be pink, red, red-brown or blue-violet in color)
  • Night sweats
  • Pain in the bones or joints
  • Pain or feeling of fullness below the ribs
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Shortness of breath
  • Weakness or feeling tired
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Acute Myeloid Leukemia
 
Risk factors associated with AML include the following:
 
  • Family history: Having a brother or sister, especially a twin, with leukemia
  • Hispanic descent
  • Cigarette smoke or alcohol exposure before birth
  • Smoking
  • History of blood disorders: Including myelodysplastic syndrome (also called preleukemia) or aplastic anemia
  • Previous chemotherapy or radiation therapy
  • Radiation or benzene exposure
  • Genetic disorders: Those with Down syndrome, Klinefelter syndrome, Fanconi anemia, neurofibromatosis or Noonan's syndrome are at a higher risk for AML

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop AML. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.
 
If you suspect that you or a loved one may have AML, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Acute Lymphoblastic Leukemia

Acute Lymphoblastic Leukemia (ALL)

Acute lymphoblastic leukemia (ALL) is characterized by a rapidly-developing cancer involving overproduction of cancerous white blood cells called lymphoblasts.
 
Because ALL grows rapidly, it can quickly crowd out normal blood cells in the bone marrow and bloodstream, leading to anemia, susceptibility to infections and uncontrolled bleeding.
 
Although ALL can be aggressive, it is also a highly treatable disease, thanks to advances in treatment protocols. Remission is usually achieve in the majority of ALL patients with intensive therapy, which can include chemotherapy, radiation therapy, immunotherapy and stem cell transplantation.
 
Signs and Symptoms of Acute Lymphoblastic Leukemia
 
The following represent symptoms typical for ALL:
 
  • Bone or joint pain
  • Fatigue
  • Fever
  • Frequent bruises or bleeds that do not clot
  • Leukemia cutis (multiple lesions with a firm or rubbery consistency that may be pink, red, red-brown or blue-violet in color)
  • Pain or feeling of fullness below the ribs
  • Painless lumps in the neck, underarm, stomach, or groin
  • Petechiae (flat, pinpoint spots under the skin caused by bleeding)
  • Shortness of breath
  • Weight loss or loss of appetite
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Acute Lymphoblastic Leukemia
 
Risk factors associated with ALL include the following:
 
  • Family history of leukemia
  • Age: ALL is more common for those older than 70
  • Caucasian descent
  • Exposure to radiation: Particularly X-rays before birth
  • Previous treatment with radiation or chemotherapy
  • Treatment with Thorotrast (a commonly used contrast medium for diagnostic X-rays from the 1930s through the 1950s).
  • Genetic disorders: Those with Down syndrome, Klinefelter syndrome, Fanconi anemia, Bloom syndrome or neurofibromatosis are at a greater risk for ALL

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop ALL. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.

If you suspect that you or a loved one may have ALL, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Chronic Myelogenous Leukemia

Chronic Myelogenous Leukemia (CML)

Chronic myelogenous leukemia (CML) is a disease characterized by increased, unregulated growth and accumulation of abnormal granulocytes, a type of white blood cells. These cancerous granulocytes do not function like normal cells, and their increased production and buildup in the bone marrow and bloodstream can crowd out normal red blood cells, white blood cells and platelets, leading the person to be susceptible to anemia, infection and bleeds that do not clot.
 
Although CML typically develops slowly with little or no symptoms, it can accelerate to a "blast crisis", characterized by rapid growth and buildup of cancer cells—similar to acute myeloid leukemia—that requires immediate and intensive treatment.
 
Thanks to developments in cancer therapy, CML is a highly treatable disease. Depending on the phase of CML upon diagnosis, treatment may include chemotherapy, radiation therapy, immunotherapy, stem cell transplantation and, in some cases, surgery.
 
Signs and Symptoms of Chronic Myelogenous Leukemia
 
Symptoms associated with CML include:
 
  • Fatigue
  • Fever
  • Night sweats
  • Pain or feeling of fullness below the ribs
  • Unexplained weight loss
 
Because CML develops slowly, some patients may not experience symptoms at all and may be diagnosed as a result of a routine blood test.
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Chronic Myelogenous Leukemia
 
Risk factors associated with CML include the following:
 
  • Age: Likelihood of developing CML increases with age
  • Gender: Men are slightly more likely to be diagnosed with CML than women
  • Radiation exposure
  • Philadelphia chromosome: A genetic abnormality involving portions of chromosome 9 and 22 to be swapped. Most patients with CML have this abnormality, but it is also found in patients with other blood cancers.

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop CML. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.
 
If you suspect that you or a loved one may have CML, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a slowly progressing disease characterized by increased, unregulated growth in lymphocytes, a type of white blood cells. These cancerous lymphocytes do not function like normal cells, and their increased production and buildup in the bone marrow and bloodstream can crowd out normal red blood cells, white blood cells and platelets, leading the person to be susceptible to anemia, infection and bleeds that do not clot.
 
One commonly recognized subset of CLL is Hairy Cell Leukemia, named for the cancerous B-cell lymphocytes that have an abnormally "hairy" appearance when viewed under a microscope. Although most hairy cell leukemia is slow-growing, there is a variant (called HCL-V) that is aggressive.
 
Treatment options for patients with CLL include chemotherapy, radiation therapy, active surveillance (regular monitoring until symptoms show) and, in some cases, surgery.
 
Signs and Symptoms of Chronic Lymphocytic Leukemia
 
Symptoms associated with CLL include:
 
  • Weakness or fatigue
  • Unexplained weight loss
  • Fever
  • Night sweats
  • Enlarged lymph nodes (often felt as lumps under the skin)
 
Because CLL develops slowly, some patients may not experience symptoms at all and may be diagnosed as a result of a routine blood test.
 
If your or a loved one are experiencing these symptoms, please contact your doctor for further evaluation, which may include a biopsy for a leukemia diagnosis.
 
Risk Factors for Chronic Lymphocytic Leukemia
 
Risk factors associated with CLL include the following:
 
  • Age: Average age of diagnosis is 65-70
  • Gender: CML is more commonly diagnosed in males
  • Caucasian descent: Particularly those who with Russian or Eastern European Jewish heritage
  • Family history of blood cancers
  • Agent Orange exposure

People who think they may be at risk should discuss this with their doctor.
 
Note that having one or more risk factors does not mean that a person will develop CLL. Most people who have risk factors never develop cancer. Likewise, some people who develop leukemia may not have any risk factors present.

If you suspect that you or a loved one may have CLL, please contact your doctor for a medical examination.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
Sources: American Cancer Society and National Cancer Institute
 

Diagnosing Leukemia

Diagnosing and Staging Leukemia

To accurately diagnose leukemia, the City of Hope care team may need to perform several tests to determine the leukemia type and stage, or how advanced the disease is. In addition to a routine physical exam and taking a patient’s medical and family history information, City of Hope staff may also perform the following diagnostic procedures.

Complete blood count
This basic test obtains an accurate count of all the different types of blood cells. The hallmark of leukemia is an overabundance of white blood cells (leukocytes) and this may be the first sign that alerts the doctor to the presence of leukemia.

Bone marrow aspirate and biopsy
Bone marrow tissue is extracted and examined by a pathologist under a microscope to determine if the suspected tissue is cancerous and, if so, classify the leukemia according to cell type and other parameters.

Lumbar puncture (spinal tap)
In some types of leukemia, doctors need to look for leukemia cells in cerebrospinal fluid surrounding the brain and spinal cord. In this procedure, the lower back is numbed and some of the spinal cord fluid is withdrawn using a needle. The fluid is then examined microscopically.

Cytochemistry and immunocytochemistry
Cytochemistry refers to using special stains and chemical reactions to differentiate between types of leukemia. Immunocytochemistry uses the same principle, employing antibodies to produce distinct color changes in the cell sample. Both of these techniques allow the pathologist to identify the type of leukemia present.

Immunophenotyping
Immunophenotyping classifies cells according to their immunity characteristics. The presence or absence of certain antigens and cell surface markers are very useful in determining the leukemia’s cell origin, as well as in predicting whether the leukemia is likely to be aggressive or slow-growing.

Cytogenetics (chromosome analysis)
Since some leukemias are caused by chromosome abnormalities, getting a complete chromosome analysis may provide important diagnostic information that can guide treatment.

Molecular testing, including polymerase chain reaction testing
This test examines genes in the leukemia cell. The presence of certain genes, called oncogenes, can help diagnose precisely what form of leukemia is present. For example, in chronic myelogenous leukemia, an oncogene called bcr-abl is often the determining factor in making a diagnosis.
 
Stages of Leukemia
 
Leukemia is described or staged according to its subtype. Currently, acute myeloid or lymphoblastic leukemia (AML/ALL) do not have a standard staging system and are described as untreated, in remission or recurrent.
 
Chronic leukemia are staged according to how widespread the abnormal cells are in the bone marrow and bloodstream.
 
By accurately describing or staging the leukemia, the care team can then properly plan for appropriate treatments in accordance to how aggressive or advanced the disease is.
 
Staging Chronic Myelogenuous Leukemia (CML):
 
  • Chronic phase: In chronic phase CML, fewer than 10% of the cells in the blood and bone marrow are blast cells.
  • Accelerated phase: In accelerated phase CML, 10% to 19% of the cells in the blood and bone marrow are blast cells.
  • Blastic phase: In blastic phase CML, 20% or more of the cells in the blood or bone marrow are blast cells. When tiredness, fever, and an enlarged spleen occur during the blastic phase, it is called blast crisis.
 
Staging Chronic Lymphocytic Leukemia (CLL):
 
  • Stage 0: Lymphocytosis and no enlargement of the lymph nodes, spleen, or liver, and with near normal red blood cell and platelet counts.
  • Stage I: Lymphocytosis plus enlarged lymph nodes. The spleen and liver are not enlarged and the red blood cell and platelet counts are near normal.
  • Stage II: Lymphocytosis plus an enlarged spleen (and possibly an enlarged liver), with or without enlarged lymph nodes. The red blood cell and platelet counts are near normal.
  • Stage III: Lymphocytosis plus anemia (too few red blood cells), with or without enlarged lymph nodes, spleen, or liver. Platelet counts are near normal.
  • Stage IV: Lymphocytosis plus thrombocytopenia (too few blood platelets), with or without anemia, enlarged lymph nodes, spleen, or liver.
 
 
If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Our Treatment Approach

Leukemia Treatment Approaches

Patients with diagnosed leukemia are cared for at City of Hope by a multidisciplinary team of professionals, including hematologists, oncologists, pathologists, specially trained transplant physicians, radiation oncologists, nurses, supportive care specialists, dieticians, therapists, social workers, psychiatrists, psychologists and pharmacists. Each member of the team focuses on individual treatment plans designed to extend life, as well as supportive care to improve the quality of life for patients and their families during the treatment period.

Because our program offers both transplant and non-transplant therapies, there is a smoother transition and expedited treatment for patients who ultimately require a stem cell transplant.

At City of Hope, patients are provided treatments based on the latest evidence and clinical guidelines. Factors that determine the therapy regimen include:

  • Type of leukemia
  • Stage of leukemia
  • Prior therapies, if any
  • Patient’s characteristics, such as age and overall health
  • Choice of the patient and care provider, if multiple treatment options are available

Based on these factors, the leukemia treatment regimen may include one or more of the following:

  • Chemotherapy
  • Immunotherapy
  • Stem cell transplantation
  • Radiation therapy
  • Surgery
  • Supportive Care

Due to the aggressive nature of acute leukemias, ALL or AML patients will usually require hospitalization and more intensive treatments. Those with slower-progressing CML or CLL may be treated in an outpatient setting.

Chemotherapy

Chemotherapy, or the use of cancer-fighting drugs, is often the main treatment for all forms of leukemia. Because leukemia is a cancer of the blood, surgery is usually not an option as it is with solid tumors. As a result, chemotherapy uses powerful drugs to kill leukemic cancerous cells in the bone marrow and throughout the bloodstream. Chemotherapy is usually given in cycles, with breaks in between to allow patients to recover from side effects.

Standard chemotherapy drugs used for leukemia may include one or more of the following:
 
  • Cytarabine, also known as cytosine arabinoside or ara-C (Cytosar®)
  • Dasatinib
  • Daunorubicin, also known as daunomycin (Cerubidine®) or idarubicin (Idamycin®)
  • Imatinib (Gleevec®)
  • L-asparaginase (Elspar®) or PEG-L-as
  • paraginase (Oncaspar®)
  • Nilotinib
  • Prednisone
  • Vincristine (Oncovin®)
 
Additionally, City of Hope researchers and clinicians are constantly developing new regimens to improve the effectiveness of existing drugs or building new drugs that are more powerful against leukemia. In particular, City of Hope’s leukemia researchers and clinicians are studying ways to target and kill leukemia stem cells, rather than just the mature leukemia cells that are targeted by conventional therapy. By eliminating these “cancer stem cells”, leukemia can be curable by destroying the disease at its source.
 

Immunotherapy

By modifying the immune system, the patient’s own disease-fighting cells can be used to track and attack leukemia cells throughout the body. This can dramatically enhance other leukemia therapies and lead to better outcomes.
 
Immunotherapy approaches being used or studied at City of Hope include:
 
Radioimmunotherapy
 
City of Hope has developed novel ways of delivering radiation utilizing monoclonal antibodies that have been combined with small amounts of radioactive substances. These radio-labeled antibodies allow doctors to target leukemia cells directly while minimizing damage to normal tissues.
 
City of Hope was one of the first programs to use radioimmunotherapy as part of a transplant regimen to improve the safety and effectiveness of the treatment.
 
Adoptive T-Cell Therapy
 
T-cells are a powerful part of the immune system, and a new approach being studied at City of Hope involves redirecting T-cells to recognize cancer cells specific to leukemia. T-cells are extracted and then genetically modified so they can recognize, target and destroy the cancer cells. Studies are ongoing for this novel approach for a number of leukemias, particularly ones that are recurrent, relapsed or refractory.
 

Stem Cell Transplantation

City of Hope is a leader in the use of stem cell transplantation to treat leukemia and other blood cancers. Since the program began in 1976, more than 12,000 transplants have been performed. City of Hope has been recognized for superior survival outcomes for nine consecutive years—the only transplant center in the United States with such an achievement. Our transplant program is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT), the standard of excellence for blood and bone marrow transplant programs in the United States.
 
Transplants are sometimes performed early in the course of treatment to improve long-term results or it may be utilized when other treatments are not working.
In this procedure, a patient undergoes intensive chemotherapy, and sometimes radiation therapy, to destroy the cancer-causing cells followed by an infusion of healthy new stem cells. The stem cell transplant may be either autologous (extracted from the patient’s own body) or allogeneic (using stem cells taken from another person.)

One known complication of allogeneic transplants is graft versus host disease (GvHD), in which the newly transplanted cells does not recognize the recipient’s body as their own and forms an immune response against it. City of Hope is on the forefront of tackling this side effect and is constantly improving allogeneic transplant protocols to reduce GvHD risk and minimizing its impact if it does occur.
 
Nonmyeloablative (Mini) Transplants
 
City of Hope physicians also specialize in “mini” stem cell transplants for patients who cannot tolerate the side effects associated with a standard stem cell transplantation. These transplants rely less on the heavy doses of chemotherapy and radiation and more on the antitumor effects of the graft itself. This novel approachallows patients who are otherwise ineligible, including patients in their 70s, to be treated with this lifesaving procedure. Thus, this is particularly beneficial for CLL patients, who are usually in this age range upon diagnosis.
 

Radiation Therapy

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. City of Hope is the first in the western United States to treat leukemia using the Helical TomoTherapy System®, which reduces the unwanted exposure of normal tissues and reduces potential complications. The system combines radiation delivery with real-time imaging, allowing doctors to deliver a higher dose of radiation with greater precision. This significantly improves outcomes and reduces side effects compared to traditional whole-body irradiation, which unnecessarily exposes healthy tissues to radiation.

Surgery

Because leukemia spreads throughout the bone marrow and bloodstream, surgery plays a limited role in treatment.  However, surgery may be needed to treat localized, leukemia-related conditions.

How to Become a Patient

If you have been diagnosed with leukemia or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.

Research/Clinical Trials

Leukemia Research and Clinical Trials

City of Hope is a recognized leader in leukemia research.  Our scientists are gaining crucial insight into the stem cells that give rise to leukemia. Their goal: find new therapies that can eliminate these leukemia stem cells and abolish the disease completely.

Current leukemia research projects include:
 
  • City of Hope researchers are studying specially designed proteins called monoclonal antibodies, which can bombard leukemia cells with lethal doses of therapy while leaving healthy tissues untouched.
  • Immune system cells called T cells guard against disease; they can detect invader such as bacteria and viruses and destroy them. City of Hope scientists are currently investigating to see how these cells can be reprogrammed to recognize and attack leukemia as well.
  • While stem cell transplants can be a lifesaving procedure for patients with leukemia and other blood disorders, it also carries a risk of graft versus host disease (GvHD), in which the newly transplanted stem cells do not recognize the recipient’s body as their own and start producing an immune response against it, leading to chronic and potentially serious complications. To reduce the likelihood of GvHD and to improve transplant outcomes, City of Hope is researching new ways to classify and match stem cell donors and recipients.
  • The Division of Stem Cell and Leukemia Research is currently investigating leukemia stem cells, which several studies have suggested to cause leukemia. By identifying and eradicating these cancerous stem cells — instead of just the mature leukemia cells that conventional therapies target — a definitive cure for this disease can be achieved. (Learn more about leukemia stem cells.)
 
Leukemia Clinical Trials
 
With our extensive program of leukemia clinical trials, City of Hope can provide our patients access to novel therapies, including many that are not available elsewhere.

Our Developmental Therapeutics Program has an active portfolio of trials for patients with recurrent leukemia, including trials of new chemotherapy and immunotherapy drugs. We are also actively involved in survivorship research.
 

Living with Leukemia

Living with Leukemia

In addition to curative treatments, City of Hope leukemia patients can also access the broad range of services offered by our Department of Supportive Care Medicine. The department’s staff of professionals can help with patients and loved ones with a variety of wellness issues, including managing side effects, maintaining emotional/social/spiritual well being, staying healthy during/after treatment and building caregivers’ skills.
 
 
The center’s staff is dedicated to reducing burden and promoting wellness for the patient and loved ones by providing professional services, educational programs and resource materials.
 
At the Biller Resource Center, a coordinated group of supportive care specialists will work with patients and caregivers to address their well-being concerns. This can include social workers, psychiatrists, psychologists, patient navigators, pain management specialists and spiritual care providers at the center, and programs such as music therapy, meditation and yoga.
 
The Biller Resource Center staff may be reached at 626-256-4673 ext. 32273 (3CARE).
 
Additional Leukemia Resources
 
 
 
 
 
Childhood Leukemia Foundation
 

Support This Program

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.


For more information on supporting this specific program, please contact us below.

Tina Pakfar, Ph.D.
Vice President
Direct: 213-241-7216
Email: tpakfar@coh.org

 
 
Meet our doctors: Hematologist Leslie Popplewell on clinicaltrials

Meet our doctors: Hematologist Leslie Popplewell on clinical trials

Research studies known as clinical trials have led to countless advances in the diagnosis, treatment and prevention of cancer. These studies test the effectiveness of new medical approaches that can l...

March 2, 2014

 
New CMV vaccine targets virus affecting third of transplantpatients

New CMV vaccine targets virus affecting third of transplant patients

In most healthy adults, the immune system wages a winning battle against a virus that infects up to 80 percent of the population by age 40. Most never even know they have cytomegalovirus, or CMV....

February 3, 2014

 
‘My cancer diagnosis: What I wish I’d known’ – Bishop J. JonBruno

‘My cancer diagnosis: What I wish I’d known’ – Bishop J. Jon Bruno

Bishop J. Jon Bruno will be one of 11 former City of Hope patients riding atop our float on New Year’s Day. Read other riders’ stories and learn more about the float, “Turning Hope and Dream...

December 23, 2013

 
Exploring cognitive decline after hematopoietic celltransplant

Exploring cognitive decline after hematopoietic cell transplant

Hematopoietic cell transplant patients who undergo what’s known as myeloablative conditioning (that is, high-intensity chemotherapy and radiation) – and who have shorter telomeres (chromosome “en...

December 17, 2013

 
Leukemia diagnosis made Bishop J. Jon Bruno see his trueimpact

Leukemia diagnosis made Bishop J. Jon Bruno see his true impact

Bishop J. Jon Bruno will be one of 11 former City of Hope patients riding atop our float on New Year’s Day. Read other riders’ stories and learn more about the float, “Turning Hope and Dreams into Rea...

December 16, 2013

 
Videos
 
Watch patient stories and other videos highlighting City of Hope's Leukemia Program, treatments and research.
Refer a Patient
Physicians can choose a number of options to refer a patient:

  • Call 800-826-HOPE (4673) to speak with a patient referral specialist.
  • Fax the patient face sheet to 626-301-8432
  • Complete an online callback request form
 
Hematologic Cancers Support Groups
The focus of the Division of Hematopoietic Stem Cell and Leukemia Research is to improve the understanding of leukemia stem cells in order to develop cures for leukemia and other hematologic malignancies.
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