This marrow is then frozen to save it. The marrow remaining in the patient's body is then destroyed with high dose chemotherapy and radiation therapy. Following that, the patient's own marrow that was frozen is thawed and given back to the patient through a needle in the vein. This mode of bone marrow transplant is currently being investigated in clinical trials. Depending on the stage of the disease, single or multiple drugs may be given.
Drugs commonly prescribed include steroids, chlorambucil, fludarabine, and cladribine.
Low dose radiation therapy may be given to the whole body, or it may be used to alleviate the symptoms and discomfort due to an enlarged spleen and lymph nodes. The spleen may be removed in a procedure called a splenectomy . Radiation therapy, which involves the use of x rays or other high-energy rays to kill cancer cells and shrink tumors, may be used in some cases to reduce the discomfort and pain due to an enlarged spleen. If the leukemic cells have spread to the brain, radiation therapy can be directed at the brain. As the disease progresses, the spleen may be removed in an attempt to try to control the pain and to improve the blood counts.