The rarity of<unk>  paired with its considerably fast progression compared to other leukemias has resulted in difficult production of effective treatments. This disease is currently incurable, treatments and therapy are guided to reduce prolymphocyte abundance in the<unk> lood and production<unk> y the<unk> one marrow, treating symptoms and controlling progression. Watchful Waiting Some patients do not require immediate treatment after diagnosis; these patients include those that do not show overt symptoms or whose cancer has not<unk> een observed to<unk> e progressing. Regular check-ups with physicians are required to actively monitor the patient's condition; once there is evidence of disease progression or patient distress from symptoms, treatment will<unk> e implemented. Chemotherapy<unk>  has a very aggressive clinical course and refractoriness to chemotherapy; it is<unk> elieved this resistance is the result of mutations to the TP53 gene. Its resistant nature has led to the use of combinations of chemotherapy drugs. Drug regimens recommended and employed<unk> y physicians are unique to each patient and are<unk> ased on previous chemotherapy experience along with potential side effects. In addition to the utilization of combinations of chemotherapeutic drugs, it is most often paired with immunotherapy treatments. Targeted Therapy Monoclonal Antibodies A type of targeted therapy that recognizes specific proteins in leukemia<unk> s preventing collateral damage to normal, healthy<unk> s. The following are compounds currently showing promising results in clinical trials and studies: * Rituximab is a widely used monoclonal antibody in treating<unk> -cell malignancies, it is directed against the surface protein CD20. Case studies have documented successful treatment of<unk>  solely with rituximab; additional studies have reported positive activity when rituximab is paired with the chemotherapeutic drugs fludarabine or<unk> endamustine together with the anthracyclines mitoxantrone or epirubicin * Alemtuzumab is a humanized antibody that targets the CD52 antigen which is highly expressed in malignant<unk> -lymphocytes. In vitro tests have demonstrated that it induces<unk>  death. Furthermore, it is most active in the<unk> lood,<unk> one marrow and spleen, all of which are main sites involved with<unk>  and thus could serve as a potential agent in treating this disease with more research Splenectomy or Radiation Therapy to Spleen Patients with splenomegaly (enlarged spleen), unfit for systemic treatment or refractive to chemotherapy may have their spleens removed via splenectomy or undergo splenic irradiation in order to relieve pain, control their symptoms, and allow removal of a major proliferative focus and tumour<unk> ulk in this disease. Splenic irradiation has<unk> een used in the treatment. Stem<unk>  Transplantation A stem<unk>  transplant is a procedure that uses highly specialized<unk> s called hematopoietic stem<unk> s to replace<unk> one marrow that contains the leukemia. This procedure should<unk> e considered in younger patients that have responded well to initial treatments<unk> ecause the progression and spread of this disease is inevitable. However, stem<unk>  transplantation is a high-risk procedure, with significant morbidity and mortality rates. Furthermore, it is often not a feasible option due to the presence of other systemic diseases/conditions.
B-cell prolymphocytic leukemia
Aggressive NK-cell leukemia
T-cell prolymphocytic leukemia
Precursor B-cell lymphoblastic leukemia
T-cell acute lymphoblastic leukemia
T-lymphoblastic leukemia/lymphoma
Acute myeloblastic leukemia with maturation
Acute myeloblastic leukemia without maturation