Leukemia Treatment in Hyderabad — Expert Blood Cancer Care Across 7 Locations
Medically reviewed by Dr. N. Kiranmayee, Medical Oncologist · Written by Dr. Basudev Pokhrel, Haematologist · Last reviewed 21 May 2026
'Leukemia' is a single word that describes four fundamentally different diseases. The treatment for one type is a daily tablet taken at home for years. The treatment for another must begin within days. A third type often needs no treatment at all for months or years after diagnosis. Understanding which leukemia has been diagnosed is the first and most important step — no two types are managed the same way.
- All Four Leukemia Types — ALL, AML, CML, CLL managed by a dedicated haematology team
- NCCN & ESMO Protocols — risk-stratified treatment with molecular and cytogenetic testing
- 7 Hyderabad Locations — day-care chemotherapy delivered across all CION centres
- 5-Star NABH Accredited — bone marrow transplant referral coordinated end-to-end
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Leukemia — Four Diseases, Four Completely Different Treatments
Every leukemia starts in the bone marrow, where blood cells are made. When the process of making blood cells goes wrong, abnormal white blood cells multiply uncontrollably, crowd out healthy blood cells, and cause the body to lose its ability to fight infection, carry oxygen, and stop bleeding. But leukemia is not one disease. It is four — and their behaviour, urgency, and treatment have almost nothing in common.
| Type | Cell Origin | Speed | Most Common In | Primary Treatment |
|---|---|---|---|---|
| ALL | Lymphoid (B or T cell) | Acute — fast | Children; adults over 50 | Multi-phase chemo (2–3 years) |
| AML | Myeloid cell | Acute — very fast | Adults over 60 | Urgent induction chemo → consolidation |
| CML | Myeloid; BCR-ABL gene fusion | Chronic — slow | Adults 40–60 | Daily targeted tablet (TKI) for life |
| CLL | Lymphoid (B cell) | Chronic — very slow | Adults over 60 | Watch and wait; targeted therapy when needed |
Did You Know? CML — once a near-certain death sentence — is now controlled by a daily tablet.
Chronic myeloid leukaemia was once a cancer that almost always progressed to an aggressive phase within a few years, requiring bone marrow transplant. Today, a daily oral tablet called imatinib (and its successors) controls CML so effectively that most patients have a near-normal life expectancy, never need chemotherapy, and never need a bone marrow transplant. CML is one of the great success stories of targeted cancer medicine.
Symptoms of Leukemia — When to Seek Help
Many leukemia symptoms overlap with common illnesses. What distinguishes leukemia is persistence and pattern — symptoms that do not resolve after treatment for ordinary infection, or that appear together without an obvious cause.
- Persistent, unexplained fatigue and weakness — a tiredness that sleep does not resolve; paleness of the skin or lips
- Frequent infections that take longer than usual to clear — a sign that the immune system is not working properly
- Easy bruising or unexpected bleeding — bruises from minimal contact; bleeding gums; prolonged bleeding from minor cuts; frequent nosebleeds
- Painless swollen lymph nodes — in the neck, armpit, or groin; particularly in ALL and CLL
- Unexplained fever lasting more than 2 weeks — particularly in acute leukaemias
- Night sweats soaking clothing
- Unexplained weight loss
- Bone or joint pain — particularly in children with ALL; the bone marrow is expanded by leukemia cells
- Fullness or discomfort in the upper left abdomen — from an enlarged spleen, particularly in CML
Acute leukaemias (ALL and AML) typically present with rapidly worsening symptoms over days to weeks. Chronic leukaemias (CML and CLL) often cause few or no symptoms at diagnosis and are found on a routine blood test.
Risk Factors for Leukemia
For most leukemia patients, no specific cause is identified. Known risk factors vary by type:
- Previous chemotherapy or radiationCertain chemotherapy medicines and high-dose radiation for another cancer increase the risk of AML years later.
- Genetic conditionsDown syndrome (trisomy 21) significantly increases the risk of ALL in children. Li-Fraumeni syndrome and certain rare inherited conditions increase AML risk.
- High-dose radiation exposureOccupational exposure or from nuclear accidents — linked to AML and CML.
- SmokingTobacco use is a recognised, modifiable risk factor for AML.
- Benzene & industrial chemicalsLong-term exposure to benzene and certain industrial chemicals is linked to AML.
- AgeALL peaks in children and adults over 50. AML, CML, and CLL predominantly affect adults over 50 to 60.
How Is Leukemia Diagnosed at CION?
Diagnosis happens in stages — each one narrowing down what type of leukemia is present, how advanced it is, and what treatment will work best.
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Full Blood Count (FBC) — the First Test
A full blood count is almost always the first abnormal test that leads to a leukemia diagnosis. In acute leukaemias, the white cell count may be dramatically elevated, and red cell and platelet counts are typically low. In CML, the white cell count is high with a specific pattern of immature myeloid cells. In CLL, the lymphocyte count is elevated. In some acute leukaemias the white cell count may be low.
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Peripheral Blood Smear
The blood sample is examined under a microscope. The appearance of the white blood cells — particularly the presence of blast cells (very immature, abnormal cells) — confirms the suspicion of acute leukaemia and guides the next steps.
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Bone Marrow Biopsy & Aspiration
A small sample of bone marrow is taken from the back of the hip bone under sedation or local anaesthetic. This is the most important diagnostic test for leukemia. The sample is examined to confirm the diagnosis, identify the exact type and subtype, measure the percentage of blast cells, and perform the molecular and genetic tests that determine prognosis and guide treatment choice.
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Molecular & Genetic Testing
The bone marrow sample undergoes specialist testing that no local hospital treatment page explains adequately: flow cytometry identifies the specific cell type (B-cell, T-cell, myeloid); cytogenetics identifies abnormal chromosome changes including the Philadelphia chromosome (BCR-ABL fusion); PCR molecular tests detect the BCR-ABL fusion gene at a sensitivity of 1 in a million cells and are used repeatedly during treatment to monitor response; gene mutation testing identifies specific gene faults (FLT3, NPM1, IDH1/2) in AML that predict prognosis and guide targeted treatment.
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A dedicated haematology team supported by 17+ super-specialist oncologists. Every leukemia case is reviewed by haematology, medical oncology, pathology, and molecular diagnostics — together.
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Dr. Mohammed Imran
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Consult a Leukemia Specialist Today
Whether you have received a leukemia diagnosis, want to understand your treatment options, or need a second opinion — CION's haematology team is available across 7 Hyderabad locations with same-week appointments.
CML — The Leukemia That Changed with a Tablet
Chronic myeloid leukaemia is driven by a single, specific genetic change: a fusion gene called BCR-ABL, created when two chromosomes partially swap segments (the Philadelphia chromosome). This fusion gene acts like a permanently stuck accelerator, driving white blood cell production into overdrive. Because the cause is so specific and so consistent, CML was one of the first cancers to be successfully treated with a targeted medicine.
A daily oral tablet — called a tyrosine kinase inhibitor (TKI) — specifically blocks the BCR-ABL accelerator. When taken consistently, it normalises the blood count in most patients within 3 months and drives the leukemia to undetectable levels within 12 to 18 months in the majority. Three TKIs are used as first-line treatment: imatinib (the original, still highly effective), nilotinib, and dasatinib (faster and deeper responses for some patients).
What this means for most CML patients in practice:
- One tablet taken once daily at home — treatment fits around normal life
- Regular blood tests every 3 months to monitor BCR-ABL levels using a PCR test — the test measures response to treatment with extreme sensitivity
- No chemotherapy, no hospital admission, no hair loss in the vast majority of cases
- No bone marrow transplant needed for most patients who respond well to TKI
- Life expectancy approaching that of the general population for patients who achieve and maintain a deep molecular response
Treatment continues indefinitely for most patients. Selected patients who achieve a very deep molecular response over several years may eventually be able to stop the tablet under close monitoring — a possibility discussed with eligible patients by CION's haematology team.
AML — Urgent, Phase-Based, Potentially Curable
Acute myeloid leukaemia is the most common acute leukaemia in adults and one of the most serious blood cancer diagnoses. Unlike CML or CLL, which develop slowly, AML progresses rapidly — treatment must typically begin within days. Before treatment starts, molecular testing identifies specific gene mutations (FLT3, NPM1, IDH1, IDH2) that directly influence both prognosis and treatment choice. For patients with an FLT3 mutation (about 30% of AML cases), a targeted medicine that specifically blocks this faulty switch is added to standard chemotherapy.
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Phase 1 — Induction Chemotherapy
The goal of induction is remission — to rapidly eliminate leukemia cells from the blood and bone marrow. Two or three chemotherapy medicines are given as continuous intravenous infusions over 7 to 10 days. The patient is admitted to hospital for 3 to 5 weeks while the treatment suppresses all blood cell production before the bone marrow recovers. The period of low blood counts (aplasia) carries a risk of infection and requires close monitoring, antibiotics, and blood product support. A bone marrow biopsy 2 to 4 weeks after induction confirms whether remission has been achieved.
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Phase 2 — Consolidation Therapy
Once remission is confirmed, consolidation therapy destroys any remaining leukemia cells that could cause relapse. Consolidation consists of 2 to 4 intensive chemotherapy blocks, each requiring hospitalisation. For patients assessed as high-risk — based on gene mutations, chromosome abnormalities, or incomplete response to induction — bone marrow transplant is recommended during or after consolidation. Patients with favourable-risk AML can be consolidated with chemotherapy alone without transplant.
AML is potentially curable in a significant proportion of patients — particularly those with favourable molecular profiles — with overall cure rates of 35 to 50% in adults under 60, and somewhat lower in older patients who cannot tolerate intensive treatment. CION's haematology team coordinates induction and consolidation and identifies patients requiring transplant referral.
ALL in Adults — Longer Treatment, Higher Transplant Need
Acute lymphoblastic leukaemia in adults is treated with a structured multi-phase programme that spans 2 to 3 years. While the broad phases resemble the treatment used in children (induction, consolidation, maintenance), adult ALL has important differences: significantly higher relapse risk than childhood ALL (overall long-term survival 35–50% in adults vs over 85% in children); bone marrow transplant recommended for a larger proportion of patients; Philadelphia chromosome-positive ALL (Ph+ ALL, about 25% of adult cases) requires a TKI alongside chemotherapy — the same class of drug used in CML. For childhood ALL treatment details, see CION's Paediatric Cancer Treatment page.
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Induction (4–8 weeks)
Intensive multi-drug chemotherapy to achieve remission. A central line is required for intravenous treatment. Protective chemotherapy is given into the spinal fluid to prevent ALL from spreading to the brain.
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Consolidation (several blocks over 6–12 months)
Intensive chemotherapy cycles to eliminate residual disease. High-risk patients are evaluated for bone marrow transplant at this stage.
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Maintenance (up to 2 years)
Low-intensity daily oral tablets and monthly clinic infusions. Most patients return to work and normal activities during maintenance.
CLL — When 'No Treatment Yet' Is the Right Answer
Chronic lymphocytic leukaemia is the most common leukaemia in adults over 60 in the Western world and is increasingly common in India. It develops from B-lymphocytes — a type of white blood cell — and grows very slowly. Many patients live for years with CLL causing minimal disruption to daily life. The majority of newly diagnosed CLL patients — those with early-stage, asymptomatic disease — are correctly told that no treatment is needed yet.
This recommendation causes understandable anxiety. Being told you have leukaemia and then told 'we're not going to treat it' is confusing. But for CLL, the evidence is clear: starting treatment immediately in patients with early-stage CLL does not improve survival compared to watching and waiting. Treatment begun too early does not extend life — it only adds side effects the patient does not yet need.
Watch and wait for CLL involves:
- Blood count review every 3 to 6 months — monitoring lymphocyte count, haemoglobin, and platelets
- Clinical assessment at each visit — checking lymph node size, spleen size, and symptoms
- Treatment triggers — clear criteria that define when treatment should begin: rapidly rising lymphocyte count (doubling in less than 6 months), falling haemoglobin or platelets from marrow involvement, significantly enlarged lymph nodes, B symptoms (fever, night sweats, weight loss), or quality of life being affected by disease
When CLL Treatment Is Needed
When CLL requires treatment — for patients with progressive or symptomatic disease — the standard approach has been transformed in recent years. A targeted medicine that works by blocking a protein (called BCL-2) that CLL cells use to avoid dying — known as venetoclax — has largely replaced traditional chemotherapy for most CLL patients. Venetoclax is given as daily oral tablets, often in combination with a second targeted medicine, for a fixed duration (typically 12 months). This approach achieves deep responses with less toxicity than conventional chemotherapy in most patients.
Did You Know? Watch and Wait for early-stage CLL is not a compromise — it is the standard of care.
For early-stage CLL — the most common leukaemia in older adults — watch and wait is the evidence-based standard. Large clinical trials have shown that treating early-stage, symptom-free CLL immediately does not help patients live longer than those who begin treatment only when the disease progresses. If your haematologist has recommended monitoring rather than immediate treatment for early-stage CLL, this is appropriate. If you have been offered immediate chemotherapy for early-stage CLL without a discussion of watch and wait, a second opinion is worthwhile.
Bone Marrow Transplant (Stem Cell Transplant) for Leukemia
A bone marrow transplant — more accurately a stem cell transplant — replaces the diseased bone marrow with healthy stem cells from a matched donor (allogeneic transplant). It is used in leukemia management in two main situations:
High-risk or relapsed AML & adult ALL
Where the risk of relapse after chemotherapy alone is high enough that the potential benefit of transplant justifies its risks. Eligibility, gene-mutation profile, and HLA donor matching are all considered together.
CML that does not respond to TKIs
A rare situation given how effective modern TKIs are — but a meaningful option for the minority of CML patients who do not achieve adequate molecular responses on first- or second-line TKI therapy.
Bone marrow transplant is a complex procedure requiring specialist transplant facilities — dedicated isolation rooms, specialised nursing, and an experienced transplant team. CION's haematology team evaluates patients for transplant eligibility, initiates HLA donor matching early in the treatment course for eligible patients, and coordinates referral to specialist bone marrow transplant centres in Hyderabad and across India.
Every Case Reviewed by a Specialist Team
Leukemia management requires haematology, medical oncology, pathology, and molecular diagnostics working together from diagnosis. At CION:
- FBC + peripheral smear reviewedLeukemia type suspected and urgent bone marrow biopsy arranged.
- Flow cytometry + cytogeneticsExact leukemia type and subtype identified before treatment decisions.
- BCR-ABL testingPhiladelphia chromosome detected — CML confirmed; Ph+ ALL identified.
- FLT3, NPM1, IDH testing for AMLPrognosis assessed; targeted medicine added where indicated.
- TKI therapy initiated for CMLImatinib or newer-generation TKI selected based on phase and risk profile.
- Induction chemotherapy for AMLStarted within days of diagnosis to achieve remission.
- Adult ALL multi-phase protocolSpinal fluid treatment included from the start to protect the brain.
- Watch & wait structured for early CLLMonitoring schedule and treatment triggers explained to the patient.
- Venetoclax-based treatment for CLLInitiated when clear treatment criteria are met.
- BMT eligibility assessedHLA matching initiated; transplant referral coordinated end-to-end.
- NCCN & ESMO Protocol AdherenceEvery plan aligned to international evidence-based standards.
- Day-care chemotherapyDelivered across any of CION's 7 Hyderabad locations — reduced travel.
Why Patients Choose CION for Leukemia Treatment in Hyderabad
- 1,000+ Cancer Cases AnnuallyTreated across the CION network — volume drives quality in oncology.
- 7 Locations Across HyderabadKukatpally, Kompally, Ameerpet, Tolichowki, MasabTank, L.B. Nagar, Banjara Hills.
- 5-Star NABH AccreditedCancer care institutes built and audited to NABH standards.
- NCCN & ESMO ProtocolsAdhered across all four leukemia types — ALL, AML, CML, CLL.
- Dedicated HaematologistDr. Basudev Pokhrel — expertise in ALL, AML, CML, and CLL.
- BMT Eligibility + ReferralBone marrow transplant assessment and specialist referral coordination.
- Day-Care ChemotherapyAvailable across all 7 Hyderabad locations — reduced travel for ongoing treatment.
- Dedicated Second Opinion ServiceFull molecular and cytogenetic review before any commitment to treatment.
- EMI FacilityFlexible payment options available for all patients.
- 4.8 / 5 RatingAcross 1,000+ patient reviews on Google.
- India's Fastest-Growing Cancer Network35+ centres across Telangana and Andhra Pradesh.
Leukemia Treatment Cost in Hyderabad
Treatment costs vary significantly by leukemia type and phase. CML (daily tablet) and CLL (watch and wait or venetoclax) have very different cost structures from AML and ALL (hospitalisation-intensive).
| Treatment / Investigation | Approx. Cost (INR) | Notes |
|---|---|---|
| Bone Marrow Biopsy & Aspiration | ₹8,000 – ₹20,000 | Essential for diagnosis and subtype confirmation |
| Flow Cytometry + Cytogenetics Panel | ₹10,000 – ₹35,000 | BCR-ABL, FLT3, NPM1 and chromosome testing |
| CML — Imatinib Tablet (monthly, generic) | ₹5,000 – ₹20,000 | Ongoing; PCR monitoring every 3 months; generic widely available |
| CML — Second-Generation TKI (monthly) | ₹20,000 – ₹75,000 | Nilotinib / dasatinib — for patients needing faster or deeper response |
| AML Induction Chemotherapy | ₹1,50,000 – ₹4,00,000 | 7–10 day course; intensive; blood products and infection support included |
| AML Consolidation Chemotherapy (per cycle) | ₹60,000 – ₹1,50,000 | 2–4 cycles post-remission; shorter hospital stays |
| ALL Induction Chemotherapy | ₹1,00,000 – ₹3,50,000 | 4–8 weeks; includes spinal fluid treatment |
| ALL Full Course (induction + consolidation + maintenance) | ₹5,00,000 – ₹15,00,000+ | 2–3 years total; maintenance is low-cost |
| CLL Watch & Wait Monitoring (per year) | ₹10,000 – ₹30,000 | Blood counts + clinic visits only; no drug cost |
| CLL Venetoclax Targeted Therapy (per month) | ₹50,000 – ₹1,50,000 | 12-month fixed course; generics available at lower cost |
Costs are indicative. A personalised cost estimate is provided following your initial haematology consultation at CION.
EMI Facility
Flexible instalment-based payment options available for all patients.
Private Health Insurance
CION works with all major TPAs for cashless hospitalisation.
Every Leukemia Diagnosis Has a Path Forward
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Start Your Story. Book Free Consultation.Frequently Asked Questions about Leukemia Treatment
What are the symptoms of leukemia?
Common symptoms include persistent, unexplained fatigue and weakness; frequent infections that take longer than usual to resolve; easy bruising or unexpected bleeding (bruises from minor contact, bleeding gums, prolonged nosebleeds); painless swollen lymph nodes in the neck, armpit, or groin; unexplained fever lasting more than 2 weeks; night sweats; unexplained weight loss; and bone or joint pain, particularly in children. Acute leukemias (ALL, AML) typically cause rapidly worsening symptoms over days to weeks. Chronic leukemias (CML, CLL) are often found incidentally on a routine blood test with few or no symptoms.
Is leukemia curable?
Many leukemias are curable or highly controllable. CML: most patients on daily TKI tablets have near-normal life expectancy; a small proportion eventually achieve treatment-free remission. AML: 35 to 50% cure rates in adults under 60 with favourable molecular profiles; lower in older patients. ALL in adults: 35 to 50% long-term survival with modern treatment; higher with bone marrow transplant for eligible high-risk patients. CLL: rarely cured, but most patients live 10 to 20+ years with the disease, often requiring no treatment for many years. The specific subtype, molecular profile, and age are the most important factors.
What is the difference between acute and chronic leukemia?
Acute leukemias (ALL and AML) are fast-moving and require urgent treatment, often within days. They are caused by an accumulation of very immature blood cells (blast cells) that multiply rapidly and crowd out normal blood cells. Without treatment, acute leukemias are life-threatening within weeks. Chronic leukemias (CML and CLL) progress much more slowly. They are caused by more mature but still abnormal blood cells that accumulate gradually. Chronic leukemias are often found incidentally and may not cause symptoms for months or years. Despite the name, 'chronic' does not mean less serious — it means slower-developing.
Does CML require chemotherapy?
No — for the vast majority of CML patients, chemotherapy is not needed. CML is driven by a specific gene fault (BCR-ABL) that is effectively blocked by a daily oral tablet called a tyrosine kinase inhibitor (TKI). Imatinib was the first TKI approved for CML and remains highly effective; newer TKIs (nilotinib, dasatinib) achieve faster and deeper responses in some patients. Most CML patients on TKI live near-normal lives without chemotherapy, inpatient hospital stays, or bone marrow transplant. Response is monitored with a blood PCR test every 3 months.
What is the treatment for AML?
AML requires immediate treatment. Phase 1 — induction chemotherapy: 7 to 10 days of intensive intravenous chemotherapy in hospital to rapidly eliminate leukemia cells and achieve remission. Blood counts fall dramatically during this period before recovering; close monitoring and infection prevention are essential. A bone marrow test 2 to 4 weeks later confirms remission. Phase 2 — consolidation: 2 to 4 further chemotherapy cycles to eliminate residual disease and prevent relapse. For high-risk AML, bone marrow transplant is recommended. Specific gene mutations (FLT3, NPM1, IDH1/2) guide treatment choices and transplant decisions.
What is watch and wait for CLL?
For early-stage, asymptomatic CLL, watch and wait is the standard evidence-based recommendation. Clinical trials have shown that starting treatment immediately does not help patients with early-stage CLL live longer than those who begin treatment only when needed. Watch and wait involves blood counts every 3 to 6 months, clinic assessment, and defined criteria for starting treatment: rapidly rising lymphocyte count, falling haemoglobin or platelets, significantly enlarged lymph nodes, B symptoms, or impacted quality of life. Most CLL patients in early stages remain on monitoring for years before treatment is needed.
Is ALL different in adults compared to children?
Yes — significantly. Childhood ALL has a 5-year survival rate exceeding 90% at specialist centres. Adult ALL has 35 to 50% long-term survival. Adults are more likely to have high-risk features including the Philadelphia chromosome (found in about 25% of adults vs 3% of children). For adult ALL, bone marrow transplant is recommended for a larger proportion of patients, particularly those with high-risk features or slow initial response. Treatment lasts 2 to 3 years in both adults and children, but the intensity of individual phases and the role of transplant differ. CION's paediatric cancer treatment page covers childhood ALL in detail.
What is a bone marrow transplant for leukemia?
A bone marrow transplant (stem cell transplant) replaces the diseased bone marrow with healthy stem cells from a matched donor. It is used for high-risk or relapsed AML and adult ALL, and occasionally for CML that does not respond to TKIs. The procedure involves high-dose chemotherapy to destroy the diseased marrow, followed by infusion of donor stem cells that repopulate the marrow with healthy cells. It is a complex procedure requiring specialist facilities and an experienced transplant team. CION evaluates patients for transplant eligibility and coordinates referral to specialist bone marrow transplant centres.
What is the cost of leukemia treatment in Hyderabad?
CML TKI therapy (imatinib, monthly): ₹5,000–20,000 for generic; ₹20,000–75,000 for second-generation TKIs. AML induction chemotherapy (hospitalisation + drugs): ₹1,50,000–4,00,000. AML consolidation (per cycle): ₹60,000–1,50,000. ALL full course (2–3 years): ₹5,00,000–15,00,000+. CLL watch and wait (annual monitoring only): ₹10,000–30,000. CLL venetoclax treatment (monthly): ₹50,000–1,50,000. Bone marrow biopsy: ₹8,000–20,000. Molecular testing panel: ₹10,000–35,000. A personalised estimate is provided after your initial CION consultation. EMI options are available.
Can I get a second opinion for leukemia?
Absolutely — and for leukemia, a second opinion is valuable in three situations: if CML has been diagnosed and chemotherapy has been recommended rather than a daily TKI tablet (TKI is the correct first-line treatment for most CML patients); if early-stage, asymptomatic CLL has been diagnosed and immediate treatment has been recommended without discussion of watch and wait; and if AML or ALL has relapsed and no discussion of bone marrow transplant has taken place. CION offers a dedicated Second Opinion service with full molecular testing review.