Latest advances and outcomes from the treatment of acute leukemia today
Leukemia is a blood cancer that can be identified by the rapid growth of defective
blood cells. The marrow of our bone produces most of the blood in our body which is
the site of this abnormal growth. Typically, leukemia cells are immature white blood
cells. Leukemic cells alter the normal blood cell formation process, leading to various
signs and symptoms such as bleeding, infection, and tiredness.
There are two kinds of leukemia: acute leukemia and chronic leukemia. Further, the
acute type was classified into acute myeloid leukaemia (AML) and acute
lymphoblastic leukaemia (ALL). Myeloblasts, or defective white blood cells, are the
cause of acute myeloid leukaemia (AML). Acute myelogenous, granulocytic,
nonlymphocytic, or myeloblastic leukaemia are other terms for this kind of cancer.
However, the overproduction of lymphocytes is caused by acute lymphoblastic
leukaemia (ALL).
Stem cell transplantation, radiation therapy, and chemotherapy have been the
cornerstones of leukaemia treatment. Targeted therapy has also been included in the
standard of care for certain kinds of leukaemia within the past 20 years. These
medications target the proteins that regulate the growth, division, and metastasis of
cancer cells. Different treatment combinations are needed for different forms of
leukaemia.
For Acute lymphocytic leukemia (ALL), Immunotherapies are being used where
many elderly people are unable to handle the severe side effects of the intense
chemotherapy therapies required to treat ALL. Compared to chemotherapy, targeted
therapies might have fewer adverse effects.
Immunotherapies are treatments that enhance the body's ability to fight cancer
through the immune system. Currently, four immunotherapies are FDA approved for
the treatment of ALL: blinatumomab, inotuzumab ozogamicin, tisagenlecleucel and
midostaurin. In ALL, the following immunotherapy techniques are being tested or
employed are CAR T-cell therapy and bispecific T-cell engagers (BiTEs). A sort of
cancer treatment called CAR T-cell therapy involves genetically modifying the
patient & own immune cells. For the treatment of some children and young adults with
ALL, one kind of CAR T cell therapy is currently approved. Dosing is based on
weight reported at the time of leukapheresis.The use of this type in elderly B-cell
ALL patients is now being investigated. Adults with B-cell precursor ALL who have
not responded to previous treatment or have returned after treatment have been
approved for another course of CAR T-cell therapy.
Bispecific T-cell engagers (BiTEs) are another immunotherapy that is being studied
for ALL. These medications bind to both cancer and immune cells, drawing the two
groups of cells closer together so that the immune cells can locate and eliminate the
cancer cells with ease. Recently, it was demonstrated that one such BiTE,
blinatumomab, can increase survival for ALL patients in remission following
chemotherapy, even in situations where the disease is completely eradicated.
Acute myeloid leukaemia (AML) tends to be aggressive and was harder to treat than
ALL. However, AML cells sometimes have gene changes that cause the tumors to
grow but can be targeted with new drugs. The management of AML involves two
phases such as remission induction therapy (first phase of treatment to kill
the leukemia cells in the blood and bone marrow ) and remission continuation therapy
(second phase of treatment to kill any remaining leukemia cells).
The treatment of AML includes chemotherapy (drugs to stop the growth of cancer
cells), radiation therapy (uses high-energy x-rays or other types of radiation to kill
cancer cells), stem cell transplant (to replace the blood-forming cells from the blood
or bone marrow of the patient) and targeted therapy (drugs or other substances to
identify and attack specific cancer cells) or combination of both. Targeted treatments
such as Enasidenib, Olutasidenib, Ivosidenib, Venetoclax, Gemtuzumab ozogamicin,
Midostaurin, Gilteritinib, Glasdegib, and Quizartinib have recently been approved to
treat AML with specific gene alterations.
In order to achieve complete remission (CR) from acute leukaemia, standard
treatment paradigms have involved high-intensity induction chemotherapy. In certain
cases, this was followed by an allogeneic hematopoietic cell transplant (allo-HCT) to
eliminate residual disease through the "graft versus leukaemia effect, which is
mediated by the immune cells of the donor. Allo-HCT is not recommended for all
patients, though, and one of the biggest problems facing the industry at the moment is
the lack of viable chemotherapy-based choices for patients who relapse after allo-
HCT or who develop chemotherapy-refractory illness.
The potential of immunotherapy in the treatment of acute myeloid leukaemia (AML)
has been established by the effectiveness of allogeneic stem cell transplantation.
Alternative T-cell-based immunotherapies have demonstrated effectiveness, but there
is a chance that they could cause on-target off-leukemia hematotoxicity. Currently,
the use of adoptive autologous or allogeneic chimeric antigen receptor (CAR) T /
natural killer cell treatment as a bridge-to-transplant approach is almost only available
in clinical studies.
Acute leukaemia used to be nearly always fatal, but now it has a 63% 5-year survival
rate in the US. The therapeutic options for acute leukaemia have increased with the
introduction of immunotherapy, however, the advancement in AML has been slower.
Novel medicines such as ADCs, CAR T cell treatments, and BiTEs continue to show
remarkable response rates and favourable toxicity profiles in various disease states
every year. Even with these developments, a large number of patients are still not
eligible for immunotherapeutic treatments, and relapses following some of the more
recent modalities are still linked to extremely poor prognoses. In the future, new
medicines with potentially unique mechanisms of action will probably be approved
together with the expansion of the indications for currently available medications.
References:
1. Leukemia. National Cancer Institute. Available at:
https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq
2. Boyiadzis MM, Aksentijevich I, Arber DA, et al. The Society for Immunotherapy
of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of
acute leukemia. Journal for ImmunoTherapy of Cancer. 2020
3. Kantarjian, H., Kadia, T., DiNardo, C. et al. Acute myeloid leukemia: current
progress and future directions. Blood Cancer J. 2021
4. Subklewe M, Bücklein V, Sallman D, Daver N. Novel immunotherapies in the
treatment of AML: is there hope? Hematology Am Soc Hematol Educ Program. 2023
Dec 8;2023
Share:
More Posts
Different Radiation Therapy Types: Applications, Therapies, and Treatments
Different Radiation Therapy Types: Applications, Therapies, and Treatments Cancer. It is a strong enemy that makes millions of people around the world afraid. The very mention of the word sends chills down our spines because it makes us feel scared, hurt, and powerless. Radiation treatment is a strong tool that brings some light into this dark world. As a strong way to kill cancer cells and help people who are suffering from this unending illness, radiation therapy is used in many cancer treatments.Radiotherapy has totally changed how cancer is treated because it can target tumours accurately, kill them, and keep side effects to a minimum. The goal of this blog is to make radiation treatments easier to understand by going over the different kinds of radiation therapy and the ways they are used to fight cancer. Different kinds of radiation Treatment are available for cancer treatment. EXTERNAL BEAM RADIATION THERAPY (EBRT). Most people who get radiation therapy do it through external radiation therapy, also known as external beam radiation therapy (EBRT). EBRT is a noninvasive treatment that is usually done over a few weeks in many fractions. With the help of a machine called a linear accelerator, high-energy radiation beams are pointed at the cancer from outside the body. The radiation beams are carefully shaped and directed so that they only hit the tumour and protect healthy tissues as little as possible. This type of treatment can be used to treat a wide range of cancers, including those in the lungs, breasts, prostate, and head and neck.Dr Ajay GV, a Consultant Healios in External beam radiation on LINAC, says that new techniques like IMRT and SBRT have made external radiation treatment more accurate and effective. With EBRT, treatment plans can be made just for each patient, and they get better results. BRACHYTHERAPY Putting radioactive sources inside or near the tumour is what internal radiation treatment, also called brachytherapy, does. In this way, healthy cells nearby are exposed less and radiation can be delivered accurately. Brachytherapy can be done with either temporary or permanent devices, depending on the situation. This method sends a concentrated dose of radiation straight to the tumour, which makes it especially good for prostate, cervical, or breast cancer that is localised. It can be used by itself or with other treatments, like surgery or external beam radiation therapy, to make them work better and stop tumours from growing. Types of radiotherapy and how they are used. The different kinds of radiation therapy are: Radiation therapy Description Cancer Type Intensity-modulated radiation therapy (IMRT) To intentionally vary the radiation dose during an IMRT treatment, the treatment machine’s integrated shielding moves while the radiation beam is operational. The radiation dose is precisely sculpted to match the contour of the tumour using multiple beams coming from different directions. It’s the most often used radiation treatment for prostate cancer. – Head & Neck Cancers (including those of the larynx, pharynx, and oral cavity) – Cancer of the Prostate – Cancer of the Breast – Gynaecological malignancies, such as those of the vagina, endometrium, and cervical regions – Lung cancer (often in tumours near vital organs including the spinal cord) – Tumours of the central nervous system (CNS) Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) High radiation doses are delivered noninvasively with SRS and SRT, which don’t require anaesthesia or incisions. They reduce exposure of healthy brain tissue while maximising radiation dose to the intended region. While SRT is given over several treatments, SRS is usually given in a single therapy. Brain tumours (such as meningiomas and gliomas) Spine Tumours Lung Cancers in Their Early Stages Prostate Cancer – Liver Cancer Diseases of the Pancreas Brachytherapy, or internal radiation therapy With brachytherapy, specialised applicators direct the radioactive sources—which are contained in protective capsules—to the malignant region. Sometimes, during surgery, the radiation sources are inserted into an organ. Gynaecological cancers (such as cervical, endometrial, and vaginal cancer) – Prostate cancer Nasopharyngeal and oral cavity cancers are examples of head and neck cancers. Lung Cancer, Skin Cancer, Eye Cancer Malignancies of soft tissues Volumetric modulated arc therapy (VMAT) Like IMRT, volumetric modulated arc therapy (VMAT) varies the radiation dosage during treatment while the treatment equipment rotates, therefore providing a continuous radiation exposure. It minimises exposure to nearby organs while accurately forming the radiation dose to the tumour. Head and Neck Cancers (e.g., larynx, pharynx, oral cavity) Breast Cancer – Cancers of the gastrointestinal tract, including stomach, anal, and rectal cancers Lung cancer (often when it is close to the spinal cord or heart) Breast Cancer and Other Central Nervous System (CNS) Tumours Image-guided radiation therapy (IGRT) By use of X-ray pictures obtained immediately before, during, or after radiation therapy sessions, image-guided radiation therapy (IGRT) improves the accuracy and precision of treatment. – Cancers of the head and neck (e.g., oral cavity, throat, larynx) – Prostate cancer – Cancer of the lung – Breast cancer – Cancers of the digestive system (such as anal and rectal cancer) – Cancers related to the gynaecology (such as endometrial and cervical cancer) brain growths – Sarcomas (bone and soft tissue) – Genitourinary malignancies, such as testicular and bladder cancer lymphomas cancers in children
The Risks of Buying Medicines Online: How to Avoid Counterfeit Drugs?
The Risks of Buying Medicines Online: How to Avoid Counterfeit Drugs? 1. Introduction Counterfeit medicines are a growing public health issue in India, especially with the rise of online pharmacies. These fake drugs, often sold online, are designed to resemble genuine products but may contain incorrect, harmful, or no active ingredients at all. With the convenience of buying medicines online, patients are increasingly vulnerable to counterfeit products, which compromises their health and the overall integrity of healthcare systems. The shift to online medicine purchases has made it more challenging for patients to differentiate between legitimate and fake medications. 2. Prevalence of Counterfeit Medicines in India India is one of the largest producers of generic drugs, but counterfeit medicines have infiltrated the market, especially through unregulated online pharmacies. Reports suggest that around 20% of medicines sold in India, including through online channels, could be fake or substandard. This is particularly worrying for life-saving drugs, antibiotics, and medications for chronic conditions like cancer. Online pharmacies, often operating without proper licenses, can sell substandard or falsified drugs to unsuspecting consumers. According to the World Health Organization (WHO), 10.5% of all drugs in low- and middle-income countries, including India, are substandard or counterfeit. 3. Impact of Counterfeit Medicines from Online Pharmacies The effects of consuming counterfeit drugs purchased online can be devastating. Patients, especially those undergoing critical treatments like cancer, may face prolonged illnesses, worsened conditions, or dangerous side effects due to the improper ingredients found in these counterfeit products. For serious diseases like cancer, taking fake drugs can lead to fatal outcomes. Beyond health risks, the growing presence of counterfeit medicines online erodes public trust in e-pharmacies, raises healthcare costs, and damages the pharmaceutical industry’s reputation. 4. How to Protect Yourself from Fake Online Medicines While the government has taken steps to regulate the sale of medicines online, patients must be cautious when buying medications through e-pharmacies. Here are steps to ensure you’re getting genuine medicines: Buy from verified online pharmacies: Only purchase medicines from licensed and regulated pharmacies. Look for licensing information. Verify the packaging: When receiving medicines, look closely at the packaging for signs of tampering, unusual logos, or misspelled brand names. Use authentication tools: Many genuine medicines now include QR codes or holograms on their packaging that can be scanned to verify authenticity. Avoid “too-good-to-be-true” offers: If the price of the medicine seems too low or the pharmacy is offering prescription drugs without a valid prescription, it’s likely a counterfeit. 5. Conclusion Counterfeit medicines sold through online pharmacies pose a significant threat to public health in India, especially for patients dealing with serious illnesses like cancer. The convenience of online medicine purchases can come at a cost if patients aren’t vigilant about where their medications are coming from. By using reputable online pharmacies and verifying their legitimacy, patients can better protect themselves from fake medicines. At Healius Cancer & Hematology Clinics, patient safety is our top priority. We understand the critical importance of genuine medicines in cancer treatment, which is why we ensure that all medications dispensed through our in-house pharmacy are thoroughly vetted and sourced from licensed and reliable suppliers. Our commitment to providing safe, authentic medicines allows our patients to focus on their recovery, knowing they are in safe hands. This dedication to safety is part of what makes us one of the Best Cancer Hospitals in Bangalore. Rest assured, your treatments at Healius are always safe and effective.
Shattering Chemo Myths: What You Need to Know
Shattering Chemo Myths: What You Need to Know When it comes to cancer treatment, chemotherapy often evokes fear and uncertainty. Many envision hair loss, severe sickness, and other daunting side effects. However, much of what is commonly believed about chemotherapy is rooted in misconceptions. Let’s explore the realities of this essential cancer treatment and clear up some myths. Myth 1: Chemotherapy Always Causes Complete Hair Loss A common fear is that chemotherapy will result in complete hair loss. While hair loss is a potential side effect, it doesn’t affect everyone. Chemotherapy targets rapidly dividing cells, including hair follicles, but the extent of hair loss varies. For many, hair loss is temporary, with regrowth occurring after treatment ends. Additionally, scalp cooling techniques can sometimes reduce or prevent hair loss. Myth 2: Chemotherapy Causes Constant Sickness While chemotherapy can cause side effects like nausea, fatigue, and mouth sores, these are not universal experiences. Thanks to advancements in oncology, side effects are more manageable than ever before. Anti-nausea medications, for instance, have proven highly effective. Fatigue can be managed through rest and personalized care strategies. Treatment plans are tailored to minimize side effects, ensuring that each patient’s experience is as comfortable as possible. Myth 3: Chemotherapy Is Solely for Curing Cancer Chemotherapy does more than just cure cancer. It can be used to shrink tumors before surgery, slow the progression of cancer, or alleviate symptoms to improve a patient’s quality of life. The specific goals of chemotherapy vary depending on the type and stage of cancer, and the overall health of the patient. Myth 4: Chemotherapy Is the Only Cancer Treatment Cancer treatment is often multifaceted, involving surgery, radiation, targeted therapies, and immunotherapy alongside chemotherapy. In some cases, early-stage cancers may be treated with targeted therapy, hormonal therapy, or immunotherapy, without the need for chemotherapy. The best cancer treatment plan is individualized, based on the patient’s diagnosis and overall health. Myth 5: There Are No Alternatives to Chemotherapy While chemotherapy is a key component in the battle against cancer, some patients also explore complementary therapies. It’s essential, however, to discuss any alternative treatments with your doctor to avoid potential interactions with chemotherapy. Complementary therapies should support, not replace, conventional cancer treatment. What You Should Know About Chemotherapy Tailored Treatment: Chemotherapy regimens are customized to the type and stage of cancer and the patient’s health. Managing Side Effects: Modern medicine offers various methods to manage and reduce side effects effectively. Communication Is Key: Open discussions with your doctor about any concerns or side effects are crucial for your treatment journey. Build a Support System: A strong support network, including family, friends, and healthcare professionals, is invaluable during treatment. Moving Forward with Confidence Chemotherapy is a powerful and often life-saving tool in cancer treatment. By understanding the facts and dispelling common myths, patients can approach their treatment with clarity and confidence. For expert guidance and the best oncology and hematology treatment, consult with Dr. Mangesh Kamath at Healius Cancer and Hematology Clinics. Being well-informed and actively participating in your treatment plan can make a significant difference in your journey toward recovery.
There are many misunderstandings regarding chemotherapy.
There are many misunderstandings regarding chemotherapy. It is understandable to be hesitant & anxious about the beginning of chemotherapy treatment. To ensure you are fully informed about the risks and benefits of any therapy, it is crucial that you discuss any particular concerns you may have with your medical oncologist. Check out some of the most widespread misconceptions about chemotherapy to get a sense of the topics you might want to go into further depth with your physician about. Myth: Chemotherapy causes significant side effects. Fact: Chemotherapy, is a cocktail of numerous medicines and it was associated with intense nausea and vomiting, and that reputation was well deserved. But, as with so many cancer treatments, advances and research have been made to improve the effectiveness of cancer drugs and reduce their side effects. Myth: I’m going to be constantly sick from chemotherapy. Fact: Chemotherapy can sometimes cause nausea – making you feel or be sick. It depends on the type of chemotherapy drug you’ve been prescribed. With advancements and research – most of these side-effects are easily managed and even stopped. A common misconception is that chemotherapy is only used in situations where there are no viable alternatives. In reality, chemotherapy can be an effective treatment at different stages of cancer for a wide range of patients. Myth: Chemotherapy will cause you to lose all your hair. Fact: While hair loss is a potential side effect of chemotherapy, not all chemotherapy drugs cause hair loss. Some only cause hair loss, while others do not cause hair loss. There are some products that can help reduce your risk of hair loss from chemotherapy. If you experience hair loss from chemotherapy, it is usually only temporary. Myth: If I get chemo, I’ll need to spend all my time in the hospital getting infusions. Fact: The duration of your chemotherapy session will depend on the type of chemotherapy you’re receiving and the type of treatment you’re getting. Some chemotherapy is done in an outpatient setting and some is done in an inpatient setting. Myth: All Chemotherapy is the same. Fact: Chemotherapy agents come in a wide variety, some of which can continue to be effective after other treatments have failed. Chemotherapy is still a valuable treatment option for most cancers. It is known to enable cure many types of cancers including blood cancer. Immunotherapy and targeted therapy are ground-breaking approaches, but chemotherapy shouldn’t be overlooked. It has effectively eliminated cancer in some cases. Early detection, timely intervention, and collaboration between healthcare teams and patients are key. As we progress into the future, oncology is witnessing remarkable breakthroughs driven by cutting-edge technologies and innovative approaches. Five key advancements are at the forefront: Artificial Intelligence (A.I.), Genomic Medicine, Next-Generation Cancer Organoids, Nanoparticles, and Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). Share: More Posts Send Us A Message