Success rates in acute leukemia treatment have reached 90 percent
It has been announced that the success rate in the treatment of acute leukemia, which is one of the most important childhood cancers that can be detected with complaints such as bleeding, anemia, non-healing infection, enlarged lymph nodes and bone pain, has reached 90%. Hematology Specialist Assoc. Dr. Özkan Sayan stated that a pleasing success has been achieved in this field with the new generation drugs that have been used in treatment in recent years. Assoc. Dr. We talked to Özkan Sayan about the diagnosis of acute and chronic leukemia and new treatment options:
What is the difference between acute and chronic leukemia?
There are stem cells in the bone marrow, the stem cells that make our white, red and coagulation cells. As a result of environmental, chemical factors, radiation or genetic changes, changes and cancerization begin in stem cells. These cancerous cells emerge from the bone marrow into the circulation, and in the circulation, they begin to accumulate in many tissues in our body, especially in the lymphoid tissues, liver, and spleen.
New drugs increase success in Chronic Myeloid Leukemia treatment
If we consider the bone marrow as an environment, the patient comes to us with very different clinical findings because the proliferation of other cells is suppressed. The rapid onset of this event and its rapid emergence within days or weeks are called acute leukemia, and the slower course that takes months to years is called chronic leukemia. Patients come to us with complaints such as bleeding, anemia, non-healing infection, enlarged lymph nodes, and bone pain.
Is it acute or chronic leukemia, hWhich is more dangerous?
Since acute leukemias start and progress rapidly, early intervention is important in terms of saving the patient’s life.
What tests are done for a definitive diagnosis?
At first, these patients; After a blood count done after an infection that does not go away, abnormalities in blood values, high or very low leukocyte counts, anemia (anemia) and low coagulation cells are suspected, and they are referred to hematology physicians.
Is the situation absolutely clear in the blood count?
When the disease becomes obvious, that is, when leukemic cells start from the bone marrow and circulate, it can occur with the symptoms we have mentioned in the disease, and sometimes it can be caught before the bone marrow enters the circulation. Then there may be no abnormality in the patient’s blood count. But when we examine it under a microscope, we can notice leukemic cells. In other words, first of all, complete blood count and routine biochemical tests, then the examination of the peripheral blood under the microscope, and then bone marrow biopsy and cytogenetic examination are performed to make a definitive diagnosis.
Leukemia (blood cancer) symptoms and new treatment options
So what kind of treatment is applied?
Since chronic leukemias have a slow course, they are mostly discovered by chance in blood count. Some types, such as chronic lymphocytic leukemia, can remain silent for years, then become active. Treatment varies according to the stage of the disease, cytogenetic findings and other prognostic features of the disease. As in acute leukemia, we apply treatments that are not fast and intense, and that we can follow up on an outpatient basis most of the time.
The most important thing in treatment, whether acute or chronic, is to create and apply individual treatments. Let me give an example: Young, two patients at the same age. Both of them were raised in almost the same conditions, the risk factors were the same and they were fed naturally. They both have the same disease, you apply almost the same treatment, but one lives and we lose the other. For this reason, it is said, “There is no disease, there is a patient”. It is necessary to apply completely customized treatment models to the patient.
In acute and chronic leukemias, we can predetermine the factors that we think the disease has a bad character and that the response to treatment will be low and insufficient, and if there is a suitable bone marrow donor with a poor prognosis, we apply bone marrow transplantation treatment after the disease is under control as soon as possible. First of all, siblings or relatives are cared for as donors, and genetic tissue compatibility tests are performed. These are not very easy and cheap tests, they are time-consuming tests.
The survival time of patients is increasing rapidly with new generation leukemia treatments
Unfortunately, we have a limited number of donors in our bone marrow and tissue banks. Treatment success rates decrease with age. In the age group of children with acute leukemia, especially acute lymphoblastic leukemia, our chance of treatment is much higher, and the response rate of children to treatment is higher. The success rate is currently around 80-90% and we have the opportunity to transplant. However, after the age of 60, bad risk factors are more common and the recovery rates decrease to 5-20%, as conditions such as having other diseases occur.
What are the factors that cause leukemia?
The most important reason is chemicals and radiation. Exposure to a number of chemicals (some volatile chemicals such as benzene and chemicals used in large amounts in the paint industry) for many years, smoking, environmental factors and genetic factors can be listed.