It may develop during treatment. She is deadly

It happens that fighting one tumor may lead to the formation of a new one after many years – acute myeloid leukemia. The probability of a cure is very small. In the last few years, however, there has been a turn – a novel drug has emerged. How it works and what is acute myeloid leukemia (AML), explains Prof. dr hab. n. med. Sebastian Giebel.

1. Even in the early XNUMXs, treatment of acute myeloid leukemia (AML) was virtually impossible
2. Today, we can cure almost half of the sick. On the other hand, more than half of the patients who fail to do so remain – these people die of the disease
3. The probability of a cure is still very small in the case of the so-called secondary leukemias, including acute myeloid leukemia
4. For many years, this problem remained unsolvable. Currently, medicine has an innovative preparation. How does this preparation work?
5. More current information can be found on the Onet homepage.

Acute myeloid leukemia (AML) is a disease that is very diverse in terms of the biology and genetic characteristics of leukemia cells, and in terms of the biological status of patients. In the early 60s, treatment of acute myeloid leukemia was virtually impossible. In the 10s, when chemotherapy was introduced, some patients were treated successfully, but the cure rate did not exceed XNUMX%.

Nowadays, it is about 45% of patients who can undergo intensive chemotherapy. It is, of course, a tremendous success that we can cure almost half of AML patients, but on the other hand, more than half of the patients who fail to do so remain and die of the disease.

Risk Level – An Indicator of Potential Treatment Success

The chance of curing AML depends on the genetic makeup of the disease. The genetic differentiation system of leukemia patients allows them to be classified into three groups:

1. standard risk group, where success in treatment may be as high as 70-80%. sick
2. intermediate risk group – here the chance of a cure is about 40%.
3. high-risk groups, where the probability of cure is still very small and does not exceed 20%.

So-called secondary leukemias are included in the high-risk group. These are leukemias that result from genetic mutations caused by chemotherapy or radiotherapy that have been used to treat the patient for another reason, such as breast cancer. Although this treatment led to therapeutic success in relation to the primary disease, it had a negative effect on health after a few or several years, leading to the formation of a new cancer – in this case, acute myeloid leukemia.

The second group of high-risk patients is patients with myelodysplastic syndrome. It is also a cancer of the bone marrow, but it is characterized by a very slow course over a long period of time. However, the disease can transform into acute myeloid leukemia. Then the course becomes aggressive and it becomes very difficult to control the disease.

Opportunity for the most difficult cases

Both of the above-mentioned groups of patients belong to the category of the highest risk of therapy failure, so these are patients who are often not able to help – about a hundred and several dozen people a year.

For many years, this problem remained unsolvable. We tried to achieve success by escalating chemotherapy and increasing its dose, and we used bone marrow transplants in patients as soon as we managed to bring the disease into remission enabling the transplant procedure to be performed. Unfortunately, these actions did not lead to any breakthrough in increasing the effectiveness of treatment in the group of patients with unfavorable prognosis.

This turnaround has occurred in the last few years with the introduction of an innovative therapeutic preparation. This drug contains two chemotherapeutic agents, previously used in the form of intravenous infusions, which are administered here in the form of an hour and a half infusion and appear in strictly defined, constant proportions. In addition, they have been enclosed in a fat capsule (the so-called liposomal form), thanks to which they have a greater chance of reaching leukemia cells. The duration of action of the combination actives thus administered is also longer than that of each when used alone in a conventional form.

The administration of this drug does not guarantee a cure, as in the case of other therapies, but it has been scientifically proven that the chance of this cure is significantly higher. This drug is currently not widely available in Poland – it is only in the reimbursement process. However, the need for access to this drug is very high in our eyes – experts in the treatment of patients with acute myeloid leukemia.

Conventional, sparing treatment for seniors

In elderly people who have developed secondary myeloid leukemias, we use traditional chemotherapy drugs, known for several decades, in appropriately reduced doses. Due to their age and comorbidities, these patients do not always have the full dosage due to the increased risk of toxicity and side effects compared to younger patients. We are trying to transplant the hematopoietic cells in older patients in a better biological condition, but unfortunately we are able to do so in a definite minority of patients in this group.

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