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Treatment of acute myeloid leukemia in Assuta

treatment of acute myeloid leukemiaTreatment of acute myeloid leukemia, tend to start as early as possible. The basic method - chemotherapy. Maintenance treatment can include blood transfusion, platelet transfusion, antibacterial therapy.

At a high level, white blood cell count procedure can be assigned under the name of leukapheresis which removes abnormal white blood cells. They are not used in AML M3, because it can cause bleeding.

Also in the treatment of acute myeloid leukemia using radiotherapy, hematopoietic growth factors, bone marrow or stem cells.

Program therapy depends on the type of AML, general health, age, level of physical fitness, the presence or absence of genetic mutations in the blasts. Different types of AML are treated differently.

Israeli researchers continue to look for the best combination therapy, engaged in the development of new treatments. Conduct clinical trials.

With the patient in the clinic Assuta employs a team of highly qualified doctors:

  • hematology;
  • radiation therapists;
  • nutritionist;
  • pathologists;
  • oncologists;
  • microbiologists;
  • specialists in palliative care;
  • pharmacists;
  • psychologist;
  • nurse.

Chemotherapy clinic Assuta

This method of treatment for acute myeloid leukemia cancer fighting by cytotoxic drugs. In AML intravenous chemotherapy is used overall. The choice of drugs is based on the type myeloid leukemia. To medication goes directly into the blood, using a central catheter, PICC line or portkat system. These devices are implanted into the body at the time of chemotherapy.

Usually requires hospitalization. This is due to two reasons:

  • In the process of developing side effects of chemotherapy, and doctors will help to control them.
  • It may be necessary antibiotic therapy for the treatment of infection.

Chemotherapy is carried out in two phases - induction and consolidation.

induction therapy

The main objective of the treatment - to achieve remission, which is confirmed by the absence of abnormal cells in the blood and bone marrow.

therapy program in most cases includes two or more drugs carried cycles (+ rest therapy).

Doctors prescribe additional treatment to reduce side effects. For instance, likely to develop an infection or bleeding. Prescribe antibiotics and blood transfusion. You may have to stay in hospital for about a month.

Consolidation

There are various techniques. For example, one of the drugs recommended phase induction at high doses, or intensive chemotherapy followed by transplantation.

Chemotherapy for acute myeloid leukemia in Israel

For the most part in AML apply high dose cytarabine and daunorubicin. As a rule, we recommend 2 courses of these drugs.

In addition, the following cytostatics used:

  • idarubicin
  • mitoxantrone
  • etoposide
  • thioguanine
  • fludarabine

Patients with AML subtype M3 also administered trans-retinoic acid. Patients who can not tolerate standard chemotherapy, recommend low-dose cytarabine.

To prevent a relapse, doctors use a combination of medications, which may include:

  • amsacrine
  • cytarabine
  • etoposide
  • daunorubicin
  • fludarabine
  • idarubicin

When high-dose chemotherapy may also recommend to a bone marrow transplant or stem cell.

If you can not make a connection, used chemotherapy drug azacytidine.

Preparations in acute promyelocytic leukemia

In this type myeloid leukemia using other medicines: atru (trans-retinoic acid), and arsenic trioxide.

Atra (trans-retinoic acid, tretinoin)

Atra is not a chemotherapy drug. It belongs to the group of retinoids that are based on vitamin A. Atru can assign along with cytostatic agents. This medicine reduces the risk of bleeding associated with chemotherapy, and increases the likelihood of achieving remission. Atru take to remission, and then some time to support the state.

arsenic trioxide

This medication accelerates the death of leukemia cells, stimulates the maturation of healthy blood cells. It is administered generally in acute promyelocytic leukemia, which is not achieved remission or recurred.

The drug is administered intravenously. As with all medications, it has side effects, which may include:

  • Fatigue.
  • Pain in the muscles and bones.
  • Fever.
  • Pain in the abdomen.
  • Headache.
  • Elevated blood sugar levels.

Side effects of chemotherapy

All the cytostatic agents used for the treatment of acute myeloid leukemia, will lead to a reduction in the number of blood cells. There is a high risk of infection a few weeks after treatment. At some point during cytostatic treatment prescribed antibiotics intravenously.

About a month later the level of red blood cells is reduced, blood transfusions can be carried out for a refill. In the case of platelet deficiency is also performed transfusion.

Chemotherapy drugs in AML provoke hair loss, which grow back after therapy.

In addition, the cytostatic treatment of myeloid leukemia almost always leads to infertility in adults. Men have the option to save the sperm by freezing it. In women, the possibility is not always, as the process of egg collection takes many weeks and treatment should start as soon as possible.

Managing side effects

Action chemotherapy releases the substance from collapsing leukemic cells that cause malfunction of the kidneys and liver. In such a situation the drug prescribed allopurinol tablets contributing processing waste abnormal cells.

Cytotoxic agents also increase the risk of infection. Doctors recommend sterilizers intestinal infections to prevent the development of bacteria in the gut, pills and mouthwashes in order to prevent occurrence of thrush type infections.

growth factors

These drugs stimulate the bone marrow to produce red blood cells, increases the level of white blood cells and stem cells. The therapy applied AML colony stimulating factor or G-CSF (filgrastim, lenograstim).

These drugs are used after cytostatic treatment of acute myeloid leukemia and before collecting stem cells.

With a high probability of infection may be recommended by growth factors, for example, if a long time there is neutropenia. Under their influence quickly restored the number of white blood cells, reduced the risk of infection.

When patients do daily infection of growth factors, bone marrow starts to make a lot more healthy stem cells that move into the bloodstream. From there, they are collected by means of special equipment, and then subjected to freezing and stored.

Possible side effects of growth factors include:

  • pain in the bones;
  • itching at the injection site;
  • fever.

Radiotherapy in the treatment of acute myeloid leukemia in Assuta

In AML sometimes spend radiotherapy if leukemia cells have spread to the central nervous system (brain and spinal cord). In general, it is not typical for this disease. If everything happens, most doctors use chemotherapy.

As part of a bone marrow transplant or stem cell radiation therapy can be carried out for the whole organism. Such radiation therapy with leukemia cells destroys the bone marrow. It is carried out twice a day for three - four days. Or it may be a single session.

When CNS radiotherapy used individually created for each patient mask which ensure immobility.

Possible side effects

Development of adverse effects caused by part of the body that is exposed to radiation. In both the cases mentioned most often noted fatigue, nausea, hair loss. Contraindicated tan a few months after treatment because of the increased sensitivity of the skin to the sun.

Total exposure may provoke the development of diarrhea, stomatitis, increased risk of infections.

Many years after treatment may develop cataracts. To prevent this complication, Israeli doctors take special protective measures.

Bone marrow transplant or stem cell in Israel

In the treatment of acute myeloid leukemia doctor may suggest that intensive therapy that involves high-dose chemotherapy + radiotherapy sometimes the entire body. Such treatment destroys the bone marrow transplant and requires - by its own resources (autologous) or donor (allogeneic).

When choosing important are the following factors: type of leukemia; having a close relative, the red blood cells which correspond to the cells of the recipient.

Before collecting the stem cells are often used injections of growth factors. Are collected by the separator.

Collection of marrow - small surgery, which is performed under general anesthesia. From the hipbone or breastbone through a syringe doctor extracts the marrow.

Autotransplantation (en materials) are rarely conducted in AML. Increasingly prefer an allogeneic transplant.

Side effects of the treatment of acute myeloid leukemia

Side effects are a consequence of the treatment. They can be quite serious and caused by several factors:

  • the type of treatment of acute myeloid leukemia;
  • a combination of procedures;
  • dose of the drug or therapy;
  • methods of treatment (tablets, injections, drip);
  • general state of health;
  • age.

Immediate side effects occur during treatment or very soon after its completion. They are due to the methods used.

Common adverse effects include the treatment of myeloid leukemia:

  • low resistance to infection;
  • anemia;
  • the risk of bleeding or bruising;
  • fatigue;
  • nausea;
  • stomatitis;
  • taste changes;
  • disorders of the heart;
  • alopecia;
  • diarrhea. 

Possible long-term effects of AML include:

  • heart disease;
  • cataracts;
  • infertility;
  • fatigue;
  • low resistance to infection;
  • malfunction of the thyroid gland;
  • secondary cancer;
  • lung function.

Methods of treatment of leukemia continues to improve. This means that more and more people survive with fewer side effects. There are medications that help to control most of the undesirable effects that occur during or immediately after treatment. Basically, they disappear after the completion of therapy.

 

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