Leukaemia can be confusing because it refers to a group of cancers that aren’t all that similar except for the fact that they involve the bone marrow and blood. Leukaemia can be divided into four main groups — acute, chronic, lymphocytic, and myelogenous leukaemia. Depending on how quickly the cancer progresses, leukaemia is either classified as acute (acute lymphocytic leukaemia (ALL) and acute myeloid leukaemia (AML)), or chronic (chronic lymphocytic leukaemia (CLL) and chronic myeloid leukaemia (CML)).
The disease is one of the most common cancers in the world affecting approximately 3.5 lakh people and killing about 2. 65 lakhin 2012. Great strides, however, have been made in our ability to better treat and manage certain forms of the disease, including in children.
Treatment
Targeted therapy is offered for some types of leukaemia.
Treatment for leukaemia is given with the intent to achieve remission. Remission means when no more leukemic cells can be detected in the blood or bone marrow and the bone marrow is functions normally again.
In patients treated for acute leukaemia, remission may last many years, and then they are considered cured. CLL is still incurable but treatment can relieve symptoms and induce long-lasting remissions. Some people with acute leukaemia were told they had achieved remission after their first course of chemotherapy, but treatment was continued to destroy any remaining leukemic cells and give the best chance of a long-lasting remission or cure.
Survival rate
Many factors contribute to the leukaemia survival rate including patient’s age at the time of diagnosis; whether the cancer cells have spread to the brain or spinal cord; whether the leukaemia is a recurrence of a condition for which the patient was previously treated and the patient's response to treatment.
Current research is aimed at developing novel therapies that address an unmet medical need in acute leukaemia therapies to obtain disease control, maintain remission, prevent relapse, and prolong survival. The evolution of therapy from stem cell transplants and chemotherapy to the use of tyrosine kinase inhibitors (TKI) has changed the course of the disease for CML patients and provides an encouraging example for the leukaemia community as they work to advance new treatments which will hopefully bring similar success to acute leukaemia patients.
Only through the continued commitment to research and innovation will we identify important and cumulative advances that give patients more time until our goal of a major transformation becomes reality, treating both acute and chronic leukaemia as manageable diseases.
The Writer is Dr Ganapathi Bhat Consultant Medical Oncologist & Stem cell Transplant Physician at Jaslok Hospital & Research Centre, Mumbai