Among the most common cancers, acute lymphoblastic leukemia is a disease that affects white blood cells. While it may be difficult to detect, this disease is treatable. The disease is characterized by the growth of white blood cells in the bone marrow, blood, and other parts of the body. It is often treated with chemotherapy and other medical therapies. However, there are some patients who have a relapse of the disease. This article will help you learn about treatment options.
Treatment options
During treatment for acute lymphoblastic leukemia, you may need to stay in the hospital. You will have blood tests and imaging tests. These tests will help doctors diagnose the type of leukemia you have and determine the most effective treatment. They can also rule out other causes of your symptoms. You may also be given medicines to help you with your symptoms.
If your symptoms have improved, you may be able to leave the hospital. However, you will need to see your doctor regularly. You may also have to receive regular blood transfusions. It is also possible that you will receive radiation therapy to the head.
You may also be given a medication called a monoclonal antibody. This medicine kills cancerous cells and improves your body’s natural defenses against leukemia. You will receive this medicine by intravenous infusion.
Other treatments may include chemotherapy, radiation therapy, and stem cell transplantation. These treatments may help you relieve your symptoms, but you may also experience side effects.
You may also need to stay in the hospital for several weeks during treatment. You may also be given pain relief medicines, which can help you cope with your symptoms. You can also take corticosteroid tablets to help you cope with chemotherapy. You may also be given morphine to help you cope with severe pain.
There are also clinical trials that test new drugs and new combinations of standard treatments. You can ask your doctor if you should participate in one of these trials. You should ask about the possible side effects of the treatment. Also, ask about support services that may be available.
Acute lymphoblastic leukemia (ALL) is a cancer that begins in white blood cells, usually in the bone marrow. It is usually diagnosed in children and adults. It is considered a type of cancer that grows quickly. You may be given chemotherapy to kill the leukemia cells. It is also possible to have a bone marrow transplant.
All of these treatments can help you get better. You may also need to have regular blood transfusions and other treatments to help you deal with the effects of cancer. However, most patients can go home and return to their regular activities.
Diagnosis
Unlike most cancers, diagnosis of acute lymphoblastic leukemia is not a simple process. In addition to blood tests, a bone marrow sample is usually required. These tests are tedious and require a considerable amount of time.
The diagnosis of acute lymphoblastic leukemia depends on the pathologist’s expertise. The disease is caused by a series of genetic aberrations. The disease affects both children and adults. Acute lymphoblastic leukemia is the most common type of leukemia, accounting for about 20% of all acute leukemia cases in adults. It is also the most common type of leukemia in children.
A diagnosis of acute lymphoblastic leukemia generally involves the identification of abnormal cells and the treatment of these cells with chemotherapy or radiation therapy. Radiation therapy uses high-energy waves to kill cancer cells. In addition to radiation therapy, a blood and marrow transplant may be needed. This involves the collection of healthy stem cells, the infusion of these cells, and the use of radiation therapy.
The symptoms of acute lymphoblastic leukemia include easy bruising, easy bleeding, and fatigue. Abdominal pain and weight loss can also occur. Other symptoms include swelling in the lymph nodes of the neck, chest, or groin. If the disease affects the central nervous system, there may be headaches, dizziness, visual or auditory symptoms, and altered mental status.
Blood tests may also be used to determine the function of the liver and kidneys. Some children with acute lymphoblastic leukemia have unusual infections. Occasionally, children develop complications years after their initial diagnosis.
Acute lymphoblastic leukemia has a good prognosis for children. It accounts for around 30 percent of all pediatric cancers. New cases of the disease are diagnosed every year in the United States. The cure rate is around 80% for children. The disease is most common in children younger than 6 years.
The risk of acute lymphoblastic leukemia starts to increase in adults after age 50. Traditionally, risk stratification has been based on age and white blood cell count. The World Health Organization (WHO) has recently updated its classification of the disease to incorporate clinical, genetic, and immunophenotype data.
Treatment after the first relapse
Approximately 50% of adult patients with acute lymphoblastic leukemia (ALL) will relapse during treatment. These relapses can occur in bone marrow, blood, or the central nervous system (CNS). However, most patients relapse into the bone marrow.
Relapsed ALL can be cured with standard chemotherapy and autologous stem cell transplantation. In recent clinical studies, complete remission rates ranged from 78% to 93%. However, these rates depend on the subtype of ALL and other prognosis factors. In addition, patients may need additional treatment to prevent relapse. Molecularly targeted therapies are being investigated as well.
In addition to traditional chemotherapy, patients may opt for clinical trials testing new treatments. These include immunotherapeutics research. In these studies, scientists study how to incorporate immunotherapeutics into salvage regimens. This research also focuses on investigating long-term survival and side effects.
In the study by Tavernier and colleagues, 421 ALL patients were evaluated. These patients were categorized by age, phenotype, site of relapse, cytogenetics, and leukemia-related factors. They were then stratified and examined for homogeneity of outcome across initial treatments. This study was conducted before 2006. After stratifying the patients, the outcomes were compared.
The 5-year overall survival rate of ALL patients who had relapsed was 10%. Patients under 30 years of age had the best outcomes. Patients with a longer first complete remission had a better 5-year overall survival rate. For patients between one and two years after achieving the first remission, the 5-year overall survival rate was 15%. For patients more than two years after achieving a first CR, the 5-year overall survival rate was 38%.
In addition, the 5-year overall survival rate of patients who had relapsed during treatment was 10%. This was similar to the 5-year overall survival rate of patients with the second remission. However, the overall cure rate was lower in patients with CNS involvement. The 5-year overall survival rate was 8% for patients who had relapsed during treatment but had not been evaluated for a second remission.
During the first remission phase, patients may have a short course of chemotherapy. They may also need to take other drugs to prevent side effects. These side effects may include low white blood cell counts and nausea. They may also need to be given antibiotics. In addition, patients may need blood transfusions to correct low blood counts.
CNS prophylaxis therapy
Currently, CNS prophylaxis therapy for acute lymphoblastic leukemia is often continued during maintenance chemotherapy. While this is important for decreasing the risk of leukemia spreading, it may also lead to neuropsychological declines. Children receiving CNS prophylaxis therapy may suffer declines in their intellectual abilities and motor programming skills. Moreover, studies have shown that visual motor skills are also impacted by CNS prophylaxis. This may be due to the fact that leukemia cells must remain in the CNS in order to survive.
In addition, the risk of CNS relapse is low with modern ALL therapy. In fact, a relapse of CNS cells is less common than a relapse of bone marrow cells. However, a relapse of bone marrow cells is associated with a significantly worse prognosis. In fact, it is estimated that CNS relapse occurs in only about two percent of all children with ALL. However, the risk of relapse of leukemia cells is still significant, especially in patients who have survived the disease for a long period of time.
In order to evaluate the risk/benefit of CNS prophylaxis therapy, two different approaches were studied. One approach involved a combination of systemic CNS-active therapy with cranial irradiation. Another approach involved the use of intravenous and intrathecal methotrexate. These approaches were studied for outcomes in ALL survivors at two different cancer centers.
A phase II randomized clinical trial was used to determine the risk/benefit profile of two different CNS prophylaxis strategies. In this study, a comprehensive test battery was administered at 2, 3, and 4 years postdiagnosis. The overall assessment of neurotoxicity by ITD was the major study endpoint. In the standard ITT arm, there were no patients who discontinued treatment due to neurotoxicity. However, four patients in the ITD arm discontinued treatment due to serious neurotoxicity.
The incidence of CNS relapse was comparable to other pediatric trials. However, the risk of CNS progression was lower than expected. A low number of patients with expected CNS recurrences made it difficult to calculate the sample size. In the ITD arm, the expected CNS progression rate was 5% or less.
Health Sources:
Health A to Z. (n.d.). HSE.ie. https://www2.hse.ie/az/
Directory Health Topics. (n.d.). https://www.healthline.com/directory/topics
Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
