Treatment of acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is a malignant disease of the blood and bone marrow. In leukemia, healthy blood cells are replaced by tumor cells (blasts). In acute leukemia, symptoms usually worsen over a short period. In children, the disease can progress very quickly and requires immediate treatment.

ALL is the most common malignant tumor in children aged 2-5 years.

Thanks to advances in oncology and improvements in diagnostic and treatment methods, childhood acute lymphoblastic leukemia survival rates have improved significantly in recent decades. In developed countries, the overall 5-year survival rate for childhood ALL is 80-90%.

Symptoms of the disease

ALL manifests itself with various symptoms and can “disguise” itself as other diseases, for example: acute respiratory infection.

Possible signs and symptoms of ALL:

  1. Frequent infections
  2. Temperature increase
  3. The appearance of bruises
  4. Bleeding that is difficult to stop
  5. Small, flat, dark red spots (dots) on the skin (petechiae) that occur due to bleeding under the skin
  6. Pain in bones or joints
  7. Lumps in the neck, armpits, abdomen or groin
  8. Pain or a feeling of fullness under the rib cage
  9. Feeling very tired or weak
  10. Pallor
  11. Loss of appetite
  12. Rapid breathing

Diagnostics

Leukemia may be suspected after a physical examination, medical history, and blood test. Children with leukemia usually have an elevated white blood cell count.

To diagnose leukemia, a bone marrow test must be performed in a specialized medical facility.

Treatment

The success of treatment depends on timely seeking medical help and starting treatment, the capabilities of the medical institution in the oncology profile. It is very important that the patient gets into the reliable hands of competent specialists who have the necessary knowledge and skills, who know the features of the disease and the pitfalls.

The Republican Scientific and Practical Center for Children’s Oncology, Hematology and Immunology has extensive experience in treating children and young adults with ALL and results comparable to those in the world. The center has organized teamwork aimed at curing the patient: highly qualified medical specialists, specially trained nursing staff, and medical psychologists.

ALL therapy is carried out in accordance with modern treatment protocols, using the latest methods, drugs, and equipment.

The main treatment for ALL is  chemotherapy . Treatment may also include  targeted therapy ,  hematopoietic stem cell therapy  (bone marrow transplant),  immunotherapy  , and  radiation therapy .

There are many different treatment options. Experienced doctors can tailor the right treatment to individual patients based on their risk group (risk of relapse). Therefore, it is very important to monitor minimal residual disease at the stage of disease diagnosis and throughout treatment. This term is used when there are so few blast (tumor) cells in the bone marrow that they cannot be detected with a microscope. Highly sensitive tests such as flow cytometry, polymerase chain reaction, and next-generation sequencing can detect 1 blast cell per 10,000 to 100,000 normal bone marrow cells.

Results of treatment of acute lymphoblastic leukemia in the Center of children’s oncology, hematology and immunology

85% of children after 5 years are in remission and are considered cured

Some patients may develop a disease that is resistant to the main treatment methods. For them, new therapeutic elements are being developed, which are referred to as “rescue” therapy and provide a chance for recovery in extremely difficult clinical cases.

An example of new treatment methods is the use of  CAR-T 19 – cell therapy (immunotherapy) . Our Center is one of the few institutions in Eastern Europe that offers this therapy.

Currently, treatment with  CAR-T 19 [B1] cells (Read attachment in  English )  is offered to patients who have failed chemotherapy and bone marrow transplantation. These patients have had one or more relapses.

At our institution, this type of therapy is used in children and patients up to 29 years of age with refractory B-cell acute lymphoblastic leukemia.

Cost of treatment

Price-list