"We offer you a personalized treatment according to your age and characteristics of your disease, with treatments that include chemotherapy, hypomethylating agents, new targeted therapies or transplantation of hematopoietic progenitors".
DR. ANA ALFONSO PIÉROLA
SPECIALIST. HAEMATOLOGY AND HAEMOTHERAPY DEPARTMENT
Leukemias can be divided into three types. Chronic lymphatic leukaemia is the most common in Western countries, accounting for 30% of all leukaemias.
On the other hand, there is chronic myeloid leukemia, which is characterized by a predominant increase in the granulocytic series, and acute leukemias, neoplastic proliferations of immature hematopoietic cells.
The symptoms and prognosis depend on each type of leukemia, the phase in which the disease is found and the complications that may appear.
New drugs and new therapeutic strategies are being developed, not only to destroy the neoplastic cell, but also to inhibit its growth and promote its differentiation.
For example, retinoic acid derivatives, new monoclonal antibodies linked to chemotherapy or gene therapy.
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What are the symptoms of leukemia?
Many times the disease goes unnoticed and does not cause symptoms, so it is detected by chance when performing routine tests.
When the disease produces symptoms, the patient often has fever, enlarged lymph nodes (adenopathy), fatigue (asthenia), and/or frequent infections, such as pneumonia, herpes zoster.
The most common symptoms are:
- Loss of weight.
- Bone pain.
Do you have any of these symptoms?
You may have leukemia
What are the causes?
Chronic myeloid leukemia
It does not have a defined cause, although some cases have been related to exposure to ionizing radiation or certain chemicals.
It is known to be related to the Philadelphia chromosome. This chromosome is produced as a consequence of an oncogenic stimulus capable of altering the structure of two chromosomes (9 and 22) in an unknown way.
Its origin is not yet defined, since it has not been possible to demonstrate its relationship with radiation or leukemogenic chemicals. Only a clear family incidence seems to have been proven.
Chronic lymphatic leukaemia
The origin of the disease is unknown, but there are some factors associated with its development: radiation, chemicals, drugs, genetic factors, viruses, etc.
What is the prognosis of leukemia?
Until not so many years ago, the mortality rate of acute leukemias was very high in a short time. However, at the present time we can talk about cure in some specific types of acute leukemia. In many other cases, survival has been significantly increased.
In chronic lymphatic leukaemia, the prognosis depends on the stage of the disease. There are cases with the same survival as a person of the same age without chronic lymphatic leukaemia.
However, in other more advanced stages, depending on prognostic factors, survival can be considerably lower.
Survival will also depend on the complications that may arise in the course of this leukemia.
How is leukemia diagnosed?
Chronic myeloid leukemia
A bone marrow biopsy should be performed. This test should include a genetic study where the existence of the Philadelphia chromosome will be demonstrated.
The cytochemical reaction of alkaline granulocyte phosphatase is also performed. This reaction allows differentiating the leukocytoses produced by chronic myeloid leukemia from those produced by other causes, mainly severe infections.
In the case of suspicion of a chronic lymphoproliferative syndrome, it is essential to carry out a study of the bone marrow by means of a biopsy.
The study must be completed with a scan to see the extent of the disease in the lymph nodes, liver and spleen. It is also essential to carry out a cytogenetic study of the bone marrow that has prognostic value.
With all these data, the study of the extension of the disease is carried out and the patients are divided into three groups: low risk, intermediate risk and high risk.
It is often suspected due to clinical symptoms (hemorrhages, intense pallor, infections, high fever...). The confirmation of the diagnosis is done by blood tests and bone marrow puncture.
Nowadays, flow cytometry, cytogenetic and molecular biology analyses are essential for the exact diagnosis of each of the subtypes of acute leukaemia.
How is leukemia treated?
We have a Day Hospital for outpatient treatment of leukemia
In the case of lymphatic leukemia, the importance of correct staging lies in the fact that each stage of the disease will be treated in one way or another. The cases with the best prognosis may not receive treatment.
At present, fludarabine and other purine analogues have very good results. New biological therapies are used, such as monoclonal antibodies.
Treatment of chronic myeloid leukemia depends on the stage of the disease. Initially it is done with oral chemotherapy and immunotherapy, trying to control the great leukocytosis.
Patients in the phase of acceleration or transformation to acute leukemia should receive more aggressive treatments.
Once the disease has been controlled, the treatment will depend on the age of the patient:
Young patients with bone marrow donors may be submitted to bone marrow transplantation, the only curative treatment.
In older patients or those who do not have a bone marrow donor, a bone marrow autotransplant may be considered.
The treatment of acute leukemias is still chemotherapy today. The schemes vary depending on the type of acute leukemia. Likewise, bone marrow transplant plays a very important role in the treatment, either autologous (from the patient himself) or allogeneic (from a donor), depending on each case.
Nowadays new drugs and new therapeutic strategies are being developed, not only to destroy the neoplastic cell, but also to inhibit its growth and to favour its differentiation, such as retinoic acid derivatives, new monoclonal antibodies linked to chemotherapy or gene therapy.
What clinical trials do we have on leukemias?
A multidisciplinary team of renowned prestige being at the forefront
AT THE FOREFRONT
Advanced Therapy Unit
The Advanced Therapies Unit of Clínica Universidad de Navarra has been established in order to deal exclusively with cellular therapies against cancer and other diseases of the immune system, favouring their administration and seeking to increase the safety of these treatments.
A multidisciplinary team of highly specialised nurses together with physicians from all the specialities involved in the approach to those treatments that depend on advanced therapy drugs and immunotherapy
Where do we treat it?
IN NAVARRE AND MADRID
The Hematology and Hemotherapy Service of the
at the Clínica Universidad de Navarra
The Hematology Service of the Clinic, formed by specialists of recognized national and international prestige, has integrated molecular diagnostic techniques and the use of new personalized treatments in its assistance work, allowing a more precise and fast diagnosis of the hematological diseases.
The joint work of the medical staff and the researcher facilitates the development and application of the new treatments and at the same time the precise evaluation of the result of the treatments.
Why at the Clinica?
- Experts in the development of Cellular Therapy treatments.
- International reference center in lymphomas, multiple myeloma and monoclonal gammopathies.
- Experts in the diagnosis and treatment of hemorrhagic and thrombotic problems.
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