From the Guidelines
To heal blood cancer, you should seek immediate medical care from a hematologist-oncologist who specializes in treating these conditions, as blood cancers like leukemia, lymphoma, and multiple myeloma require professional medical treatment that may include chemotherapy, immunotherapy, targeted therapy, radiation, stem cell transplantation, or CAR T-cell therapy, as recommended by the National Comprehensive Cancer Network (NCCN) guidelines 1.
Importance of Medical Care
Blood cancers are complex and require personalized treatment plans that only medical professionals can provide. The specific treatment depends on your exact diagnosis, cancer stage, age, and overall health.
- Chemotherapy, immunotherapy, targeted therapy, radiation, stem cell transplantation, or CAR T-cell therapy may be used to treat blood cancer.
- A balanced diet, physical activity, rest, and follow-up appointments are crucial while undergoing treatment.
- Emotional support through counseling or support groups can also be beneficial during treatment.
Recent Guidelines and Recommendations
The NCCN guidelines version 2.2020 recommend hematopoietic cell transplantation (HCT) as a potentially curative treatment option for patients with certain types of hematologic malignancies 1.
- HCT is classified as autologous or allogeneic based on the origin of hematopoietic cells.
- The guidelines also discuss the importance of pretransplant conditioning, preparative regimens, and the role of HLA-matching in allogeneic HCT.
- More recent guidelines, such as the NCCN Guidelines Insights: Acute Myeloid Leukemia, version 2.2021, provide updated recommendations for the treatment of AML, including the use of targeted agents like venetoclax 1.
Treatment Options and Outcomes
The outcomes of HCT vary according to the type and stage of the disease being treated, the overall health of the patient, and the degree of HLA-mismatch between donor and recipient (for allogeneic HCT) 1.
- The choice of graft source, such as peripheral blood, bone marrow, or umbilical cord blood, depends on several clinical factors, including disease type, disease stage, and patient comorbidities.
- The use of epoetin and darbepoetin in adult patients with cancer has been updated in the American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update, which recommends against the use of ESAs in patients with anemia associated with malignancy who are not receiving concurrent chemotherapy 1.
From the FDA Drug Label
Chronic Phase IFN Failure (n = 532) Accelerated Phase (n = 235) Myeloid Blast Crisis (n = 260) 400 mg 600 mg n = 158 400 mg n = 77 600 mg n = 223 400 mg n = 37 % of patients [CI 95%] Hematologic Response* 95% [92.3−96.3] 71% [64.8-76.8] 31% [25. 2−36.8] Complete Hematologic Response (CHR) 95% 38% 7% No Evidence of Leukemia (NEL) Not applicable 13% 5% Return to Chronic Phase (RTC) Not applicable 20% 18% Major Cytogenetic Response† 60% [55.3−63.8] 21% [16.2−27.1] 7% [4.5−11. 2]
To heal blood cancer, specifically Chronic Myeloid Leukemia (CML), treatment with imatinib (PO) can be effective. The drug label shows that:
- Hematologic Response was achieved in 95% of patients with chronic phase CML, 71% with accelerated phase, and 31% with myeloid blast crisis.
- Complete Hematologic Response (CHR) was observed in 95% of patients with chronic phase CML, 38% with accelerated phase, and 7% with myeloid blast crisis.
- Major Cytogenetic Response was achieved in 60% of patients with chronic phase CML, 21% with accelerated phase, and 7% with myeloid blast crisis. It is essential to note that these responses were seen in patients treated with imatinib, and the effectiveness of the treatment may vary depending on the individual patient and the stage of their disease 2.
From the Research
Treatment Options for Blood Cancer
- Targeted therapy and personalized medicine are emerging disciplines in cancer research, focusing on individualized treatment based on molecular characterization of malignant cancer 3
- Hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimens have been used to treat acute lymphoblastic leukemia (ALL), with varying degrees of success 4, 5, 6
- Dasatinib monotherapy has shown modest clinical activity in chronic myeloid leukemia in lymphoid blastic phase (CML-LBP), while hyper-CVAD plus dasatinib has improved outcomes in CML-LBP and Philadelphia chromosome-positive ALL 6
- Allogeneic stem cell transplantation has been associated with better outcomes in certain cases of blood cancer, including CML-LBP and Ph-positive ALL 5, 6
Recent Advances in Treatment
- The identification of recurrent genetic alterations has helped refine individual prognosis and guide management in acute lymphoblastic leukemia (ALL) 7
- Multi-agent chemotherapy with vincristine, corticosteroids, and an anthracycline remains the backbone of therapy for ALL, with allogeneic stem cell transplantation for eligible candidates 7
- Elderly patients often have a poor prognosis due to inability to tolerate aggressive regimens 7
Molecular Characterization and Personalized Medicine
- Molecular characterization of malignant cancer is crucial for individualized treatment and personalized medicine 3
- Targeted therapies have been developed to select the best treatment available based on molecular characterization of cancer 3
- Genetic, immunological, and proteomic profiling are used to provide therapeutic alternatives and prognostic information about cancer 3