New drugs for acute leukemia “gift” time and quality of life to patients

New drugs for acute leukemia have been approved in the last five years, after three decades of stagnation in therapeutic developments.

Newer drugs not only prolong overall survival but also significantly improve quality of life, especially for older patients who, due to significant comorbidities, cannot receive aggressive chemotherapy.

The latest data on molecular genetics as well as the newest therapeutic developments in hematological malignancies – including developments in immunotherapy with CAR-T lymphocytes – were presented at the 33rd Panhellenic Hematology Congress, held in Thessaloniki.

In recent years, significant progress has been made in understanding the biology of acute leukemias and myelodysplastic neoplasms, with the identification of genetic disorders, which are of particular importance for the prognostic classification and therapeutic treatment of these diseases.

The scientists participating in the Conference pointed out that in the era of precision medicine, the widespread application of advanced laboratory methods, in addition to contributing to a more complete understanding of the pathogenesis of the disease and the development of targeted therapies, leads to the prediction of the imminent relapse of leukemia and early therapeutic intervention that improves patient outcome.

Allogeneic hematopoietic cell transplantation remains the curative treatment for the majority of patients with acute leukemia. The indications for transplantation are expanding and the number of patients who are candidates for transplantation is increasing. In Greece, more than 200 allogeneic transplants are performed annually, but according to the needs and data from the rest of the European countries with developed health systems, an increase in transplant activity by at least 50% is required.

Therapies with genetically modified T cells (CAR-T cells) are treatments approved by the European Medicines Agency (EMA) for the treatment of several haematological malignancies that are resistant to conventional therapy.

The diseases for which the above treatment is indicated are acute lymphoblastic leukemia in children and adults, large B-cell lymphomas, mantle cell lymphoma, nodular lymphomas and multiple myeloma.

The administration of these treatments is done under close monitoring and specific conditions, which are met only by the licensed stem cell transplant units. At the same time, there must be coverage from the Intensive Care Unit, to deal with the immediate complications from the treatment that may occur in these patients, such as cytokine release syndrome and neurological complications.

In Greece, more than 50 patients have already been treated with CAR-T lymphocytes. With the expansion of indications, the number of patients in need of these treatments will be many times greater in the near future.

According to the Hellenic Society of Hematology, in order for all patients to receive the best possible treatment for their disease, it is necessary to support the work of hematologists from the State. The Hellenic Hematology Society considers that today the most urgent interventions that must be done are:

* The institutionalization of the reimbursement of the laboratory control of biomarkers increase the beds of transplantation of stem cells and cell therapies.

* Strengthening the infrastructure and staffing of the country’s hematology departments and transplant units.

* The improvement of the conditions of hospitalization of hematological patients.

The Hellenic Hematology Society notes that the number of patients in need of access to innovative treatments is increasing exponentially and because this need is becoming increasingly urgent, immediate actions are required.

RES-EMP

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