Acute lymphocytic leukemia is a group of diseases where there are several sub-types, however, there are different views and uses various treatment programs.

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And the characteristics On specificity of the Israeli health care can learn more in the articles of the private and public clinics , regarding the treatment without intermediaries .

leukemia treatment in Israel  The choice of treatment option is an important decision, so take time to think about it. For each patient, the program is determined based on certain subtypes of leukemia and prognostic signs.

It is important to consider all options for the treatment of acute lymphoblastic leukemia in Israel, including the main tasks and side effects with your doctor to make a final decision that will best meet the needs of the patient. It is important to ask questions if there is any uncertainty.

Treatment usually begins almost immediately after the diagnosis, but if time allows, a good idea is to appeal for a "second opinion." It can provide more information and help you feel more confident with regard to the selected treatment plan.

The main types of leukemia treatment is chemotherapy, targeted therapy, stem cell transplantation. As additional methods for special circumstances apply radiation therapy and surgery.

Treatment of acute lymphoblastic leukemia in most cases lasts about two years. Often it is intense, especially in the first few months, so it is important to contact a medical center that has experience in the treatment of this disease.

Targeted therapy in the treatment of acute lymphoblastic leukemia in Israel

In recent years, medicines have been developed aimed at specific segments of malignant cells. These drugs work differently from standard chemotherapy drugs. For them, typically less severe side effects. Some of the drugs targeted therapy may be useful in acute lymphatic leukemia.

In 1 out of 4 adults with leukemia are "Philadelphia chromosome" formed translocations between chromosome 9 and 22. This produces a chimeric gene BCR-ABL. "Philadelphia chromosome" and this gene were detected in leukemia cells of another species - chronic myeloid leukemia (CML). Cells with this gene produce abnormal protein that helps them grow. Scientists have developed drugs that attack the protein. These drugs are called tyrosine kinase inhibitors. It imatinib (Glivec), dasatinib (Spraysel®) of nilotinib (Tasigna®), bosutinib (Bosulif®) and ponatinib (Iclusig ™). Although they were designed primarily for the treatment of CML, some of them have been proven effective in the treatment of other types of leukemia to the "Philadelphia chromosome."

According to studies, in patients with acute lymphocytic leukemia and the "Philadelphia chromosome" addition to chemotherapy, one of these drugs contributed to remission. The duration of their reception helped prevent relapse.

These medications are taken daily in pill form. Among the common adverse effects are called fatigue, muscle aches, diarrhea, skin rash, nausea. A common side effect is swelling around the eyes, as well as the hands and feet. Potential adverse effects can be reduced the number of erythrocytes and platelets in the beginning of treatment. Side effects of drugs are enhanced with increasing dose.

In the treatment of ALL in Israel use an integrated team approach, working multi-disciplinary group of experts. They use the most advanced methods of diagnosis and therapy. Doctors also work closely with the patient and his family.

Surgery in the treatment of acute lymphoblastic leukemia in Israel

Surgical intervention has been limited to the treatment of acute lymphocytic leukemia. Because abnormal cells spread via blood, to cure this type of cancer can not be surgically. Apart from lymph node biopsy surgery is rarely used in the diagnosis of leukemia, as by aspiration, and bone marrow biopsy is usually confirmed diagnosis.

Often, before the start of leukemia chemotherapy in Israel, needed surgery to insert a central venous catheter or port system (subcutaneous port Infusion port) into a large vein. Port system is designed for continuous intravenous infusion of chemotherapy.

Ommaya reservoir

Introduction of cytostatics in the cerebrospinal fluid surrounding the brain and spinal cord, in most cases, is part of the treatment of leukemia. In this type of therapy, known as intrathecal chemotherapy, drug administration is carried out via lumbar puncture or an Ommaya reservoir. The latter is a device connected to the catheter. Using it in the brain ventricles is performed in the constant liquor administering injections. Surgery allows the implant under the skin of the head tank silicone small size.

Radiation therapy in the treatment of acute lymphoblastic leukemia in Israel

Treatment of radiation therapy of leukemiaRadiation therapy uses high energy rays to destroy cancer cells. Radiation therapy is prescribed in certain situations:

  1. If the disease has spread to the brain, spinal fluid or testicles.
  2. Whole body irradiation in many cases is part of the treatment of acute lymphoblastic leukemia in Israel prior to bone marrow transplantation or peripheral blood stem cells.
  3. Rarely radiotherapy is used to reduce swelling, exerting pressure on the trachea and provoke respiratory problems.
  4. The last option - to reduce pain in the bones, which invaded the disease after failure of chemotherapy.

External radiation therapy is most often used in leukemia in Israel. Possible side effects will depend on where the directed irradiation. Can change color, hair may fall out in the treated areas. Radiotherapy in the abdomen is able to provoke nausea, vomiting or diarrhea. If the irradiation covers most of the body, can be added to fatigue, a decreased level of red blood cells, increased risk of infections.

Israel clinics offer access to numerous innovative methods of treatment of leukemia, to increase the patient's chances of a successful outcome.

Relapse of acute lymphoblastic leukemia - Treatment in Israel

Leukemia treatment in IsraelIf not amenable leukemia therapy after the first attempt, that occurs in 10% - 20% of the cases, they can be tested or a new more intense doses of drugs, although more likely that they may not be effective. Proposed stem cell transplantation if leukemia is, at least in partial remission. Clinical trials of new treatments, may also be considered.

If leukemia goes into remission state from the initial stage of treatment, but then returns (relapses), most often it affects the bone marrow and blood, sometimes brain and cerebrospinal fluid. In these cases, lead to leukemia remission is possible by means of chemotherapy. The approach to treatment may depend on how soon relapsed acute lymphoblastic leukemia. If after a long break, use the same or similar treatment. When the time period - a shorter, there is a need for a more aggressive chemotherapy with other drugs.

All patients with Philadelphia chromosome, which took targeted agents imatinib (Gleevec), often transferred to another tool.

For patients with T-cell leukemia may be beneficial cytostatic Nelarabine (Arranon ®).

If the second remission can be achieved, most authorities recommend a stem cell transplant, whenever possible.

If the leukemia does not go away or keeps recurring, the chemotherapy is rendered useless. When astem cell transplantationcan not be considered as an option, it is possible to take part in clinical trials of new drugs. Sometimes it's the only way - to get access to some innovative treatment methods.

The Israeli medical centers for the treatment of leukemia, an individual approach, doctors evaluate all risk factors before you decide that a certain treatment is necessary. After that recommended by the most advanced technique with the least adverse effect on the body.

Palliative treatment of leukemia

At some point, it becomes clear that further treatment of acute lymphocytic leukemia, even in clinical trials, it is highly unlikely to lead to a cure. In such a case, the focus moves to attempt to cure leukemia to manage symptoms of the disease. This palliative or supportive care. For example, your doctor may advise less intensive chemotherapy to try to slow down the growth of the disease rather than cure it.

When leukemia affects the bone marrow, it becomes a cause of pain. Then, irradiation may be useful and appropriate pain medication. If medications, such as aspirin and ibuprofen are not able to relieve pain, apply strong opioids, such as morphine.

Other common symptoms of lymphocytic leukemia are low blood counts and fatigue. It may be necessary medication or blood transfusion in order to solve these problems. Nausea and loss of appetite are treated with medicinal drugs and nutritive supplements. Against infections using antibiotics.

Standard treatment of acute lymphoblastic leukemia in Israel

leukemia treatment in Israel, doctorsThe main treatment of acute lymphocytic leukemia (ALL) in adults involves a long-term chemotherapy. In the past few years, doctors have begun to use more intense its modes that accelerate and improve treatment outcomes. But it is noted side effects such as low levels of leucocytes. Therefore, the required drugs that prevent or treat unwanted effects.

Treatment of acute lymphoblastic leukemia in Israel, as a rule, includes 3 stages: induction, consolidation and maintenance. The total treatment period is about two years. It will be more or less intense, depending on the subtype of the disease and other prognostic factors.

Induction in the treatment of leukemia

The goal of induction therapy is in remission. This does not mean that the leukemic cells do not show up in the bone marrow samples during diagnostics and blood counts are normalized. Remission does not indicate a healing, cancer cells may still be hiding somewhere in the body.

Induction - a phase of intensive chemotherapy, which usually lasts for a month or so. Apply different combinations of chemotherapy drugs, but in most cases they include:

  • vincristine;
  • dexamethasone or prednisone;
  • doxorubicin (adriamycin), daunorubicin or similar anthracycline drug group.

On the basis of the patient prognostic factors in some schemes can also be cyclophosphamide (Cytoxan), l-asparaginase, etoposide (VP-16) and / or high-dose methotrexate or cytarabine as a part of the induction phase.

For all patients whose leukemia cells contain in their composition "Philadelphia chromosome", often also include targeted therapies, such as imatinib (Gleevec).

This first month of treatment is quite intensive and requires frequent visits to the doctor. The patient may spend part or most of that time in the hospital, because there is a possibility of serious infections or other complications. It is very important to take all prescribed medications. Sometimes the side effects may be sufficiently severe as to be life-threatening. However, due to modern advances in recent years in the maintenance treatment (care, nutrition, antibiotics, platelet transfusions as needed, etc.), they occur much less frequently than in the past.

Leukemia most often goes into remission at the stage of induction chemotherapy. But because the abnormal cells may still be hiding somewhere in the body, further treatment is necessary.

Treatment and prevention of central nervous system

Prophylactic measures aimed at preventing the proliferation of leukemia cells in the CNS. Treatment is similar to treatment applied in the case of penetration of the disease in this area. His often begin during induction. Prevention can include the following procedures and drugs - one or more option:

  1. Intrathecal chemotherapy. Drugs that are most commonly used: methotrexate, cytarabine, and sometimes steroids such as prednisone. They are administered via lumbar puncture or an Ommaya reservoir.
  2. High-dose cytarabine or methotrexate.
  3. Radiation therapy to the brain and spinal cord.

Consolidation (intensification) in the treatment of leukemia

If the leukemia goes into remission state, the next step often involves a relatively short course of chemotherapy, using many of the same drugs as in the induction phase. Treatment usually lasts for a few months. In most cases, cytostatics are appointed in high doses, so the treatment is quite intensive. Preventive measures related to the central nervous system, and can be continued at this stage. Also use targeted drugs - imatinib for the treatment of patients with the "Philadelphia chromosome."

A number of patients with certain adverse prognostic factors in remission is still at high risk of relapse of acute lymphoblastic leukemia. Doctors in Israelhave to offer allogeneic stem cell transplantation at the time, especially those who have a brother or sister that can be good donors. The possible risks and benefits of the procedure should be carefully weighed for each patient, taking into account all the features of the particular case of the disease.

Maintaining in the treatment of leukemia

After consolidation of the patient, as a rule, a maintenance chemotherapy program - methotrexate and 6-mercaptopurine (6-MP). In some cases, they are combined with other drugs such as vincristine, and prednisone.

In accordance with the same aforementioned conditions apply imatinib.

This supporting step lasts usually for about 2 years. At this time it can be extended preventive measures aimed at the central nervous system.

Approximately 80 - 90% of adults reach a state of complete remission in the course of these procedures. This does not mean that there is no leukemia cells in the bone marrow. Unfortunately, almost half of these patients relapse occurs, so that the overall percentage cured is approximately 40%. It affects a subtype of acute lymphocytic leukemia (ALL) and other prognostic factors. For example, the cure rates are generally higher in younger patients and lower in the elderly.

Prices for treatment of ALL in Israel

Acute lymphoblastic leukemia - a serious disease that requires quick and effective treatment. In Israel, there are many techniques you can use to stop this disease. The cost of their therapy will depend on what the scheme will choose the doctor. You can calculate the basic costs in advance, if the service call consultants Some prices for treatment of ALL in Israel are as follows:

  1. Consultation oncologist - $ 600
  2. Biochemical analysis of blood - 280 $
  3. Drugs - $ 360
  4. Chemotherapy for 1 session - $ 1080

Prices for leukemia treatment in Israel less than in Europe, but the quality remains high. Tlv.Hospital service will help you choose the best clinic and organize the entire therapeutic process. Contact us and leave your request, our consultants will be contacted immediately.