myeloid leukemia treatmentChemotherapy is the main treatment for acute myeloid leukemia in Israel. According to the research, certain chemotherapy drugs are very effective in the treatment of AML. Usually they are administered in combination. In some cases, high-dose therapy and bone marrow transplantation and stem cells are used to improve the chances of a cure.

If you are looking for a highly qualified treatment, we can help you. Ourcenter «Tlv.Hospital» provides professional organization of treatment of AML in Israel.

This comprehensive service includes the selection of experts - highly qualified doctors from around the world, specialized clinics or attraction features several hospitals in the country; organization of the entire treatment process, residence; the provision of transport services and much more.

Development of the program of treatment of acute myeloid leukemia in Israel

With the patient runs a multidisciplinary team of specialists:

  • One or more of Hematology.
  • Nurses.
  • Pathologist.
  • Clinical oncologist who specializes in radiation therapy and chemotherapy.

The team can also be social workers, a nutritionist, a physiotherapist.

myeloid leukemia treatment program scheduled based on several factors including the overall health condition and type of abnormal genes that are present in the leukemic cells. The patient will explain the plan and answer any questions.

fertility

Treatment of acute myeloid leukemia can cause temporary or permanent infertility. Therefore, before starting treatment, the doctor discusses with the patient the question to take measures that will help to maintain fertility.

Advantages and disadvantages of treating myelocytic leukemia

Most patients younger than 60 years of intensive chemotherapy is recommended. This suggests a long stay in the hospital for a few weeks in most cases, and the occurrence of side effects. Most of them are of a temporary nature and usually controlled with medication. However, some, such as the effect on fertility, can become permanent. Intensive chemotherapy can cure leukemia in some cases and not affect others. This means that a proportion of patients will experience severe side effects, did not get a result from the treatment.

Some people older than 60 years can take a course of intensive chemotherapy to try to cure the disease. But it is not always possible to do health. Instead, doctors recommend lower doses of chemotherapy to control the disease, rather than trying to cure it. Often this treatment is performed on an outpatient basis myeloid leukemia, patients spend less time in the hospital. The probability to achieve remission with the help of this therapy is much lower.

second opinion

A multidisciplinary team in an Israeli hospital, working with the patient, using common standards and algorithms for treatment, generally accepted in Western countries. Selected most suitable treatment option. But the patient is always the opportunity to hear a second opinion, it can benefit.

The Israeli medical center conducts research aimed at studying and improving its AML treatments. This applies to maintenance therapy, stem cell transplantation, the development of new chemotherapy regimens, immunotherapy.

High-dose therapy and stem cell transplantation

Treatment of acute myeloid leukemiaTransplantation of stem cells allows to receive high doses of chemotherapy, increase the chance for a cure or remission extension.

High-dose treatment of acute myeloid leukemia in Israel suggests higher doses of chemotherapy and sometimes radiation within a few days. Usually, it is carried out after initial therapy with cytostatics.

In addition to the destruction of leukemic cells this treatment destroys the healthy stem cells in the bone marrow. This blood cells at an early stage of development, and later they are transformed into different types of blood cells.

Stem cell transplant

To help the patient to recover from the high-dose treatment of myeloid leukemia transplantation procedure performed. Stem cells come droplets, via infusion. They find their way into the bone marrow, where they begin to produce new ones.

The source of stem cells can be donor (allogeneic transplantation), or the patient himself (autologous transplant). In most cases, at the diagnosis of acute myeloid leukemia performed allogeneic transplantation.

allogeneic transplantation

Donor, usually a brother or sister. Sometimes it can be an unrelated donor, as well as stem cells harvested from umbilical cord blood. Donor stem cells contain healthy immune cells that attack the leukemia segments.

transplant procedure is performed using an intravenous infusion via central catheter, PICC line system (implantable central venous catheter).

autologous transplantation

Before the high-dose patient collect stem cells from the blood. They were preserved, and then returned through an IV catheter or implantable port.

Bone marrow transplantation

It is similar to a stem cell transplant. In this case, the stem cells are not harvested from the blood and bone marrow fluid - the donor or the patient. In the body they are introduced dropwise, after high-dose treatment.

After the transplant procedure

It would take weeks before the new stem cells begin to produce blood cells. During this time, the patient will be very low immunity. You will need to stay in the hospital, in a single room, in order to reduce the risk of infection until the white blood cell count is restored.

Transplantation of stem cells and bone marrow always involves a risk, therefore, is carried out in specialized health centers. All the conditions for a successful outcome provide Israel Hospital.

The Israeli medical centers have successfully used an innovative approach to stem cell transplantation, known as non-myeloablative or "mini" stem cell transplantation. When this procedure to use the minimum dose of radiation or chemotherapy for patients who are not able to withstand the high-dose treatment. According to the study, survival rates after transplantation are similar to mini-figures after the standard procedure.

Chemotherapy in the treatment of acute myeloid leukemia in Israel

Leukemia Treatment in IsraelThis type of therapy using anti-cancer (cytostatic) drugs to kill or damage the leukemic cells. Since drugs circulate in the bloodstream, reach the abnormal cells, no matter where they are.

Chemotherapy for AML is generally carried out in cycles. Each of them lasts 5-10 days, a break of 3-4 weeks. The rest period allows the body to recover from the side effects of the treatment of myeloid leukemia. Full course takes about 6 months.

Induction chemotherapy in the treatment of myeloid leukemia

The main goal - to try to cure the disease completely. The first step is to achieve remission. This is a condition when the blood and the bone marrow do not exhibit immature cells (blasts).

This treatment is called myeloid leukemia induction chemotherapy. Most people need two of her cycle. If the patient will feel good enough, it can be treated as outpatients.

The most frequently used the following drugs during induction chemotherapy:

  • cytarabine (Ara-C, cytosine arabinoside);
  • daunorubicin;
  • mitoxantrone;
  • etoposide (VP-16, Etopophos®, Vepezid®);
  • idarubicin (zavedos);
  • fludarabine (Fludara).

If this treatment does not kill all myelogenous leukemia abnormal cells will be assigned additional chemotherapy to achieve remission.

consolidation phase

The remission in the body may still be malignant segments, even if they can not identify. To reduce the risk of recurrence, appointed subsequent chemotherapy cycles. This stage is called consolidation.

In most cases, these types of drugs are used:

  • cytarabine;
  • etoposide;
  • amsacrine (Amsidine®);
  • mitoxantrone.

Creating hope for children with AML - an innovative approach Cancer Research Center Fred Hutchinson! The Israeli hospitals performed a second transplant of stem cells, to increase the chances of children at relapse after the first transplant.

High-dose chemotherapy in Israel

In some cases, high-dose chemotherapy with stem cell transplantation and bone marrow can yield significant benefits. Doctors consider options to be enough of treatment with cytostatics or need will change. They take into account the results of cytogenetic tests that detect mutations in the genes of the leukemic cells, and the body's response to induction chemotherapy.

If there is a high risk of recurrence after cytostatic treatment, your doctor may recommend a course of high-dose chemotherapy or chemotherapy with radiation and subsequent transplantation. Transplantation is carried out using donor stem cells, and bone marrow.

Standard chemotherapy in the treatment of acute myeloid leukemia in Israel

This is the best option for patients who do not fit high-dose chemotherapy, or they refuse such intensive treatment. Drugs enter the body orally, by infusion or injection. Therapy is often done on an outpatient basis.

Doctors watch closely how well the disease responds to treatment, and plan further actions depending on the reaction condition.

How is chemotherapy?

Preparations for the treatment myeloid leukemia typically administered via intravenous infusion, and by injection. The therapy is performed by central catheters, PICC line system or the implantable port.

Potential side effects of chemotherapy

risk of infection

Leukemia Treatment in IsraelCytostatic drugs acting on leukemia cells, and reduce the number of healthy people. When the number of white blood cells is reduced, developing neutropenia, increased risk of infection.

Status of blood is checked regularly during treatment of myeloid leukemia. Doctors prescribe drugs that reduce the likelihood of infection and treating it. Most of the infections caused by the bacteria in your own body. If the temperature rises above 38 ° C, malaise occurs even at normal temperature, it is necessary to seek medical help.

During the course of chemotherapy, should avoid contact with people who may have an infection. This means that you need to stay away from the cluster of large groups of people. It is also necessary to be careful not to become infected by ingestion of raw, undercooked or contaminated food. Doctors at the hospital told in detail how to prepare food, and that should not be consumed.

The patient can be assigned to the drug G-CSF (granulocyte colony stimulating factor). This type of protein, which stimulates the synthesis of leukocytes in bone marrow. Injections were subcutaneously.

Anemia (low red blood cells)

Deficiency of red blood cells causes fatigue, shortness of breath, weakness. Anemia is treated with blood transfusions.

Bruising and bleeding

Platelets promote blood clotting. When their number myeloid leukemia in the blood below normal, and chemotherapy is able to even reduce it.

This means the appearance of symptoms such as petechial hemorrhages in the skin (petechiae), hematoma, nosebleeds, intense bleeding even from minor cuts and abrasions.

It may be necessary during treatment myeloid leukemia platelet transfusions.

Fatigue

It is a common undesirable consequence of chemotherapy, intensified by the end of treatment and for a few weeks after its completion. At this time, it is important to get enough rest. Thus it is necessary to pay attention to short walks that will be useful.

Inflammation in the mouth

In the treatment of myeloid leukemia inflammation can develop, dry, small ulcers in the mouth. Drinking plenty of fluids, proper and regular oral care will reduce the risk of this side effect. In the presence of these problems physicians prescribe special rinsing and drugs for prevention and treatment of infections in the oral cavity.

Nausea

Some cytotoxic agents cause nausea and even vomiting. The physician can prescribe drugs that prevent them. It must be put into a specialist known if the drug does not work, as there are many different types that you can try.

Hair loss

Acceptance of chemotherapy in the treatment of myeloid leukemia is often the cause of hair loss. There are many ways that can help to hide it - a variety of wigs, hats, scarves or bandanas.

Hair usually starts to fall for a few weeks after starting treatment, it is extremely rare - in a few days. Man sees as more hair left on the comb, on a pillow in the morning, drops during washing.

After 3-6 months after completion of treatment myeloid hair grow. Slightly change the color or texture.

Radiation treatment of acute myeloid leukemia in Israel

Radiotherapy treats leukemia, using high-energy rays to kill leukemia cells, causing minimal damage to healthy cells in the body.

In these situations, use this type of treat myeloid leukemia:

  1. When the spread of the disease in the brain, cerebrospinal fluid or testicles.
  2. In order to reduce the size of a tumor, which presses on the trachea (windpipe) and causing breathing problems.
  3. To reduce the pain in the bones, when they struck leukemia, and chemotherapy is not helping.
  4. The irradiation of the whole body is an important part of treatment before transplantation of stem cells.

For the treatment of acute myeloid leukemia is used teletherapy. Before the start of a team of doctors conducting careful measurements to determine the pointing angles and the radiation dose. The procedure takes a few minutes, the preparation process much longer.

Potential side effects depend on where the radiation is aimed. Zagaropodobnyh may cause changes in the treatment area. The irradiation of the head and neck can cause a sore throat and difficulty in swallowing. If radiation therapy is subject to the abdomen, symptoms may include nausea, vomiting, or diarrhea. Irradiation can reduce blood parameters that trigger anemia and neutropenia.

Other drugs for the treatment of acute myeloid leukemia in Israel

Treatment of acute myeloid leukemia in IsraelAs noted earlier, chemotherapy is the main treatment for most types of AML. But acute promyelocytic leukemia (APL) is different from the other types in some important respects.

APL leukemia cells contain proteins, which when released into the blood, can cause blood clots in the blood vessels, which leads, including a strong bleeding. In the past, when certain chemotherapy drugs used to kill these cells and their proteins rushed into the bloodstream. Patients sometimes die from complications due to problems with blood clotting.

Scientists have found that PLA cells have gene mutations that are sensitive only to certain chemotherapy drugs. These cytotoxic agents given signal leukemia cells transformed into mature myeloid cells. This process is called differentiation. As the immature cells do not die, they do not release harmful proteins in the blood clotting process remains under control.

ATRA (trans-retinoic acid, tretinoin, vesanoid)

Patients with APL treated with ATRA drug. This is a special form of vitamin A.

Appointed for a period of up to 3 months, often along with chemotherapy or arsenic trioxide, being a part of the induction phase. Also used during the consolidation phase.

Side effects are similar to the effects of excessive intake of vitamin A. They may include headache, chills, dry skin and mouth, skin rash, swelling of the legs, sores in the throat and in the mouth, itching and irritation of the eyes, increased cholesterol levels. Undesirable effects disappear after drug withdrawal.

arsenic trioxide

It's a form of arsenic that becomes poison when taking the medication in larger doses. Doctors found that he acts like ATRA in patients with ALI. It is administered along with ATRA at a stage of induction, as well as disease recurrence after applying trans retinoic acid with chemotherapy.

Most of the side effects of the drug are quite weak. Celebrating fatigue, nausea, vomiting, diarrhea, abdominal pain, neuropathy. Serious adverse effects are problems with the heart rhythm.

syndrome differentiation

This is the most important side effect of these drugs, formerly known as retinoic acid syndrome. It occurs when the leukemia cells release certain chemicals in the blood. Most often it is observed during the first cycle of treatment of myeloid leukemia.

Symptoms may include fever, respiratory problems due to fluid accumulation in the lungs and around the heart, low blood pressure, renal function. Treat state, ceasing the administration of drugs for some time and assigning steroids such as dexamethasone.

Evoltra (klofarabin)

Regarded as one of the new drugs in the treatment of acute myeloid leukemia in Israel. Similar to fludarabine but has fewer side effects, it is a good option for older people, for which for health reasons is not recommended high-dose chemotherapy.

Evoltru introduced into the body via infusion, the drug is available to individuals with AML in clinical trials.

gemtuzumab

Gemtuzumab, also known as Mylotarg®, administered intravenously.

It is a combination of monoclonal antibody and chemotherapy. Monoclonal antibody is attached to a protein CD33, which is on the surface of leukemic cells. Thus, gemtuzumab delivers chemotherapy drug specifically to diseased cells, causing less damage to healthy.

AC220

Some people with AML have FLT3 mutations in leukemia cells, which increases the risk of the disease returning. AC220 is a new experimental drug aimed at the mutation. While the drug is available in a clinical trial, taken orally.

Medical service «Tlv.Hospital» will assist in the organization of the treatment of myeloid leukemia in Israeli hospitals, in the selection of the best doctors and medical institutions in matters of domestic support. If you need help, be sure to contact through the inquiry form.

Prices for treatment in Israel

Treatment of the disease in Israel includes a variety of services provided to the patient depending on the prepared treatment programs. Therefore, with respect to the exact cost can be calculated only after the results of diagnostics (in the absence of any error therein). Below is a price to chemotherapy in Israel:

  1. hemato-oncology consultation - $ 600
  2. Medications - from $ 360
  3. One chemotherapy session - $ 1080

Chemotherapy is held under the supervision of doctors. the cost of drugs and the presence in the Israeli clinic is calculated individually. Please contact us with requests, by phone or e-mail!