Leukemia and its Therapeutic Advancement in Combination Chemotherapy


Leukemia is a group of blood malignancies that often develop in the bone marrow and produce large numbers of abnormal blood cells. It is also known as leukaemia and is pronounced /lukimi/ loo-KEE-mee. Blasts or leukaemia cells are the term for these immature blood cells. A higher risk of infections as well as bone discomfort, weariness, and bleeding and bruising are possible symptoms. These symptoms are brought on by a deficiency of healthy blood cells. Typically, blood tests or a bone marrow biopsy are used to make the diagnosis.

Adult Acute Lymphocytic Leukemia (ALL) patients are being treated with combination chemotherapy that includes prednisone, vincristine, and an anthracycline. Other medications, such as asparaginase or cyclophosphamide, were added to some regimens in a Cancer and Leukemia Group B (CALGB) research (CLB-8811). The current multiagent induction regimens have full response rates ranging from 60% to 90%11. Imatinib mesylate is included in the treatment regimen for individuals with Ph1-positive ALL. Imatinib mesylate, an orally accessible BCR-ABL tyrosine kinase inhibitor, has shown clinical efficacy as a single treatment in Ph1-positive ALL. Imatinib from the Northern Italy Leukemia Group was studied in combination with chemotherapy idarubicin, vincristine, prednisone, and L-asparaginase for patients with newly diagnosed, untreated Ph1-positive leukaemia. All patients who achieved remission were expected to have allogeneic transplantation when and if an HLA-matched donor could be found.

Patients who did not have a donor had an autologous transplant. Following the completion of chemotherapy and transplant, all patients were to take imatinib maintenance for as long as tolerated. Because of toxicity, L-asparaginase was removed from both arms' induction regimens after 20 patients were assigned to the imatinib arm. Patients who had preventive platelet transfusions at a level of 10,000/mm3 rather than 20,000/mm3 had comparable results. Careful teaching in personal cleanliness and dental care, as well as recognising early indicators of illness, are appropriate for all neutropenic febrile patients. Isolation facilities, such as filtered air, sterile food, and gut flora sterilisation, are not generally recommended but may assist transplant patients. The frequency of platelet alloimmunization was comparable across groups randomly assigned to receive either unfiltered or filtered platelets from random donors. Pooled platelet concentrates, UV-irradiated pooled platelet concentrates, and filtered platelets derived by apheresis. Rapid marrow ablation, which results in early marrow regeneration, reduces morbidity and mortality. White blood cell transfusions can help certain people with aplastic marrow and severe infections that aren't responding to drugs.