Does having leukemia mean you have a terminal illness? Huang Rui, deputy chief physician of the Hematology Department of Zhujiang Hospital of Southern Medical University, recently emphasized that leukemia is not a terminal disease, which is very different from the message consistently conveyed in film and television works. “We must have a correct and objective understanding of leukemia in order to better manage and treat it.” Huang Rui said that once sick, as long as patients actively standardize treatment and adjust their mentality, the 5-year survival rate will exceed 50 %.
Leukemia is a common malignant tumor, with the incidence rate ranking sixth among malignant tumors. Among its subtypes, acute myeloid leukemia is the most common. As my country enters an aging society and grassroots diagnosis and treatment methods improve, the number of elderly patients is increasing, and the age of onset is on the rise.
After acute myeloid leukemia is diagnosed, the key goals of treatment are to eliminate abnormal leukemia cells and restore the balance of normal blood cells in the bone marrow. For a long time, “chemotherapy + transplantation” has been the only choice for the treatment of acute myeloid leukemia. When treated aggressively, the 5-year survival rate is acceptable. However, it is more harmful to the human body and has more complications, so it is more suitable for young patients. , elderly patients with poor basic conditions need to find other methods.
How should elderly patients with acute myeloid leukemia be treated? Huang Rui said that with the launch of new targeted drugs, complications have been reduced and remission rates have been higher, giving elderly patients more opportunities to receive transplants.
“In the past, patients with relapsed and refractory acute myeloid leukemia who carried FLT3 gene mutations might have a response rate of only 20% to 30% with chemotherapy. Now, after using a single targeted inhibitor drug, the response rate can reach 54%. With combination With other targeted drugs, the response rate can reach 75%, providing opportunities for subsequent transplantation,” Huang Rui said.
Currently, some people’s understanding of acute myeloid leukemia is still stuck at the “cannot be cured” stage, which urgently needs to change. Huang Rui repeatedly emphasized that compared to the dangers of the disease itself, what is more terrifying is the lack of a correct understanding of leukemia.
Targeted drugs are currently in the exploration and trial stage, and are gradually transitioning from routine use in the elderly to use in younger patients. Huang Rui said that for patients who have undergone chemotherapy and have relapsed, choosing one or several targeted drugs based on the genetic mutation results will be much better than traditional chemotherapy. However, transplantation remains an irreplaceable and important option for many patients.
“Transplantation technology is now quite mature and can be generally carried out in tertiary hospitals, with a high success rate.” Huang Rui pointed out that transplantation is only a means to help patients, and transplants should be accepted as soon as possible when necessary.
When leukemia patients receive a transplant, they need to “enter” and “exit”, that is, they will be admitted to the laminar flow ward after the transplant and leave the laminar flow ward after they improve. After patients enter the clinic, they first receive chemotherapy, and then undergo peripheral stem cell transplantation. After the stem cells have fully grown, they can leave the clinic and stay in the clinic for a total of 3 to 4 weeks. Currently, bone marrow transplantation has been largely replaced by peripheral blood stem cell transplantation.
“If everything goes well, immunosuppressants can be stopped 6 to 9 months after stem cell transplantation. If there is no recurrence after 3 years of reexamination, it is basically cured. From what we have observed, most patients under the age of 65 Elderly patients can tolerate transplantation.” Huang Rui said that it is worth mentioning that with the support of medical insurance policies, the cost of most leukemia treatments has dropped significantly. Taking this hospital as an example, the average cost of haploid transplantation is about 150,000 yuan, and Guangzhou residents with medical insurance pay less than 50,000 yuan out-of-pocket after reimbursement.