Leukaemia

Leukaemia is a type of blood cancer, which starts in bloodforming tissue, such as the bone marrow, and causes large
numbers of immature blood cells to be produced and enter
the bloodstream. Leukaemia is subdivided into different
subtypes according to cellular maturity (acute or chronic)
and cell type (lymphocytic or myeloid). The mainstays of
leukaemia treatment for adults have been chemotherapy,
radiation therapy, and stem cell transplantation. There
different types of leukaemia that require different
combinations of therapies. Although much progress has
been made against some types of leukaemia, others still
have relatively poor rates of survival. And, as the population
ages, there is a greater need for treatment regimens that are
less toxic. Acute Lymphoblastic Leukaemia (ALL)
Combining less-toxic therapies. The intensive
chemotherapy treatments used for ALL have serious side
effects that many older patients cannot tolerate. Targeted
therapies may have fewer side effects than chemotherapy.
Researchers are developing clinical trials that will test
whether combinations of these types of therapies can be
used instead of chemotherapy for older patients with a form
of ALL called B-cell ALL. Using CAR T-cell therapy. CAR
T-cell therapy is a type of treatment in which a patient’s
own immune cells are genetically modified to treat their
cancer. Currently, CAR T cells are approved for the
treatment of some children and young adults with ALL.
They are now being explored for use in older adults with Bcell ALL. Scientists hope that it will be possible to use CAR
2
T-cell therapy to delay or even replace stem-cell
transplantation in older, frailer patients. A major challenge
in treating another type of ALL, called T-cell ALL, has been
that it can be resistant to chemotherapy and radiation
therapy. Researchers are working to develop clinical trials
to test new drugs that could potentially help counter this
resistance. Acute Myeloid Leukaemia (AML); Targeted
therapy. AML tends to be aggressive and is harder to treat
than ALL. However, AML cells may have gene changes
that can be targeted with new drugs. Targeted therapies that
have recently been approved for AML include: Enasidenib
(Idhifa), Venetoclax (Venclexta), Midostaurin (Rydapt) and
Gilteritinib (Xospata). Researchers are also testing other
ways to treat AML such as Looking at newer targeted
therapies. One promising drug, called pevonedistat, targets
a protein called NAE that is involved in cell division and is
being studied in clinical trials.