How Leukemia Treatment Has Evolved in Recent Years

In observation of Leukemia Awareness Month in September, CURE spoke with an expert about basics of the disease.

In observation of Leukemia Awareness Month in September, CURE spoke with an expert about basics of the disease, including its earliest warning signs and symptoms and how treatment of the disease has evolved in recent years.

Dr. Firas El Chaer, chief of Leukemia and medical director of Infusion Services at Baptist Health Miami Cancer Institute, sat down for the interview with CURE.

What are the earliest warning signs and symptoms of leukemia?

Leukemia affects blood cells, particularly the white blood cell count, the red blood cell count and the platelet and subsequently, the patient can develop symptoms and signs that are related to either very high levels of these blood counts or very low levels. For instance, if the red blood cell count goes down very low, the patient can suffer from extreme fatigue, weakness, chest pain and shortness of breath. And if the platelet count goes down, the patient can develop bleeding as well as bruising. Usually those are easy bruising or excessive bleeding. Those are early signs of a disturbed blood count. Not only that, if the white blood cell count is very low, the patients have increased risk of recurrent and severe infections. Those are primarily the main symptoms and signs of leukemia as it affects the blood levels.

How has leukemia diagnosis and treatment evolved in recent years, and what advancements do you have your eye on for patients today?

The treatment of leukemia has evolved enormously in the past decade or so. Previous to that, there were very few drugs which we could use to treat leukemia, and they mostly relied on old school chemotherapy. We still definitely use those. They are part of the backbone of the treatment for leukemia; however, in the past few years, we started to discover many specific genes that are drivers of the leukemia, and subsequently we develop drugs that can target those genes specifically.

So the treatment landscape has evolved a lot in the past few years to include those drugs in addition to the old school chemotherapy, not only that, we have now lighter chemotherapy that can be used to treat leukemia, that would offer the patient a better tolerance to chemotherapy and will allow them to enjoy some good quality of life while they're getting treatment.

A lot of the treatments these days are combination treatments, so you use multiple drugs to target multiple pathways and the cancer pathway, and that would help prevent any emergence of resistance, as well as faster treatment of leukemia.

Is there anything you want to add about what treatment options are currently available for the different kinds of leukemia, and how doctors determine which approach is best for each patient?

There are many types of leukemia, and depending on each type, the treatment approach is very different. I want to focus that a lot of the new treatments for leukemia focus on targeted therapy, whether it is an oral pill given to the patient that can control the disease, or it can be an intravenous or subcutaneous injection that is given to the patient to control the cancer. And those injections, usually they control the cancer by targeting specific antigens or proteins on the cell surface of the leukemia cell, and subsequently, those drugs can control the leukemia much more efficiently and in a manner that is much more specific, sparing the patients from side effects that could affect other cells in the body. These types of chemotherapy, we call them immunotherapy, as well, they can potentially harness the immune system to control the cancer, which has been one of the major advances in cancer care.

Transcript has been edited for clarity and conciseness.

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