Three Weapons Collaborate to Defeat Refractory/Relapsed Leukemia

Leukemia is a type of disease in which hematopoietic stem cells become cancerous. Leukemia cells will appear in the bone marrow and blood, and without effective treatment, it will eventually be highly threatening.

Leukemia is generally classified as myeloid leukemia and lymphocytic leukemia. The treatment methods include chemotherapy, radiotherapy, targeted therapy, immunotherapy and hematopoietic stem cell transplantation. The application of single or combined therapy can make most patients achieve disease relief or even cure. For example, for childhood acute lymphoblastic leukemia, the cure rate of conventional therapies such as chemotherapy can reach 80%, and childhood lymphoma can also achieve 80% cure through conventional treatments such as chemotherapy, but 20% are still refractory/relapsed diseases.

In recent years, there has been rapid progress in the treatment of leukemia. To overcome leukemia, there are three advanced weapons: first, the advancement of diagnostic technology; in addition, the application of hematopoietic stem cell transplantation is becoming more and more popular and the efficacy is continuously improving; third, immunotherapy, such as CAR-T therapy (Chimeric antigen receptor (CAR)-engineered T cell therapy, the most promising approach, which has shown remarkable ability to eliminate various kinds of tumors, especially for B cell malignancies, with up to 95% response rates and durable complete remission), can greatly help more patients achieve complete remission and improve the chance of cure.

Integrated diagnosis of leukemia emphasizes integration, which includes more comprehensive tests at the cytomorphology, immunotyping, cytogenetics, and genetic levels to improve the accuracy of diagnosis and make accurate typing, thus to select the appropriate treatment. Integrated diagnosis allows doctors to estimate the difficulty of disease treatment and the possibility of recurrence. If it is a type in which chemotherapy doesn’t work, hematopoietic stem cell transplantation should be performed early after remission. In addition, genetic and flow detection can also monitor the effectiveness of treatment and find small residual diseases in time, so as to treat the disease as soon as possible and reduce the chance of recurrence.

Immunotherapy has been a hot topic in the cancer community in recent years. In the CAR-T clinical trial of the University of Pennsylvania, Emily Whitehead is the first child patient in the world to receive experimental CAR-T therapy. When she was 5 years old, she was diagnosed suffering from acute lymphoblastic leukemia (ALL). In 2012, 6-year-old Emily had two relapses of leukemia and her life was in jeopardy. After confirming that bone marrow transplantation was impossible, she participated in a clinical trial of CAR-T therapy. After three times of CAR-T cells transfusion, Emily woke up a week later, and three weeks later, the doctors performed a bone marrow examination on Emily, and the result was negative, which meant her cancer disappeared completely. Now, she has lived a cancer-free life for 8 years.

The emergence of CAR-T is a revolution in the treatment of cancer, and it has rekindled new hope for many desperate patients. Although leukemia CAR-T therapy has its drawbacks, scientists are also working to improve it. "Scientists all around the world are trying to release more potential in CAR-T therapy, which now has evolved to the fourth generation with better curative effect," introduced by a senior scientist at Creative Biolabs, a global company focusing on TCR and CAR-T & NK cell immune therapy development services.

Suffering from leukemia is unfortunate with the whole family facing heavy mental pressure and financial burden. However, with the advancement of technology, when it comes to blood diseases nowadays, people realize that it is no longer an incurable disease. Keep up to the forefront, find the right direction, and achieving a cure is not a dream anymore.