Advanced Treatment For Blood Cancer Relapse: Challenges & Innovation

Blood cancer, which includes leukemia, lymphoma, and myeloma, is a major challenge in cancer treatment. In India, around 70,000 new cases of blood cancer are diagnosed each year. Blood cancer relapse, the return of the disease after initial treatment, can be devastating. However, advancements in medical science offer a ray of hope.

Understanding Relapse:

Relapse can occur due to various reasons.Some cancer cells might have evaded initial treatment, harboring mutations that make them resistant. The specific type of blood cancer, the initial treatment approach, and individual patient factors all play a role in the likelihood of relapse.

Treatment Options for Relapse:

The treatment plan for relapse depends on the type of blood cancer, the extent of the relapse, and the patient's overall health. Here's a breakdown of some advanced treatment options:

1. Chemotherapy:  While traditional chemotherapy may be revisited, doctors may explore modifying the initial regimen or using high-dose chemotherapy followed by stem cell transplant.

2. Targeted Therapy: These drugs target specific molecular abnormalities present in cancer cells In India, targeted therapies like Gilteritinib for FLT3-mutated AML and Ivosidenib for IDH1-mutated AML are making a difference. The Leukemia & Lymphoma Society of India [LLS India] offers resources on targeted therapies.

3. Immunotherapy: This approach harnesses the body's immune system to fight cancer cells. CAR-T cell therapy, where a patient's T cells are genetically modified to recognize and attack cancer cells, is a promising option for some blood cancer relapses. While not yet widely available in India, clinical trials are underway to explore its potential.

4. Stem Cell Transplantation (SCT): This procedure involves replacing diseased bone marrow with healthy stem cells from a donor (allogenic) or the patient (autologous). Allogeneic SCT remains the only potentially curative option for many relapsed blood cancers in India. The DATRI bone marrow registry facilitates donor searches for Indian patients.

Challenges and Considerations:

Advanced treatments can be expensive, and access to these therapies can vary across India. It's crucial to explore insurance coverage options and patient assistance programs offered by pharmaceutical companies and patient advocacy groups. Additionally, these treatments can have significant side effects that require careful management by a qualified medical team.

The Road Ahead:

The field of blood cancer treatment is constantly evolving. Clinical trials offer access to cutting-edge treatments still under investigation. Participating in a trial allows patients to receive potentially life-saving therapies while contributing to medical advancements. Research into newer targeted therapies, CAR-T cell therapies, and even gene editing holds immense promise for the future. Indian researchers and institutions are actively involved in developing and testing these novel approaches, offering hope for improved patient outcomes.

The author is Chairman, Medical Oncology, Cancer Care, Medanta, Gurugram

Dr Ashok vaid

Guest Author