Step out leukemia treatment Misunderstanding

Recently, the First Military Medical University Hospital Hematology director of the Pearl River Professor Guo Kunyi, leukemia treatment to correct the errors : First, not all leukemia who need a bone marrow transplant; Secondly, not necessarily require bone marrow transplantation HLA (human leukocyte antigen) typing fully matched donor, under current conditions, the introduction of new technology line, half of HLA matching is possible. Not all people need to leukemia bone marrow transplant Professor Guo said that the leukemia stem cells different developmental stages, divided into acute and chronic-type nature of the two different types, which are divided into lymphoblastic leukemia or non-lymphocytic leukemia, child or adult type. Different types and subtypes of treatment principles, programs, technology routes are different. Some patients on conventional chemical treatment is very sensitive, chemotherapy can only cure. For example, the older generation of experts established by the children lymphoblastic leukemia chemical treatment programs, and techniques to cure more than 80% of the patients, many of these children have grown up and got married and had children, health work. China's international colleagues in the differentiation therapy, vitamin A derivatives or arsenic treatment (all-trans retinoic acid), can be cured more than 95% of adults in male urgent M3 (promyelocytic) leukemia. Adhere to regulate the chemical treatment, nearly 1 / 2 of urgency in male adult M1 and M2 can cure leukemia. The need is a bone marrow transplant that part is not sensitive to chemotherapy patients, they need help from the normal immune cells kill cancer cells resistant to rebuild hematopoietic function. Do not think that bone marrow transplantation is the treatment of leukemia Foolproof is that the case of bone marrow transplantation in the treatment requirements in 20 million over the current domestic and international access to five-year survival were less than half. Bone marrow transplantation in the spiritual, emotional, airframes, the cost is far higher than the cost of chemical treatment and differentiation of treatment. The first course of chemotherapy can achieve remission, must adhere to consolidate intensive treatment and we must not blindly pursue bone marrow transplant. Otherwise, not only will we waste money and other limited resources, will also affect the patient's treatment time. Leukemia patient should pay high attention to the two phenomena, first, the diagnosis is not a standardized system for chemical treatment, only to find donor transplantation; 2 is a timely transplant therapy, but the delay not resolved. Current microscope morphology, immunology, genetics (chromosomes and genes) and clinical symptoms composite indicator, and can quickly identify the type of leukemia, how the risk of clinical uphold conventional chemotherapy or bone marrow transplantation increases with a clear basis. "Semi-matching bone marrow transplantation," open up new possibilities The traditional bone marrow transplantation in the treatment of the first to find HLA matching for all, HLA matching can reduce rejection and enhance the safety of transplantation. However, HLA matching fully conform to the probability is very low, even brothers and sisters are only 1 / 4. International Bone Marrow Bank is usually used to establish the non-blood relationship to find a crowd for the match, but consistency in the risk of a few thousandths of one ten thousandth. This situation prompted people to create. In recent years the international level with relatives semi-matching bone marrow transplant, using graft removal of T lymphocytes, and selected hematopoietic stem cells, or cytokines control solutions rejection problems in complete remission for patients with the treatment and made great progress. 80% of the patients in a timely manner can be parents, children, siblings and tongs scale-half to find matching donors, the cost savings of many. Zhujiang Hospital from 1999 onwards, the choice of 12 at the state of refractory adult leukemia patients, half of HLA matching the transplant treatment. Donor from parents, children, siblings, the donor and recipient were among HLAI substandard category, sub-category II, Class I and Class II not Hopewell, a blood group incompatibility, gender incompatible. Patients include access to accelerated phase and blast crisis of chronic myeloid leukemia, acute monocytic leukemia, lymphoma merger lymphoblastic leukemia, the merger meningeal leukemia, these patients are invalid radiotherapy and chemotherapy, survival is already very short period of the patients. Among them, 11 cases of transplantation, the transplantation of cases, leukemia and lymphoma completely disappeared, displayed a semi-match with a strong immune cells to kill the leukemia, there are six cases so far no incidence original survival. Professor Guo said that the inter-haploidentical transplant has risks. In recent years, they have established a line of three technologies, in order to different diseases and different for those who do reasonable transplantation. Last year, they used the mother's immune hematopoietic cell transplantation, the successful rescue of its suffering from severe acute aplastic anemia daughter's life, the transplantation process was very smooth, healthy patients have disease-free survival was six months. Unrelated HLA-matched transplantation and blood of HLA-matched transplant results comparable. In 2001, 27 European blood and bone marrow transplantation in the meeting, former Chairman of the Institute of Experimental blood GorinN report to ANLL example, the 299 cases unrelated HLA matched transplants and 224 cases blood of HLA-matched transplant Comparative Analysis of the results are as follows : the first at ease transplant, disease-free survival rates were 41% ± 8%, 46% ± 5%, in the second mitigation when a transplant, disease-free survival rates were 28% ± 5%, 27% ± 4%, treatment-related mortality was 56% ± 6%, 52% ± 6%. Right relapsed patients should not give up easily Professor Guo said, leukemia treatment has entered the genetic individual under the guidance of artistic treatment and the treatment that we can do for each patient scientific selective treatment and prognosis of judgment. The molecular mechanisms of pathogenesis of leukemia research and treatment of leukemia entered the era of molecular targets. New cancer gene product inhibitors, growth factor receptor antagonist, the specificity of antibody targeting therapy, specificity of immune cells for the treatment of leukemia for more treatment. For relapsed patients should not give up easily. For high-risk transplant patients sooner the better, not fully HLA matched donor, the blood of HLA-matched transplants in time to save the lives of some patients.