A new multidrug re-induction protocol with topotecan, vinorelbine, thiotepa, dexamethasone, and gemcitabine (TVTG) for relapsed or refractory acute leukemia.
Leukemia is the most common blood cancer in childhood. Leukemia affects two types of white blood cells: lymphocytes and granulocytes, which are supposed to protect the body from infection. Due to a malfunction of the hematopoietic system, neighboring organs and tissues fail, as well as the lymphatic system. When the doctor finds a pathology in a child, he proceeds to immediate treatment.
Experts cannot name the exact causes of the disease. However, they identify the following risk factors that influence the onset of the disease:
- Genetic predisposition;
- The presence of chronic infections;
- Exposure to chemicals;
- Exposure to radiation.
If you notice that your child has suspicious signs of pathology, you should immediately consult a doctor. He will conduct a comprehensive study of the body and select unique methods of treatment.
Treatment
The Israeli clinic Tel Aviv Medical Clinic employs a team of true professionals who know how to establish friendly contact with a child. Thanks to the modern equipment of our department, it is possible to identify pathology at an early stage and prescribe the correct treatment. Our staff provide round-the-clock care and supervision for young patients. The clinic has a support center for parents and children, where you can get a qualified help from psychologists and speech therapists. Our staff helps to contact the charities we work with.
In our clinic, the latest therapy protocols are used as treatment, including the use of drugs with topotecan, vinorelbine, thiotepa, dexamethasone and gemcazone. The study involved 28 patients with multiple recurrent or refractory acute leukemia. A total of 14 patients had pre-B-ALL (acute lymphoblastic leukemia), three had T-cell leukemia, nine had acute myeloid leukemia (AML), and two had biphenotypic leukemia. Overall, 13 patients achieved significant responses (10 complete responses and three partial responses).
10 of these patients subsequently underwent hematopoietic stem cell transplantation, and four are alive without disease. One patient died while in remission from complications caused by an episode of sepsis and pneumonia following repeated induction with topotecan, vinorelbine, thiotepa, dexamethasone, and gemcitabine. Other toxic effects included grade 4 neutropenia in all patients and transient grade 2 hepatotoxicity in 10 patients (36%). Thus, 47% of patients receiving severe pretreatment with multiple relapsed or refractory leukemia achieved a significant response after therapy with this treatment protocol.