an aggressive disease, for which it is essential to intervene quickly, with integrated treatments and a team with several specialists. It is also particularly important to obtain adequate psychological support from the time of diagnosis
Multidisciplinary collaboration, rapid intervention and structuring of integrated treatments in Italian hematology centers. By intervening on these three points it is possible to improve the management of patients with acute myeloid leukemia, a blood cancer that affects around 3,500 people in Italy every year, which originates in stem cells present in the bone marrow and develops very rapidly. as established by a vademecum developed in the context of the HEMA NET project, presented in recent days to the Ministry of Health and created by ISHEO in collaboration with FAVO Hematological Neoplasms Group, addressed to the departments of hematology and oncology, to the general and administrative directorates, but also to patient and voluntary associations.
Targeted therapies on the genetic mutations present in the patient
After 30 years in which only chemotherapy was available, only partially effective, in the last five years many innovative treatments have arrived that are radically changing the therapeutic profile of acute myeloid leukemia, which still remains an aggressive and difficult to fight cancer. because, not infrequently, it recurs. Today the treatment for those suffering from acute myeloid leukemia is really differentiated on the basis of the type of molecular alterations present in the individual case. For this reason, it is essential that all patients, before starting therapy, do a very sophisticated but currently essential blood and bone marrow cell test to quickly and accurately identify the targets for drugs to be associated with traditional treatment. NGS haematological genetic tests, in particular the FLT3 gene alterations (which are among the most common in this neoplasm), open the way to personalized treatment with selective inhibitors which, if well used, give exceptional and long-lasting chances of cure in patients. acute leukemia of both relapsed and frail patients – says Giovanni Martinelli, Scientific Director of the Dino Amadori Scientific Institute of Romagna for the Study of Tumors, IRST of Meldola -. It is therefore essential to implement an adequate follow-up to allow the timely identification of relapsing forms. Integrated care, and in particular psychological support, can help improve the patient’s quality of life and increase readiness for intervention.
More psychological support
From a survey conducted in hematology centers in Italy (always part of the HEMA NET project, carried out with the non-conditioning contribution of Astellas Pharma), it emerges that psychological support in many hospitals is a service supported by patient and non-patient associations. structured through the health service. In the treatment path, psychological support represents a backbone of taking care of people with cancer – underlines Davide Petruzzelli, national coordinator of FAVO Hematological Neoplasms Group -. Fragility, uncertainty and anxieties are the key words that accompany the lives of patients and caregivers on a daily basis. The investigation that we have carried out has highlighted some critical issues on which it is necessary to intervene as soon as possible to ensure a global care for the patient, who starting from the now documented benefits that integrated treatments can offer, at the same time help and also support the intervention of clinicians and the care team. Since in most patients this leukemia has a rapid onset and immediately aggressive, those affected quickly pass from a state of complete well-being to a condition of severe impairment of the state of health. The emotional impact of a diagnosis of acute myeloid leukemia is devastating for the patient and family – explains Felicetto Ferrara, director of the Department of Onco-Hematology at Cardarelli in Naples -. The most common reaction is a sense of deep anguish, despair and worry, which subside upon achieving complete remission and, even more so, upon discontinuation of therapy.
Fear of relapse
In patients in remission, even after the completion of the therapeutic program which often includes allogeneic transplantation, there is uncertainty due to the possibility that the disease may recur. In our experience, the fear of recurrence palpable on the occasion of periodic control exams, triggered as a specific response to the experience of a cancer diagnosis and by the need to re-face treatments, even invasive ones – adds Ferrara -. In fact, one of the most frequently asked questions concerns the possibility of new, less aggressive and more tolerable therapies. These elements strongly underline the need to provide patients with structured and continuous psychological support over time. Integrated care and psychological support, in the different phases of the journey of the individual sick person, are precious and helpful tools for those directly involved and for the system. sanitary: The monitoring of the cancer patient is of fundamental importance not only in the active phase of the disease but also in the follow-up phase, when intercepting a relapse more or less quickly can have direct consequences for a person’s life, concludes Elisabetta Iannelli, Secretary General of FAVO and vice president of AIMAC.
July 5, 2022 (change July 5, 2022 | 17:21)
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