Thanks to advances in scientific research, it is now possible to administer a cure with a fixed duration and talk about remission of the disease: this is how half of the patients. years after the end of the therapy, a good quality of life is restored
For chronic lymphatic leukemia it is not yet possible to speak of healing, even if the average survival of patients exceeds 10 years from diagnosis, but of remission: a term used when a tumor, once the therapies have been completed, is absent, and is not detected by no control test. And it can stay that way for months, even years. this is the goal that has now been achieved for many patients with this form of blood cancer which, depending on the clinical and biological characteristics, can have a more or less indolent course. In short, thanks to the therapeutic advances in recent years, there has been a change of perspective that allows us to rewrite the history of many people who fall ill with chronic lymphatic leukemia: the treatment can have a fixed duration, therefore be suspended at a certain point (after two years), without the disease returning or with a reduced risk that it will start to progress again.
You don’t always need treatment
Chronic lymphocytic leukemia is a slow-growing form of leukemia, which often can only be kept under control because it has no symptoms and does not progress, due to which an excessive number of immature lymphocytes (a type of white blood cell) are detected, mainly in the blood and bone marrow. The course of the pathology varies greatly from person to person: some have a very stable disease that does not require any treatment or requires it only after years, while in other cases the treatments must be started right from the diagnosis. It all depends on the biological characteristics of the leukemia cells present in the individual case, which condition behavior with a more or less pronounced attitude towards growth. of the neoplasm. Among the factors that are considered there are some genetic characteristics (cytogenetic alterations evaluated with the FISH method; the TP53 gene mutations and the mutational status of the IGHV genes), with tests performed only by specialized laboratories usually present in hematology centers.
3 thousand new cases in Italy every year
Every year in Italy about 3 thousand people receive a diagnosis of this haematological neoplasm, which affects men twice as many as women, especially in the age group between 65 and 74 years – says Giuseppe Toro, president of the Italian Association against leukemia, lymphomas and myeloma (Ail) -. Advances in scientific research and therapeutic innovations result in a significant impact on patients’ lives. In fact, the data we now have available confirm the lower risk of disease progression and ensure that patients can return as soon as possible to lead a normal life, regaining possession of their daily lives. improvement of the quality of life.
A good quality of life for half of the patients
The final analysis of the Murano study, which followed the patients for a period of over five years, shows that one in two patients is free from progression of the disease for up to three years after having finished treatment with two drugs, venetoclax and rituximab, given for 24 months. A combination, without chemotherapy, which was administered for the first time with a fixed duration of two years and then suspended without the leukemia recurring or delaying the eventual recovery of the disease by years. Thanks to a new therapy developed in recent years, patients live longer and better, with fewer side effects and without having to continually undergo therapies – underlines Marco Vignetti, president of the GIMEMA Foundation (Italian Group of Adult Hematological Diseases) Franco Mandelli Onlus -. Of course, the relationship between doctor and patient plays a central role, especially in the management of a chronic disease and in its evolution. Those directly concerned need to feel involved and also for this reason we have recently developed the GIMEMA-ALLIANCE platform, to better understand the needs of patients, symptoms, adherence to care and facilitate the management of patients in clinical practice.
Advantages also for the NHS
The treatments available today also offer positive implications from the point of view of economic sustainability for the National Health System and for the community. A cost-therapy analysis, recently carried out in Italy, showed that a therapy with a defined duration of 24 months determines, for each patient treated, a reduction in the cost of drugs of about 31 thousand euros compared to a chronic therapy – says Claudio Jommi, Professor of Practice of Health Policy at the SDA Bocconi School of Management -. A comparison based on data from clinical trials of the therapies compared over 37 months and on the prices of drugs published in the Official Gazette. While introducing, again on the basis of clinical trial data, a hypothesis of patient retreatment after therapy with a defined duration, there would still be a saving for the NHS equal to 23 thousand euros. may have passed from a chronic treatment to one with a fixed duration – underlines the Honorable Angela Ianaro, Member of the XII Commission of Social Affairs and Professor of Pharmacology at the Federico II University of Naples, who spoke at a meeting organized by AbbVie -. It is clear that our commitment must be to continue to support patients and guarantee all of them access to the most advanced therapies. Science, thanks to advances in research, has made tremendous progress changing the lives of many patients and their families. therefore it is desirable that the evaluation of a patient’s therapeutic approach looks at the impact in the short and long term, both in terms of health and quality of life, and that the evaluation of the expenditure for treatment is not limited to annual budget limits .
May 11, 2022 (change May 11, 2022 | 11:32 am)
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