Acute myeloid leukemia, a brochure dedicated to hematology centers to treat patients better –

From Health editorial team

Aggressive disease, it is necessary to intervene quickly, with integrated treatments and a team of many specialists. It is also especially important to have adequate psychological support from the time of diagnosis

Multidisciplinary cooperation, rapid intervention and structuring of integrated therapies in Italian hematology centers. By intervening in these three points, the management of patients with acute myeloid leukemia, a blood cancer that affects about 3,500 people in Italy each year, that originates in stem cells in the bone marrow and develops very rapidly, can be improved. It was also created by vademecum developed in the context of the HEMA NET project, presented in recent days to the Ministry of Health and created by ISHEO in cooperation with the FAVO Hematological Neoplasms Group, addressed to the departments of hematology and oncology, to the general and administrative directorates, but also to patient associations and voluntary.

Targeted therapies on the genetic mutations present in the patient

After 30 years where chemotherapy was only available and only partially effective, in the past five years, several innovative therapies have arrived that fundamentally change the curative profile of acute myeloid leukemia, which remains aggressive and difficult to fight cancer. It is rarely repeated. Today the treatment of those with acute myeloid leukemia is differentiated based on the type of molecular changes present in the individual case. For this reason, it is essential that all patients, prior to initiating treatment, perform a highly complex but currently necessary blood and bone marrow cell test to quickly and accurately identify drug targets that should be linked to conventional therapy. Genetic testing of blood in NGS, in particular FLT3 genetic alterations (which are among the most common in this tumor), opens the way to personalized treatment with selective inhibitors, which, if used well, offer exceptional and long-term opportunities for treatment in patients. Acute leukemia for both relapsed and debilitated patients – says Giovanni Martinelli, scientific director of the Dino Amadori Scientific Institute in Romania for the Study of Oncology, IRST in Meldola -. It is therefore necessary to carry out adequate follow-up to allow timely identification of relapsing forms. Integrated care, especially psychological support, can help improve a patient’s quality of life and increase willingness for intervention.

More psychological support

From a survey conducted in hematology centers in Italy (always part of the HEMA NET project, implemented with a non-adaptive contribution from Astellas Pharma), it is found that psychological support in many hospitals is a service supported by associations of patients and non-patients organized through the service health. In the course of treatment, psychological support is the backbone of the care of people with cancer – emphasizes David Petruzzelli, national coordinator of the FAVO Hematological Oncology Group. Fragility, uncertainty and anxiety are key words that accompany the lives of patients and caregivers on a daily basis. Our investigation has highlighted some of the critical issues that need to be intervened as soon as possible to ensure global patient care, starting with the documented benefits that integrated therapies can provide, at the same time. It also supports the intervention of physicians and the care team. Because in most patients this leukemia has a rapid and immediately aggressive onset, sufferers rapidly transition from a state of complete well-being to a state of severely impaired health. The emotional impact of the diagnosis of acute myeloid leukemia is devastating for the patient and the family – explains Felicio Ferrara, Director of the Department of Hematologic Oncology at Cardarelli in Naples -. The most common reaction is a feeling of deep distress, hopelessness, and anxiety, which subside when complete remission is achieved, and even more so, when treatment is discontinued.

Fear of relapse

In patients in remission, even after completion of a treatment program that often includes allogeneic transplantation, there is uncertainty due to the likelihood of disease recurrence. In our experience, the fear of recurrence is evident in the occasion of periodic monitoring tests, which was triggered as a specific response to the experience of a cancer diagnosis and the need for retreatment, even invasive treatments – Ferrara adds -. In fact, one of the most frequently asked questions relates to the possibility of new treatments that are less aggressive and more likely. These elements strongly emphasize the need to provide patients with structured and continuous psychological support over time. Integrated care and psychosocial support, at different stages of an individual’s journey, are valuable and useful tools for those directly involved and for a healthy system: Monitoring a cancer patient is of primary importance not only in the active phase of the disease but also in the follow-up phase, when intercepting a relapse quickly or less can have direct consequences for a person’s life, concludes Elisabetta Ianelli, FAVO General Secretary and AIMAC Vice President.

Jul 5 2022 (change on Jul 5 2022 | 18:34)

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