Success gives hope to children with leukemia resistance, in which conventional drugs do not work.
The most common oncology in children is acute lymphoblastic leukemia. For 50 years the chance of a lasting 4 out of 90 is expected to increase. Scientists are enthusiastic: immunotherapies change the paradigm for treatment
It is normal that the heart of each parent shrinks from disgust when he or she hears that his child is sick of leukemia. For a moment the ground is open under his feet and absorbs his whole life. Until the horror is likely to be timid with the surrealist words of the doctor. He will say something that is not news for specialists in developed countries: nowadays most children achieve permanent remission or practical healing.
New therapies increase the chances even for acute leukemia that has proved insensitive to standard treatments. 19659005] In the history of medicine the struggle to prevail over childhood cancer of blood is a 50-year-old fairy tale with an unexpected, once-lucky development
Cancer is not only many species but also has dozens of subspecies with specific characteristics at different ages. For example, carcinomas are the most common tumors in adults, but they will hardly occur in the first years of life. The most common oncological condition in children – one in four cases, is acute lymphocytic (lymphocytic) leukemia. The most important difference in cancer in children and later, however, is the outcome of the therapy. The 5-year survival rate for juveniles is on average 88.4%, with some cancers approaching 100%
. It is all the more remarkable that since the 1960s, therapeutic success in the treatment of acute lymphoblastic leukemia by 4% survive on the 5th year is already more than 90%. Lymphomas also have an impressive success – the survival of non-Hodgkin increased from 7 to 85%, in the case of the chickens, from 50 to more than 90%. This was announced by Prof. Dobrin Konstantinov, national advisor in pediatric hematology and oncology, chairman of the Bulgarian medical society for pediatric hematology and oncology and head of the specialized clinic in the university hospital "Tsaritsa Yoanna – ISUL". The specialty combines benign and malignant blood disorders and solid tumors in children, which are considered relatively rare in the context of the incidence of these diseases in adults. In children, the approaches to these diseases are identical or very close, and since the 1970s the world has embraced the model in which the treatment is carried out by a children's team. Certified centers for Child Oncohematology are located in Tsaritsa Yoanna – ISUL and the university hospitals in Plovdiv and Varna.
At various stages of science, the disease is mainly associated with electromagnetic radiation, radiation, genetic mutations, the onset of oncogenesis of infectious diseases, inadequate excessively reacted infant immune system due to too sterile education in early life years and dozens of hypotheses
exact mechanism is still a challenge for science, says Professor Tantinov.
of first in the oncology opinion that radical treatment occurs in complete razkonspirirani process of generating cancer. However, it is possible that science is approaching it on shipping routes because in recent years encouraging success in treatment has been reported more and more
In acute lymphoblastic leukemia, most children respond to standard chemotherapy, radiotherapy or stem cell transplantation to produce whole blood. But in some cases, the treatment fails to overcome cancer, or the success is temporary and the disease returns. When that happens, the chance of survival has dropped to 1 in 10. Very expensive even for medical treatment in the US The "living" medicine looks like the miracle that can reverse the trend.
World symbol of this hope became American Emily Whitehead – the first child to be treated in 2012 with the method at the Children's Hospital in Philadelphia. On May 10 she
celebrated the sixth
Today, research detects no cancer cells and a children's funded foundation for children buys funds to provide knowledge about the disease in society and high -tech to promote cancer research
"Emily lives with cancer research We are recognized and happy for every day we spend with her We have received so much and we hope to get much more in return With your help we carry The early results of clinical trials are very promising – 93% of children with recurrent acute lymphoblastic leukemia reach remission, except for leukemia, it is probably also applicable to lymphomas, and other cancers are expected to be successful, "says the parents' website. Therapy is considered to be a major breakthrough in oncology, particularly in onocratology, in resistant forms of the disease, although most patients are associated with temporary but potentially fatal complications. Apart from the hospital where Emily was treated, treatment began to administer other US children's hospitals, clinics in Canada, Australia, Norway and Belgium.
The treatment is not a pill or liquid to be taken regularly, scientists hope it is a powerful weapon with a reserve in the man who
with a one-time
procedure teaches the immune system
to to treat.
Ideally – for a lifetime. This is a type of immune therapy in which white blood cells are taken from the patient's blood to reprogram them to "see" the hidden cancer cells and attack them in their vulnerable position.
The whole process takes about 16 weeks. The "captured" millions of lymphocytes are frozen and transported to a super-technological laboratory. There they are genetically reformatted to & # 39; invisible & # 39; to detect cancer cells and attack specific proteins on their surface. Modified T lymphocytes, called chimeric antigen receptor cells, are then reinfused into the patient's veins. If everything goes well, they multiply and start to destroy the cancer. Because remodeling lymphocytes are taken from the patient's own body, there is no need for anti-rejection drugs that are needed after a classical transplant.
However, when T-lymphocytes begin to attack tumor cells, amount of cytokines. They are signaling molecules with an important role in cell communication
A cytokine tsunami
that causes a strong temperature rise to critical values and drastic blood drops. This is the most dramatic moment. But the therapy, say the oncologists, extends the limits of cancer treatment to the horizon
Emily Whitehead is the symbol of hope for success. She was diagnosed with acute lymphoblastic leukemia in May 2010 when she was only 5 years old. In fact, this is the age at which the disease shows its first peak, the second about 20 years ago. Children with her fate have an 85 to 90% chance of being cured with the therapies imposed over the past 30 years. However, Emily gets a relapse and the therapy does not work anymore. Doctors plan the last option: a bone marrow transplant that purely medically represents the infusion of healthy hematopoietic cells. A few weeks before the intervention, the disease becomes so aggressive that the transplantation becomes unthinkable. Doctors say that nothing can be done anymore. Parents Tom and Kari understand the ultimate opportunity that gives some hope for their child – a new revolutionary treatment called T-cell therapy experimenting with the children's hospital in Philadelphia
In April 2012 Emily was included in a clinical trial of the risky phase I and
was the first child in the world
with an immune system,
fight against cancer
The first reaction to the treatment is dramatic, the child runs terribly empty, more than 40 degrees and falls into a coma for 14 days. Doctors prepare the family for the worst – they give less than 1 per 1,000 Emily chance to survive the cytotoxic tsunami and the high amount of inflammatory proteins in the blood, which can lead to organ failure due to a thousand fold increase in one of the cytokines – interleukin-6. But the lead researcher has the idea of using a drug that can lower interleukin – his daughter takes it for rheumatoid arthritis. It was never used to Emily's crisis, but there was nothing to lose in her condition.
The movement turned out to be genius. Emily begins to recover within 12 hours. Later, the algorithm also works with other patients. Therefore, one of the conditions for administering the therapy is that the team has the drug that can control the side effects. In addition, clinics must be specifically
for the application of
and physicians for further training. Oncologists believe that knowing the possible complications and ways to control them significantly reduces the risk of poor development. The treatment was approved in 2017 by the Food and Drug Administration to combat certain types of cancer, making it the first authorized gene therapy. For the institution, the data are based on research data: of the 52 patients whose results were analyzed, 83% had complete remission, indicating that their cancer had disappeared. Most have experienced serious side effects, but almost all have been restored. Long term prognosis can not yet be given, so the agency recommends that patients receiving such therapy be observed for 15 years.
Emily's treatment gained worldwide attention after her story appeared in the New York Times "
The scientist at the University of Pennsylvania
Dr. Karl Jun,
leader of the
team, the most influential
figures for 2018
in the Times Magazine rankings are among the 100
and he received a new admission on Wednesday.The World Agencies announced that it was one of the three new laureates were from the award in the authoritative medical center in Albany, distinguishing the doctrine of his contribution to cancer research and the application of new promising therapies for the treatment of leukemia