New hope for those affected by monoclonal antibodies obinutuzumab.
What is the life expectancy in chronic leukemia ? New therapy methods give CLL and CML patients new hope.
Just a few years ago, chronic leukemia meant premature death, but by inventing new drugs, scientists gave CML patients hope of a normal long life. The monoclonal antibody obinutuzumab discovered a few years ago promises to increase the life expectancy of people suffering from chronic lymphatic leukemia. This is part of the drug Gazyvaro ® , which was approved in 2014 for untreated CLL .
Life expectancy in chronic lymphocytic leukemia
Life expectancy and the choice of therapy depend on many different factors. Binet’s stadium classification is helpful for the assessment.
Life expectancy stage A:
- Stage A:
The life expectancy of patients suffering from chronic lymphocytic leukemia is more than ten years if the doctor detects the disease in stage A. At this point, CLL affects fewer than three lymph node regions.
Life expectancy stage B:
- Stage B:
If the doctor discovers the disease in the second stage, the patient lives an average of seven years. More than three lymph node regions are affected.
Life expectancy stage C:
- Stage C:
When CLL reaches the third stage, there is a shortage of red blood cells ( erythrocytes ) and blood platelets (thrombocytes). From this point in time of the lymphatic form of chronic leukemia, life expectancy is twenty months.
Doctors slow down the progression with chemotherapy and immunotherapy. The therapies have so far not been able to cure the lymphatic leukemia, but have been able to inhibit its growth. In this way, CLL can be controlled for many years. Chemotherapy is drug-based with cytostatics. Immunotherapy consists of genetically engineered immunoglobulins.
In stages A and B, the patient is usually free of symptoms. Treatment would bring no benefit. Therefore, during these stages, the doctor’s task is to monitor (watch and wait). If symptoms appear, he starts the therapy.
If the patient is in stage C, the doctor treats him with gentle cytostatics. Antibiotics support the therapy of infections. Further therapeutic measures consist in the administration of thrombocyte and erythrocyte concentrates. Doctors hope that modern therapy with monoclonal antibodies (example: rituximab) will prolong the life of their patients. The physicians may combine this remedy with cytostatics.
New hope for CLL patients
For a long time, chronic lymphocytic leukemia was considered incurable. Stem cell transplantation was not an option due to the high risks. Modern procedures are now giving hope to many patients over the age of 65.
The German CLL study group proved in their multi-centre phase II clinical study that it is possible to heal older patients with a stem cell transplant. The study was led by Professor Dr. Peter Dreger. At the time of the study, he held the position of senior consultant and head of the stem cell transplantation section at the “Medical Clinic V of the University Hospital Heidelberg”. The press office of the mentioned house reported about it in September 2011.
In 2013 there were reports of success from research. n-tv.de raised new hopes for CLL sufferers. The headline was “Fight against leukemia – new drug extends life expectancy”.
Chronic leukemia is losing its horror. In 2013, Professor Michael Hallek, leading scientist in the field of CLL research and head of the German Study Group at the University of Cologne, firmly believed in great progress in the next ten years. He showed so much optimism as he tested the new antibody GA101 (Obinutuzumab). This proved to have few side effects and was significantly more effective than the antibody rituximab previously used.
American researchers have also developed a new drug that, like that of the University of Cologne, significantly extends the life expectancy of people suffering from chronic lymphatic leukemia and significantly improves their quality of life.
In November 2013, the FDA classified the monoclonal antibody obinutuzumab as a “breakthrough” and accelerated its legitimacy as a drug against CLL. On May 22, 2014, it received the recommendation for EU-wide approval from the Committee for Human Medicinal Products of the European Medicines Agency EMA. In July 2014, Gazyvaro ® (trade name of Obinutuzumab) received approval for the treatment of previously untreated CLL.
Life expectancy in chronic myeloid leukemia
Chronic myeloid leukemia ( CML) used to be considered incurable. Today, drugs extend life expectancy. Fifteen years ago, the 6-year survival rate was 60 percent. With today’s therapy options, the patient assumes a normal life expectancy. Then as now, an allogeneic stem cell transplant promised chances of recovery. The procedure poses a great risk for the patient because the weakened immune system threatens serious infections.
In contrast to CLL, treatment for CML begins immediately after the disease is discovered. Tyrosine kinase inhibitors such as imatinib can be used. This inhibits the BCR-ABL tyrosine kinase. Alternatives are dasatinib and nilotinib. Mistakes in taking prevent the success of the therapy.
Another treatment option is chemotherapy in combination with interferon. If the medication begins in the early phase of CML, more than fifty percent of those affected achieve full remission (complete resolution of the symptoms of the disease).
All drug therapies are lifelong, otherwise the disease will flare up again.
Additional information
http://www.klinikum.uni-heidelberg.de/ShowSingleNews.176.0.html?&no_cache=1&tx_ttnews%5Btt_news%5D=5803
