Pediatric hematologist/oncologist Deepa Bhojwani shares her insight on the latest developments in the treatment of acute lymphoblastic leukemia (ALL).
Discovery of high-risk subtypes of ALL
Historically, a subtype of acute lymphoblastic leukemia (ALL) known as Philadelphia-chromosome positive ALL had been difficult to treat, but the addition of new drugs like imatinib has resulted in improved cure rates. Recently, by genomic studies, another high-risk subtype of ALL was discovered, called “Philadelphia-chromosome-like ALL” (Ph-like ALL). The frequency of this subtype increases with age, and is more common in adolescents and young adults. Researchers are unravelling several genetic alterations associated with Ph-like ALL, some of which may be targeted by drugs that are already available. The development of widely accessible tests to identify Ph-like ALL is ongoing. By understanding the biology of different types of ALL, treatment can be individualized, which will ultimately lead to improved outcomes.
Survivorship Series: New Jersey musician shares his story and the song he wrote to thank his brother for saving his life
Well, times were dark indeed
Feeling my body betrayed me
Life was good. My wife Bonnie and I were settling into a lifestyle that was becoming less demanding and more fun. Our only son was about to graduate college. My son and I were making music together and playing some local clubs and bars. I was physically active and worked out regularly.
I had recently made changes to my diet due to a history of slightly high cholesterol and was curious to see what effect (if any) it would have. A routine blood test told me that my cholesterol was well within normal range, but my red, white and platelet counts were all low. I was convinced the lab had somehow screwed up the test. I felt fine. After a repeat test, same result. I was referred to a hematologist. When I called they answered something like "Cancer Center." Uh Oh. Not good.
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Check back for blogs by survivors telling their own stories
So you’re in remission and you can officially call yourself a cancer survivor. Congratulations for making it through the hardest part of the journey. Now you may be thinking “What comes next?”
Most people don’t think about survivorship until they finish treatment. And it’s only much later, when there hasn’t been a recurrence and they’re not thinking about the cancer so much, that they really contemplate long-term survival. At that point, there can be many questions: What can I do to make sure it doesn’t come back? What if it does? Will I have issues or late or long-term effects from treatment?
The post-cancer recovery period is all about finding a new normal, said Patricia Ganz, M.D., professor of medicine and associate director of the Cancer Center at University of California at Los Angeles: “What will life be like? Who can I count on? Who don’t I want to spend time with? Who brings positivity into my life? Who brings negativity?”
What we’ve learned is it’s not over when it’s over, Ganz said. Survivors may face ongoing symptoms or problems resulting from their initial treatments — pain, fatigue, late effects such as second cancers or organ dysfunction, as well as other chronic diseases. There needs to be a focus on prevention, symptom management, emotional support, and healthy living – and it’s best that the oncologist share the care with a primary care physician.
