Molecular markers would indicate the type of treatment for Acute Myeloid Leukemia

The objective of the specialists when knowing these results is to predict the appropriate treatment and the patient’s prognosis.

Dr. Omayra Reyes Santiago, Hematologist and Oncologist at the Cayey Mennonite Hospital. Photo: Provided by the specialist to the Journal of Medicine and Public Health.

Genetic and molecular markers are increasingly reliable to help define the type of treatment that can be more effective in patients, after carrying out preliminary studies in the case of Acute Myeloid Leukemia, this was announced exclusively the Dr. Omayra Reyes Santiago, Hematologist and Oncologist at the Cayey Mennonite Hospital.

The specialist indicated that there is a strong tendency to use this marker divided into favorable risk, medium risk or high risk. “What these markers do is determine the aggressiveness of the cells and, therefore, can help predict which patients will respond better to traditional treatment or a bone marrow transplant.”

“These risks are important because sometimes we find patients with little or no disease or comorbidity and depending on the age of the patient, it will help us predict what type of treatment is best for a patient and which is not, but they also help identify the prognosis of the patient. patient”, emphasized Dr. Reyes.

Another aspect highlighted by the hematologist oncologist is that Acute Myeloid Leukemia has a high morbidity rate, due to “leukemias are not classified as we normally know solid tumors, because it is a disease of the entire blood system, therefore, the patient is told about risks”.

The doctor indicated that to date there is no clear reason why a patient tends to suffer from this condition, “most of these patients with AML develops the disease spontaneously. However, the P53 gene could be involved, since it arises from the mixture of solid tumor diseases and leukaemias”.

When the P53 gene is mutated, as pointed out by the specialist, it is known as Li Fraumeni syndrome, which is characterized by the appearance of tumors in multiple organs.

What possibly does influence the appearance of this condition is that the patient has been exposed to environmental factors or medications, “which can cause the patient to develop Acute Myeloid Leukemia. For example, chemotherapies for breast, prostate, or cancer of the lymphatic system; as well as some chemicals such as benzene or agent orange or being exposed to radiation ”.

Once the diagnosis is known, the specialist indicated that the aim is to prevent the patient’s quality of life from being affected, understanding that this disease occurs with an average prevalence in adults from 40 years of age, and with a high prevalence in adults older than 60 to 65 years.

That is to say, this type of leukemia is presented by accumulations of persistent generic mutations throughout life. On the other hand, when it occurs in children, it is usually linked to conditions such as Down syndrome.

Most common symptoms and warning signs

abnormal bleeding

Bruises or bruises, in unusual places.

Frequent infections.

Low hemoglobin.

Tachycardia.

Shortness of breath.

Excessive tiredness.

In order to determine the diagnosis, two types of tests are performed, a CBC (complete blood count), which allows the count of white blood cells, platelets and hemoglobin, and depending on the results of these, in contrast, a bone marrow biopsy is performed with the that the diagnosis can be defined, said Dr. Reyes.

Treatments

It depends on the type of risk, it is also classified.

Induction Chemotherapy: It only applies to patients with a physical condition, few chronic diseases and with the possibility of a cure. The dose of chemotherapy is supplied, to empty the bone marrow of malignant cells. Some time later, transfusions and antibiotic support are carried out, to avoid infections, for a period of up to 4 weeks.

Palliative treatment: With the aim of improving the quality of life of the patient and avoiding aggressive treatments that can generate more diseases, infections or side effects, all this with a mixture of intravenous and oral medications that can lead to the patient’s remission.

Bone marrow transplant: It depends on the patient’s condition.

– When they are not candidates, it occurs in cases of patients, older than 60 years in some cases or with diseases in important organs, lungs, heart, liver, psychiatric patients, all patients who do not have bone marrow donors.

Lastly, the specialist highlighted that at this moment in Puerto Rico the invitation to the population is for them to participate in the bone marrow donor bank, since there is not much availability at this moment, due to the fact that Puerto Ricans, due to the genetic mixture they possess cannot always be donors.

In this sense, he indicated that the process to know if a patient can or cannot be a donor is simple.

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