Leukemia in India: Challenges and hope for children and adults

Verified by Dr. Punit Jain – Consultant Hematologist, Program Coordinator & Transplant Physician and Dr. Vipin Khandelwal – Consultant Pediatric Hemato-Oncology at Apollo Cancer Centres Navi Mumbai.

Leukemia, a cancer of the blood and bone marrow, remains a significant health concern in India, affecting both children and adults.

Understanding Leukemia

Leukemia arises when abnormal white blood cells multiply uncontrollably, disrupting healthy blood cell production. There are various types of leukemia, categorized by the type of white blood cell affected:

• Acute lymphoblastic leukemia (ALL): Most common in children, ALL affects immature lymphocytes.
• Acute myeloid leukemia (AML): More prevalent in adults, AML affects immature myeloid cells, responsible for red blood cells and other components.
• Chronic lymphocytic leukemia (CLL): A slow-growing cancer, CLL affects mature lymphocytes, primarily in adults.
• Chronic myeloid leukemia (CML): Another slow-growing type, CML affects a specific genetic mutation in myeloid cells, most commonly diagnosed in adults.

The Indian Scenario

Due to limited access to advanced diagnostics and healthcare infrastructure in some regions, early diagnosis of leukemia can be a challenge in India. However, data suggests an increasing trend in leukemia cases, particularly ALL in children. This highlights the need for improved awareness and accessibility to diagnostic tools.

Management

Upfront therapy in such hematological malignancies involve conventional chemotherapy regimens and several advances in the form of immunotherapy- drugs targeting specific mutations and even simple oral chemotherapy regimens. Bone marrow transplants are offered in high risk leukemias.

In diseases like refractory/ relapsed B cell lymphoblastic leukemias and B cell lymphomas, CAR T-cell therapy has provided a new hope.

CAR T-cell therapy: A new hope for relapsed / refractory B cell acute lymphoblastic leukemia

CAR T-cell therapy offers a revolutionary approach for certain types of leukemia. This personalized immunotherapy involves extracting a patient’s T-cells (immune cells), genetically modifying them to recognize and attack cancer cells, and then reintroducing them into the patient’s body.

Benefits of CAR T-cell Therapy

• Targeted Therapy: CAR T-cells specifically target cancer cells, minimizing damage to healthy cells.
• Potential for Cures: This therapy offers the potential for long-term remission or even a cure in some cases.
• Reduced Relapse Risk: CAR T-cell therapy shows promise in reducing the risk of relapse compared to traditional treatments.

Accessibility

CAR T-cell therapy is a novel treatment option currently available at Apollo Cancer Centres in Navi Mumbai. Apollo Cancer Centers (ACCs) has successfully completed CAR T-cell therapy in 3 patients with encouraging outcomes. ACC Navi Mumbai will now provide access to ‘Made in India’ CAR T-cell therapy, beginning with NexCAR19™ (Actalycabtagene autoleucel), for the treatment of B-cell lymphomas and B-acute lymphoblastic leukemia in patients aged 15 years and above.

Looking Forward

Leukemia in India demands a multi-pronged approach. Early diagnosis, use of treatment options like CAR T-cell therapy, and continued research are crucial for improving patient outcomes. 

Consult our experts, Dr. Punit Jain – Consultant Hematologist, Program Coordinator & Transplant Physician and Dr. Vipin Khandelwal – Consultant Pediatric Hemato-Oncology at Apollo Cancer Centres Navi Mumbai.Call 022 6280 6280 for an appointment.