JOIN USFrom fatal to fortuitous
Leukaemia, commonly known as blood cancer, is one of the most common cancers that occur in children worldwide accounting for up to 80% of all the cancers with Acute lymphoblastic leukaemia taking the number one spot (75 to 80%) followed by Acute myeloid (15%) and chronic leukaemias (5%).
The history of leukaemia traces back to the 1800s when it had remained a devastating terminal illness with no cure other than death till the 1960s. During that time, a series of medicines to cure this disease were being discovered, however, this path has over the years witnessed a lot of scientific research and trials.
Leukaemia treatment has been one of the most successful stories in modern medicine. It was known to be a disease with no cure before the 1960s, to a disease that had transient cure up to the 1970s, and then to a highly curable cancer (up to 85-90%) in the present times.
Now, a child with leukaemia is diagnosed and treated with very high chances of complete cure and gifted a second chance of normal healthy life. This milestone has been achieved over the decades due to persistent herculean scientific efforts and a thirst to find a cure for this disease. There have been key strategies that have resulted in achieving such marvellous results. To name the important ones: the primary being the discovery of drugs that could cure the disease. It was not just a single drug but a combination of them that could produce remission. This paved the way to strategies that meticulously time scheduled these drugs and the duration of the treatment which helped in maximally utilising the available drugs.
The major breakthrough was when biology ie., how leukaemia behaves in a child, was established as we are constantly learning about the human body and also robust diagnostic and therapeutic testing tools that became largely available allowing for a more rapid scientifically sound diagnosis at the molecular level which helped in stratifying children into low, intermediate and high risk. This paved the way to modulate the intensity of the treatment plan as per risk strata thereby sparing a subset of patients from unnecessary intense treatment, side effects and costs.
Therapeutic (response assessment) testing tools help us to understand the depth of cure at a molecular level in every individual patient, thereby helping in customising the treatment process and also accurately predicting the cure rate. Along with these tests, there has been the introduction of highly curative drugs and robust supportive care be it antibiotics, availability of blood products, nutrition, which has tremendously helped in improving the cure in children in India. Currently, the availability of bone marrow transplants at many cancer centres in India, which are meticulously conducted is required only for a small subset.
Though we all have come a long way, our survival rates still take a back seat compared to the western data due to various logistics and socio-economic reasons. However, the effort continues to find logical, scientifically sound and customised methodologies to fit in our local scenarios as the motivation is a tremendous belief that every child with leukaemia deserves a second chance of living a normal life.
(The author is a paediatric oncologist.)