Late diagnosis, high costs driving blood and bone marrow cancer cases: Experts

Late diagnoses and high costs are driving cases of acute myeloid leukaemia (AML) — an aggressive form of blood and bone marrow cancer, said health experts.

After the US and China, India reportedly had the highest number of cases of AML in 2021.

According to health experts, early screening, accurate diagnosis and timely initiation of treatment are extremely important to improve survival rates.

“We lose critical time because AML is detected late in our country and often masquerades as fatigue or infection. By the time the right tests are done, the disease has often progressed to a stage where treatment options are limited or less effective,” Dr. Ranjit Sahoo, D.M. (Medical Oncology) Professor (Additional) at All India Institute of Medical Sciences (AIIMS), told IANS.

While acute leukaemia can be detected by a simple blood test, “the treatment of AML is carried out at tertiary centres and the cost of supportive treatment is high,” the expert said.

For many patients, the onset is silent, the symptoms of AML are vague, and the window for intervention is tragically narrow.

Many patients also delay treatment due to financial constraints or seek care in late stages when treatment is less effective.

“AML, while rare among all haematological malignancies, is the most feared one. It has an excellent chemotherapy combination for control of disease, including deep remission (control, not cure), but is fraught with complications, including life-threatening ones due to severe infections and bone marrow suppression,” said Dr. Abhay A. Bhave, a haematologist, from a Mumbai-based hospital.

Bhave noted that “AML can be a relapsing, relentless disease based on the genes that cause this disease”.

Traditional chemotherapy, the mainstay of AML treatment, has often been poorly tolerated, especially in older patients. However, the emergence of targeted therapies — which act on specific genetic mutations driving the disease — has dramatically improved remission rates, reduced toxicity, and enhanced quality of life for patients globally.

However, these are often expensive; and bone marrow transplantation is also not easy to obtain, the doctors said.

Dr. Punit L Jain, a leukaemia specialist at a Mumbai-based hospital stated that 60 per cent of AML patients arrive in advanced stages with infection and bleeding, impairing treatment methods.

The experts suggested integrating AML into the national cancer control strategy and expanding access to diagnostics may be necessary to boost awareness as well as treatment outcomes. They also called for including AML-targeted therapies in Ayushman Bharat and private insurance schemes to ease out-of-pocket expenditure for patients; and to support clinical research and trials.

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