[Treatment of acute and chronic leukemias]

Abstract

In the last decade the use of new drugs (retinoic acid, interferons, purine nucleoside analogs etc.) had only minimal impact in the evolution of leukemia management. In most cases, therapeutic options have progressed because of advances in supportive therapies and optimization of old chemotherapeutic strategies. Several experiences with autologous bone marrow transplantation (BMT) have proved that in acute leukemias and in selected patients with chronic leukemias is a valid alternative to allogeneic BMT. The availability of hematopoietic stem cells from unrelated donors and from cord blood, has overcome difficulties related to the absence of a suitable HLA identical sibling donor. Modern therapeutic approaches point to tailor treatment intensity according to risk categories, defined by clinical and biological parameters at diagnosis. In this context, the prognostic role of karyotypic lesions is under investigation.