Acute Myeloid and Lymphatic Leukemia AML, ALL

Treatment of AML, acute myeloid leukemia patients

Our unit performs laboratory tests on blood and bone marrow. The tests we provide include: FACS antigen phenotyping, immunohistochemical staining, genetic and chromosomal analysis (such as FISH and BioView), molecular profiling (including quantitative PCR, mutations, and duplications like FLT3 or NPM1), and genetic profiling (GenChip), as needed. Biopsies of bone marrow are also taken and sent for tissue classification.
To promote and enhance remission, and in the case of rescue treatments, patients receive updated combinations of chemotherapy. Additionally, they are treated with current and novel drugs such as FLT3 inhibitors, epigenetic drugs, BCL2 inhibitors, and low-molecular weight immunological therapies.

Molecular monitoring is used to track patients' response and eliminate minimal residual disease (MRD), which has a strong prognostic value. Eligible patients are referred for allogeneic stem cell transplantation from a family member or unrelated volunteer donor with full or partial matching. Transplants can be obtained from peripheral blood, bone marrow, or cord blood.

Our unit also conducts research to identify genes and mutations for personalized treatments and investigates new drugs for AML which are still in the research stage. Hematologists specializing in acute leukemia regularly collaborate with physicians from the bone marrow transplantation department to develop tailored comprehensive treatment plans including stem cell transplantation for leukemia patients.
 

Treatment of acute lymphocytic leukemia ALL patients 

Our unit performs laboratory tests on blood and bone marrow. These tests we provide include:  Antigen phenotyping (using FACS), immunohistochemical staining, genetic and chromosomal analysis, FISH for chromosomal translocations including ph+. Additionally, we utilize the BioView molecular profiling, including quantitative PCR for BCR/ABL and mutations, as well as the GenChip genetic profile when necessary. Our molecular hematology lab, led by Prof. Gideon Rechavi and Prof. Ninette Amarillo, has obtained European certification and calibration for this purpose. In addition, we perform bone marrow biopsies and send tissue samples for classification.

For treatment purposes, we utilize advanced combinations of chemotherapy to induce and consolidate remission, and for rescue treatments. Moreover, we offer patients treatment with current and cutting-edge drugs like TKI inhibitors. We also prioritize immunological treatments using BiTE antibodies against CD19 (blinatumomab) and CD22 (inotuzumab) expressed on the surface of malignant cells.

We also perform molecular monitoring to track how patients respond to treatment and the clearance of leukemia using the minimal residual disease (MRD) method, which has shown to be a crucial prognostic factor. Moreover, eligible patients receive treatment with genetically engineered lymphocyte cells, known as CD19 CAR-T cells (chimeric antigen receptor), and we've seen remarkable outcomes in around 50 CAR-T ALL patients treated at Sheba so far.

For eligible patients, a vital part of the treatment process entails receiving a referral for allogeneic stem cell transplantation. This procedure involves utilizing grafts acquired from either a family member or an unrelated volunteer donor with full or partial matching. Regular consultations are conducted between the physicians from the acute leukemia unit and the coordinators and doctors from the bone marrow transplantation department to ensure a well-coordinated and comprehensive treatment strategy, encompassing stem cell transplants for leukemia patients.