Emilio Ignacio García, head of the SECA Research Projects.
Specialists warn that it is crucial that the time between the diagnosis of an acute myeloid leukemia and the start of treatment is less than five days. This has been shown in the European Week against Leukemia, the Spanish Society for Healthcare Quality (SECA), with the participation of the Miguel Hernández de Elche (UHM) and Cádiz (UCA) universities and the collaboration of Astellas.
During this meeting, the experts presented the consensus document Indicators and standards for quality care for patients with acute myeloid leukemia. A work that was born with the objective of lay the foundation for integrated care for patients with acute myeloid leukemia from the identification of the key milestones in its monitoring and the establishment of quality and clinical safety standards.
For the elaboration of this consensus document, four key milestones to take into account in the process of caring for patients with acute myeloid leukemia: diagnosis, multidisciplinary committee, treatments and follow-up.
According Emilio Ignacio Garcia, responsible for the SECA Research Projects, “the time between diagnosis and the start of treatment is crucial to be very short, it must be less than five days, that the patient has a diagnosis integrated in a maximum of 30 days, and that the cytometry is performed in the first 24 – 48 hours “, he says.
More than 6,000 cases of leukemia a year in Spain
The Spanish Society of Medical Oncology (SEOM) estimates that more than 6,000 cases of leukemia per year in Spain, which is a cancer of the hematopoietic tissue, such as the bone marrow. Although there are four subtypes of this type of tumor: acute myeloid leukemia, chronic myeloid leukemia, acute lymphocytic leukemia and chronic lymphocytic leukemia.
Specifically, acute myeloid leukemia is the most common type of leukemia in adults, representing 40 percent of all leukemias in the western world, with a worldwide incidence of 3.7 cases per 100,000 inhabitants.
Acute myeloid leukemia is the most common type of leukemia in adults
Although a high percentage of patients with AML will respond to initial treatments, approximately 20 percent will have disease refractory to treatment and more than 50 percent will relapse. The prognosis in these patients is bleak, with survivals of between 6 and 9 months.
Certain mutations, such as the FLT3-ITD mutation, confer a particularly negative prognosis, with a higher proportion of relapses and lower survival rates than those patients who do not have this mutation.
Quality and safety in treatments
“With this work we have been able to detect the barriers that we find to achieve offer quality and safety care to the patient with acute myeloid leukemia, as well as the failures or errors that occur in daily clinical practice ”, highlights García, who adds that the median age of patients with AML is 64 years and most of them are in the range of 60–75 years. years.
The work also highlights the importance of having a consensual protocol for cytogenetic diagnosis and molecular of patients with AML where the minimum tests for the correct clinical management of these patients are established. “These genetic tests must be carried out in the first week the patient is seen,” says Inmaculada Mediavilla, president of the SECA.
Likewise, “the existence of a protocol for interdisciplinary management of pathology (Hematology, Critical Care, Nutrition, Infectology, Internal Medicine, Palliative, Pharmacy, Radiology, Microbiology) is a more than important aspect when managing the AML approach ”, he warns.
Involving patients in treatment
The specialists involved in the elaboration of this consensus point out the need to involve patients in certain decision-making. “aIt will always be a very successful action to improve their diagnosis and favor the incorporation of the appropriate treatments, ”says Dr. Mediavilla, who warns of the need for a representative of these patient associations in the multidisciplinary committee, which would help to make a correct diagnosis. and proper treatment.
On the other hand, specialists warn of the lack of proper health education for caregivers and the patient, and that is reflected in the report. In this sense, professionals must deal, not only with aspects related to diagnosis and treatments, “aspects that we call aspects of scientific-technical quality”, points out the head of Research Projects of the SECA, but they must also incorporate the patient in decision-making and inform and educate them of all the aspects that they must know in order to manage their disease in the best possible way.
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