Overview for Acute Lymphocytic Leukemia (ALL) Treatment in India

Introduction:

Acute Lymphocytic Leukemia (ALL) is a type of blood cancer that primarily affects adults. The mainstay of treatment for ALL involves a comprehensive and multi-phased approach, primarily centered around long-term chemotherapy. Recent advancements in intensive chemotherapy regimens have shown increased response rates, albeit with a higher likelihood of side effects. The treatment typically spans three phases: Induction, Consolidation, and Maintenance, spanning approximately two years.

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Induction Phase:

The primary goal of induction chemotherapy is to achieve complete remission, where leukemia cells are undetectable in bone marrow samples. This phase typically lasts around a month and employs a combination of chemotherapy drugs, including Vincristine, Dexamethasone or Prednisone, and anthracycline drugs like Doxorubicin or Daunorubicin. Additional drugs may be included based on prognostic factors, such as Cyclophosphamide, L-asparaginase, high doses of Methotrexate, or Cytarabine. For patients with the Philadelphia chromosome, targeted drugs like Imatinib or Dasatinib may be incorporated.

Central Nervous System (CNS) Prophylaxis:

Given the potential for ALL to spread to the brain and spinal cord, CNS prophylaxis is initiated during induction, continuing through subsequent phases. This may involve intrathecal chemotherapy, high-dose IV chemotherapy, or radiation therapy to the brain and spinal cord.

Consolidation Phase:

If remission is achieved, the consolidation phase involves another intense round of chemotherapy, often utilizing drugs from the induction phase. CNS prophylaxis continues during this phase. For high-risk patients, especially those with certain subtypes or poor prognostic factors, an allogeneic stem cell transplant (SCT) may be recommended.

Maintenance Phase:

Following consolidation, maintenance chemotherapy with drugs like Methotrexate and 6-mercaptopurine is administered for about two years. Patients with the Philadelphia chromosome may receive targeted drugs like Imatinib. CNS prophylaxis remains a part of this phase.

Response Rates:

Approximately 80% to 90% of adults achieve complete remission during treatment. However, relapse occurs in about half of these cases, resulting in an overall cure rate of around 40%, varying based on ALL subtype and prognostic factors.

Relapse or Refractory Cases:

In instances of refractory leukemia, more intensive or novel chemotherapy approaches may be attempted. Immunotherapy, such as monoclonal antibodies or CAR T-cell therapy, may be considered, as well as stem cell transplantation. Clinical trials exploring new treatment options could be an alternative.

Palliative Treatment:

For cases where further curative treatment is unlikely, the focus may shift to palliative treatment, aimed at controlling leukemia and managing symptoms. This may involve less intensive chemotherapy, pain relief through radiation and medication, correction of blood counts, fatigue management, and addressing infections.

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Conclusion:

The treatment journey for ALL in adults is a complex and phased process, emphasizing the importance of personalized approaches and ongoing research to enhance therapeutic options and improve outcomes.

FAQs:

Q1: What is the typical duration of the induction phase in ALL treatment?

A: The induction phase, focused on achieving complete remission, usually lasts around a month. The duration may vary based on individual response and medical considerations.

Q2: Are there alternatives for patients unable to tolerate intensive chemotherapy during induction?

A: For older patients or those with health concerns, similar drugs are used in induction, although doses might be adjusted. Close monitoring and supportive care help manage potential complications.

Q3: How does CNS prophylaxis work, and when is it administered?

A: CNS prophylaxis involves treatments like intrathecal chemotherapy, high-dose IV chemotherapy, or radiation therapy. It is initiated during induction and continues through subsequent phases to prevent or address CNS involvement.

Q4: What options are available for patients at high risk of relapse during the consolidation phase?

A: High-risk patients may be considered for allogeneic stem cell transplant (SCT) during consolidation. The decision is based on individual factors and donor availability, especially for those with a sibling match.

Q5: How long does the maintenance phase typically last, and what does it involve?

A: Maintenance chemotherapy spans approximately two years, employing drugs like Methotrexate and 6-mercaptopurine. Patients with the Philadelphia chromosome may also receive targeted drugs like Imatinib during this phase.

Q6: What happens if leukemia relapses after initial treatment?

A: If relapse occurs, treatment strategies vary. For late relapses, similar treatment may be attempted, while early relapses might necessitate more aggressive chemotherapy or alternative approaches like immunotherapy. Stem cell transplantation is often considered if a second remission is achieved.

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BLK-Max Hospital

Number of beds: 700
ICU Beds: 175
Airport Distance: 13 Km

About Hospital:

BLK Super Speciality Hospital was established by Dr. B.L. Kapur in 1959. It was inaugurated by the then Prime Minister of India, Pandit Jawahar Lal Nehru.
BLK Super Speciality Hospital was established by Dr. B.L. Kapur in 1959. It was inaugurated by the then Prime Minister of India, Pandit Jawahar Lal Nehru.
BLK has a unique combination of the best in class technology, put to use by the best names in the professional circles to ensure world-class health care to all patients.

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Spread on five acres of land, with a capacity of 700 beds,
BLK Super Speciality Hospital is one of the largest tertiary care private hospitals in the country,
BLK has consistently ranked amongst the Top 10 Multi Super Specialty Hospitals in Delhi NCR.
The outpatient services are spread on two floors with 80 consultation rooms. All ambulatory services have been designed with the intent to create dedicated aides for all specialities, with their interventional services in close vicinity.
The hospital has 17 state-of-the-art well equipped modular operation theatres with three-stage air filtration and gas scavenging system to ensure patient safety. All the Operation Theatres are fitted with best in class pendants, operating lights, anaesthesia workstations and advanced information management system.
The Hospital has one of the biggest critical care programmes in the region with 125 beds in different intensive care units viz Medical, Surgical, Cardiac, Paediatrics, Neonatology, Neurosciences and Organ Transplant.
Each Critical care unit is equipped with high-end patient monitoring devices, ventilators and dedicated isolation rooms.
Liver and Renal Transplant Centres have been equipped with dedicated ICUs with individual HEPA filters, specialized instruments and equipment.
Awarded the Prestigious Gold Award at Hospital Management Asia (HMA), Bangkok (2013) and HMA Awards 2014.

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Indraprastha Apollo Hospital

No. of beds: 900
ICU Beds: 262
Airport: 20kms

About Hospital:

Indraprastha Apollo Hospital is a flagship hospital of India’s foremost healthcare groups,the Apollo Group. It is a highly renowned multi-speciality facility that offers tertiary and quaternary care services to domestic and international patients.
The 900 bedded hospital is outfitted with the most modern technology for diagnostics as well as therapeutic purposes.
A team of highly trained medical professionals work under all the 52 specialities at the hospital.

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Indraprastha Apollo is an accredited hospital with international standard quality services for patient care and safety norms.
The hospital uses its own system, called The Apollo Standards of Clinical Care (TASCC), to maintain top standards for all kinds of treatment and procedures.
The Apollo Organ Transplant Program is one of the most successful programs in the country that has performed over 1627 transplants (410 Liver and 1210 Kidney), including 979 transplants (289 Liver and 690 Kidney) performed at the Transplant Program in Delhi.
It is the First Hospital in India to perform a Paediatric Liver Transplant in 1998. They have successfully performed various kinds of liver transplant for different kinds of liver conditions.
Indraprastha Apollo Hospital has some world-reputed surgeons and specialists who are the pioneers of their specialities, especially in Cardiology and Neurology.
The hospital has won many national and international accolades and continues to be one of the top healthcare service providers in India.
It is the first hospital in India to get international accreditation by international (JCI) consecutively for the fourth time

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Max Hospital Saket

Number of beds: 500
ICU Beds: 267
Airport Distance: 13 KM

About Hospital:

Max Super Speciality Hospital at Saket is one of the topmost healthcare service
Providers in India. The multi-super speciality hospital has a capacity of over 500 beds, 250 functional beds. It is equipped with state-of-the-art facilities, advanced technologies.
With the help of over 300 leading specialist Doctors, strong nursing staff, and state-of-the-art innovative medical tools.

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Max Hospital, Saket aims to provide the highest standard of medical care to the patients, right from admission and all the way to the patient discharge.
Max Smart Super Speciality Hospital, Saket, offers the advantage of integrated medical care in a multidisciplinary setting provided by a faculty of highly qualiﬁed doctors, nurses, & healthcare professionals.
Max Smart Super Speciality Hospital, Saket, is a regional hub for complex procedures such as neurovascular intervention, targeted cancer treatments, heart surgeries, orthopaedic surgeries, liver & kidney transplant, and fertility treatments.
With over 35 Speciality units, this renowned hospital caters to many patients from different parts of India as well as abroad on an everyday basis.
The super specialty hospital is well known for having Asia’s first and the world’s third BrainSUITE technology.
It is an advanced Neurosurgical operation theatre, which allows the medical team to use MRI during the surgery. This sophisticated technology can be used for various kinds of brain surgery.
Max Hospital group is also the first super speciality tertiary care centre that has the facility for advanced cardiac life support ambulances and air evacuation service.

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Artemis Hospital Gurgaon

Number of beds: 600
ICU Beds: 185
Airport Distance: 19 Km

About Hospital:

Artemis Hospital, established in 2007, spread across 9 acres, is a 600plus bed; state-of-the-art multi-speciality hospital located in Gurgaon, India.
Artemis Hospital is the first JCI and NABH accredited hospital in Gurgaon.
Designed as one of the most advanced hospitals in India, Artemis provides a depth of expertise in the spectrum of advanced medical & surgical interventions, a comprehensive mix of inpatient and outpatient services.

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Artemis has around 400 + best doctors. It has put modern technology in the hands of renowned doctors from across the country and abroad to set new standards in healthcare.
The medical practices and procedures followed in the hospital are research-oriented and benchmarked against the best in the world.
Top-notch services, in a warm, open patient-centric environment, clubbed with affordability, has made us one of the most revered hospitals in the country.
Most Promising Start-Up of the Year 2007 award – Express Healthcare magazine
Best IT Implementation for the Year 2008 – PC Quest magazine for Hospital Information System
Best institute for Medical Value Year 2010 – The CNBC Awaaz travel awards
Asia Pacific Hand hygiene excellence Award Year 2011 – World Health Organisation (WHO)
The patient base is 400000
750000 surgeries conducted since the inception

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Medanta Hospital Gurgaon

Number of beds: 1250
ICU Beds: 300
Airport Distance: 18 KMs

About Hospital:

Medanta – The Medicity is amongst India’s largest and most renowned multi-super speciality healthcare centre with 1250 beds, 29 super speciality units and more than 800 accomplished doctors.
Supported by state-of-art infrastructure, all the departments in the hospital are fully equipped with cutting-edge technology, modular Operation Theatre and modernized monitoring systems in ICUs.
The panel of doctors from Medanta, headed by A.S.Soin performed the first successful intestinal transplant in India.

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The team of Medanta has performed over 15,000 cardiac surgeries and 2500 joint replacement surgeries.
It Has performed over 500 living donor liver transplants. It is the highest number of liver transplants done in India and the 2nd highest in the world.
Further to its credits, the doctors at Medanta are highly trained experts with international repute and have contributed in making world records and claimed many firsts not only in India but on a global scale.
It has all kinds of procedures like Liver transplant, intestine,transplant and Knee Replacement surgery.
The hospital maintains a high standard of quality clinical care and is operational with the latest technologies like 256 Slice CT, Brain Suite with Intraoperative MRI Imaging, Da Vinci a surgical system with Robot for Minimally Invasive Surgery, Artis- Zeego Endovascular Surgical Cath Lab- with combined operating room.

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Providing total cost including treatment, air tickets, accommodation, and food
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Booking accommodation and guest house as per your budget/ prefrence
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Fortis Hospital Gurgaon (FMRI)

Number of beds: 1000
ICU Beds: 298
Airport Distance: 17 KMs

About Hospital:

Fortis Memorial Research Institute was established in 2001.
It is an outstanding multi-speciality quaternary care hospital,having the top-notch infrastructure, advanced equipment, highly qualified and experienced medical professionals and super sub-specialists.
Fortis Hosptial Gurgaon is an advanced centre of excellence in Robotic Surgery, Neurosciences, Oncology, Renal Sciences, BMT, Organ Transplants, Orthopaedics, Cardiac Sciences and Obstetrics & Gynaecology.

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JCI & NABH Accredited Hospital, NABL Accredited Lab, NABH Certified Nursing Excellence, NABH Accredited Blood Bank
FMRI is a 1000 bedded and 15 Operation theaters and over 400 diagnostics centres (including JVs).
Medical facility endowed with a dedicated team of 200 world-renowned doctors, covering a number of specialities, who aim to provide the best quality medical care to all the patients, national as well as international.
This hospital is well set up with the latest technologies and equipment throughout all the specialties and research labs, which are accredited by NABL.
This ensures that the patients at FMRI receive diagnostic results and treatment with high accuracy and in minimum time.
With a vision for the community, FMRI operates various speciality clinics such as, for Paediatrics, Nephrology, Neurology, Gynecology, Orthopedics, Oncology and many more, which provide long term healthcare management and follow up care.
FMRI is the premium healthcare provider and endeavours to be known as the “Mecca of Medicine” – the ultimate healthcare destination.

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Sanar International Hospital

Number of beds: 130
ICU Beds: 35
Airport Distance: 20 Km

About Hospital:

Sanar International Hospital was established in 2018.
Sanar International Hospital founded by Mr. Naresh Kapoor.
Sanar International Hospital offers comprehensive advanced surgical care in specialties like Cancer, Heart, Blood and Marrow Transplant, Lung, Liver, and Neurosciences along with other major departments with advanced state-of-the-art facilities.

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It establishes itself as a center of excellence with world-class infrastructure, a team of experienced surgeons, doctors, and nursing staff.
Sanar International Hospitals is not only leaving a mark amongst domestic patients but also making it a preferable choice for patients from other countries.
Sanar International Hospital offers comprehensive advanced surgical care in over 15 Specialties.
The hospital’s skilled faculty is on numerous medical clinical & advisory boards and lectures nationally & internationally on a regular basis.
It focuses on High-End Complex Surgeries with cutting-edge technology to enable the carrying-out of the most complex surgical procedures with clinical excellence at par with anywhere in the world.
All facilities are based on the latest revolutionary and technological advancements of global standards particularly in radio diagnosis, research, clinical and surgical practices.
Hospital technology & Radio Diagnostic foray is of the latest generation of MRI, CT, Digital X-Ray, Ultrasound, pharmacy, ambulance & 24 hrs Transfusion Medicine, Laboratory & Emergency services.

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W Pratiksha Hospital

Number of beds: 110
ICU Beds: 31
Airport Distance: 19 KMs

About Hospital:

Established in 1995, W Pratiksha Hospital is a 110+ bedded flagship hospital of the Pratiksha group.
W Pratiksha Hospital in Gurgaon, the flagship hospital of Pratiksha Group is a one-of-its-kind facility in Gurgaon that brings to you 30 years of experience.
The hospital has treated more than 25,000 people In 2018.

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The chairman of the Pratiksha group – Dr. Pramod Kumar Sharma is one of the pioneers of IVF treatment.
The hospital has done more than 5500+ IVF success
It is an accredited hospital with NABH,& NABL.

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Accord Superspeciality Hospital

Number of beds: 380+
ICU Beds: 41
Airport Distance: 46 Km

About Hospital:

The story of Accord began with the thought of leveraging the new age technology with the healthcare infrastructure to serve the patients, rightly, effectively, and timely.
Accord Superspeciality Hospital (A Unit Of SCL Healthcare Pvt. Ltd) is India’s first smart hospital and one of the first of its kind in the world.
Accord Superspeciality Hospital aims at providing technologically advanced healthcare services to international patients who are looking out for medical tourism in India.

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It delivers world-class patient care services.
Highly experienced team of super specialist available at accord superspeciality hospital
It believes in enhancing the expertise of doctors through the use of augmented artificial intelligence, generated through various systems and software.
Its smartness is the result of a super-brain that accompanies the hospital.

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Aakash Health Care Delhi

Number of beds: 230
ICU Beds: 70
Airport Distance: 10 Km

About Hospital:

Aakash Healthcare Super Speciality Hospital is a tertiary care facility, with 15 Dialysis, and 70 Critical care beds for treating the most complex cases in the National Capital Region (NCR) of Delhi, Dwarka.
The hospital is equipped with state of the art infrastructure, latest technology, competent clinicians and compassionate staff.
Aakash Healthcare Super Specialty Hospital is known for its leading care in Orthopaedic and Joint replacement surgery.

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The hospital also has a 24×7 ‘Trauma & Emergency Center’, blood bank, with state of art Neonatal and Paediatric ICU.
The Super Specialty Hospital is being managed by highly qualified and trained experts from their respective fields and a unified team of healthcare experts ensure 24×7 comprehensive patient care
The Hospital has deployed high-end technologies and smart digital systems along with robust Hospital Information Systems to address complex medical needs and convenience of patients.
Mr. J C Chaudhry is the chairman of Hospital and Dr. Aashish Chaudhry is Managing Director, who is also a renowned Orthopedic Surgeon in this region.
Total number of surgeries done is 25000+ till now.

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Jaypee Hospital Delhi India

Number of beds: 525
ICU Beds : 150
Airport Distance: 32 KMs

About Hospital:

The Jaypee Hospital was conceptualized by a revered Founder Chairman, Shri Jai Prakash Gaur in 2014, with the vision of promoting world-class healthcare amongst the masses by providing quality and affordable medical care with commitment.
Jaypee Hospital at Noida is the flagship hospital of the Jaypee Group, which heralds the group’s noble intention to enter the healthcare space.
This hospital has been planned and designed as a 1200 bedded tertiary care multi-speciality facility and has commissioned 525 beds in the first phase.

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The Jaypee Hospital is constructed across a sprawling twenty-five-acre campus in Sector 128, Noida which is easily accessible from Delhi, Noida and the Yamuna Expressway.
With its best in class facilities, state-of-the-art technology, diagnostic services, and skilled doctors.

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We offers these Services

Providing a doctor’s opinion and proper quotation
Selecting the best hospital and doctor as per your case
Arranging a call with the doctor (if the case required)
Visa assistance, Providing Visa Invitation Letter (VIL)
Providing full guidance how to get Visa from your country
Providing total cost including treatment, air tickets, accommodation, and food
Assitance to book flight ticket from your country
Arranging airport pick up/ drop
Providing professional language interpreter
Booking accommodation and guest house as per your budget/ prefrence
Providing help in money exchanging
Providing local sim card
Arranging video consultation with specialist doctor if case requires

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