Chronic Myelogenous Leukemia Treatment

Veenat capsules are anti-cancer drug which is given to the patients to treat the gastrointestinal tumors and leukaemia.

Brand Name: Veenat

Active Ingredients: Imatinib Mesylate

Strength: 100mg / 400mg.

Dosage Form: Capsules / Tablets.

Retail Pack: 30’s Bottle, 120's Bottle, 10's Blister Strip.

Manufactured By: NATCO PHARMA LTD.

Veenat is a generic formulation of imatinib 400 mg Mesylate. This is one of the 1st generic form of Imatinib Mesylate which was introduced in the world. Veenat is manufactured by Natco Pharma. Imatinib is used in treating CML (Leukemia) and gastrointestinal stromal tumors (GIST). Imatinib (Veenat) is also considered as targeted therapy.

There are many countries where Imatinib is not available or approved. Patients from those countries can import medicine on named patient bases. They have to take import permission from their Government before importing the product. They have to provide their prescription and id proof before importing the product. It is always better to check the credential of the exporter before importing the product.

There is another way for the patient to get access to generic medicines from India. Patients can travel to India for consultation with a qualified Doctor and based on the prescription, they can buy 3-6 months of therapy. Patients need to know the legal requirement of their domicile countries before taking medicine along with them. It is advisable not to buy and medicine which contains narcotic substance.

A generic medicine is a broad term. There might be many generic products available for one molecule. The patient/buyer should check the Credibility of the manufacturer before buying the product.

Where can I Buy Veenat 400 mg in India?

Patients from all over the world can buy generic imatinib mesylate 400 mg (Veenat) from Pharmacy shops in India. Patients need to consult Hematologist / Oncologists before starting treatment.   

Can we buy Veenat 400 mg online?

Veenat 400 mg (Imatinib mesylate 400mg Tablet ) is a prescription medicine. The patent should start treatment with Imatinib Mesylate after consultation with treating Physician

Chronic Myeloid Leukaemia (CML)  is a cancer that develops when the blood forming cells of the bone marrow (the soft, spongy tissue in the center of bones) starts producing too many WBC (white blood cells), including immature ones. Managing patients with the CML in chronic phase has changed dramatically with the advent of the imatinib. The use of the Abl tyrosine kinase (TK) inhibitor, imatinib mesylate 400 mg (IM), for the treatment of patients with the chronic myeloid leukaemia (CML) in chronic phase appears to be well tolerated and effective

FAQ

How long can you live with chronic myeloid leukemia?

Is CML leukemia is fatal?

Is chronic myeloid leukemia curable?

Is CML considered cancer?

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T-Cell Acute Lymphoblastic Leukemia Guidelines

Leukemia is generally known as a group of cancers that develop in the bone marrow. Under normal circumstances, the bone marrow contains a small number of immature blood cells, sometimes called blast cells. These immature blood cells mature and turn into red cells, white cells, and platelets, which are eventually released into the bloodstream. Leukemia originates in developing blood cells, which have undergone a malignant change. Rather than maturing precisely these cells grow and start to multiply in an uncontrolled way and interfere with the production of normal blood cells in the bone marrow. The maximum cases of leukemia originate in the developing white cells. In a few cases, leukemia develops in other blood-forming cells, for instance in developing platelets or red cells.

Types of leukemia:  There are basically four types of leukemia:
• Acute myeloid leukemia (AML)
• Acute lymphoblastic leukemia (ALL)
• Chronic myeloid leukemia (CML)
• Chronic lymphocytic leukemia (CLL)

Both adults and children can develop leukemia but certain types are more common in different age groups.

What is T-Cell Acute Lymphoblastic Leukemia?

 T-cell lymphoblastic leukemia, also known as precursor T-lymphoblastic leukemia, basically is a form of lymphoid leukemia and lymphoma in which too many T-cell lymphoblasts (immature WBC) are detected in the bone marrow, tissues and blood, particularly mediastinal lymph nodes.

It is generally uncommon in adults, but it represents approx 15% of childhood acute lymphoblastic leukemia and about 90% of lymphoblastic lymphoma.

T-Cell Acute Lymphoblastic Leukemia Symptoms: A diagnosis of ALL is usually made through blood and bone marrow tests, based on information on blood cell counts blood chemistry studies and bone marrow sampling.

Patients with ALL often have several non-specific symptoms, including weight loss, fever, night sweats, fatigue, and loss of appetite.

T-Cell Acute Lymphoblastic Leukemia Causes: Acute lymphocytic leukemia mainly occurs when a bone marrow cell develops errors in its DNA. The errors indicate the cell in order to continue growing as well as dividing when the healthy cells will normally not divide and eventually die. When this takes place, the production of blood cells becomes abnormal.

T-Cell Acute Lymphoblastic Leukemia Diagnosis: Your doctor will ask about your symptoms and medical history. They’ll do a physical exam to look for swollen lymph nodes, bleeding and bruising, or symptoms of infection.

If your healthcare provider suspects leukemia, they may do tests, including:

• Blood tests: A complete blood count (CBC) shows how many of each type of blood cell you have. A peripheral blood smear checks for changes in how your blood cells look.

• Bone marrow test:. Your doctor will put a needle into a bone in your chest or hip and take out a sample of bone marrow. A specialist will observe it under the microscope for the signs of leukemia.

• Imaging test:. X-rays, CT scans, or ultrasounds can tell your doctor whether cancer has spread.

• Spinal tap: This is also known as a lumbar puncture. Your doctor will use a needle to take a sample of fluid from around your spinal cord. A specialist can look at it to see if cancer has reached your brain or spinal cord.

What is the fastest way to cure T-Cell Acute Lymphoblastic Leukemia?

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive cancer that is curable with proper treatment.

In today's era, the way T-cell acute lymphoblastic is treated is with the prolonged schedule that includes several various kinds of chemotherapy drugs given over several months. In addition, the phase of intensive chemotherapy (which mainly lasts for 4 to 8 months) is followed by the oral chemotherapy for a long period of time, typically from 1.5 to 2 years or even longer.

T-Cell Acute Lymphoblastic Leukemia Treatment: The aim of treatment is to induce a lasting remission, defined as the absence of detectable cancer cells in the body (usually less than 5% blast cells in the bone marrow).

Over the past several decades, there have been strides to increase the efficacy of treatment regimens, resulting in increased survival rates. Possible treatments for acute leukemia include chemotherapy, radiation therapy, intensive combined treatments (including stem cell or bone marrow transplants), and/or growth factors.

New chemo medications are also being developed anelarabine side effectss well as tested. For instance, clofarabine (Clolar) is approved to treat childhood ALL and shows promise in early studies of adults with this disease. Atriance (nelarabine injection is a newer drug that can be used to treat T-cell ALL.

Side Effects: The most commonly reported nelarabine side effects may include:

• fever
• nausea
• vomiting
• diarrhea
• constipation 
• headache 
• sleepiness 
• blurry eyesight
• trouble breathing
• unusual bleeding
• decreased blood counts 

These are not entire adverse reactions associated with atriance injection. Discuss with your healthcare provider in order to get more information.

What are the risks associated with taking the medication nelarabine?

The drug nelarabine may be responsible for causing serious system problems including: extreme sleepiness, numbness and tingling in the hands, fingers, feet or toes.

Also some rarely reported complications may include; weakness, seizures, coma, and paralysis. The tumor lysis syndrome can also be appeared as an outcome of the treatment of leukemia..

Can you take the drug Atriance during pregnancy?

The atriance 250 mg should be avoided by pregnant women. It may be responsible for causing harm to a baby if conceived prior to, during or soon following treatment.

How does Nelarabine work? 

Nelarabine is a group of medications named antimetabolites. It is believed to work in order to destroy the quickly dividing cells (cancer cells).

Atriance:  Atrience 250 mg is mainly used for the treatment of patients with T-cell acute lymphoblastic 15 leukemia and T-cell lymphoblastic lymphoma whose disease has not responded to or has 16 relapsed following treatment with at least two chemotherapy regimens.

Atrience 250 mg is an intravenous medicine. This means it is given through a tube in your vein.  

Chronic Myeloid Leukemia Guidelines

Leukemia is basically a cancer of the blood. Different forms of leukemia exist, which depends on what sort of blood cell is affected. The term Chronic basically describes the slow progression or a gradual, and the term myeloid represents the origin from myeloid cells, which are more likely immature cells that generally become mature RBC, WBC, or Platelets. In the phase of chronic myeloid leukemia (CML), the bone marrow produces excess myeloid blood cells which are at various maturation stages including cells known as immature granulocytes, myeloblasts, and metamyelocyte. Basophils and platelets are more often overproduced at the time of diagnosis. Excess production of myeloid blood cells in the bone marrow ultimately prevents the normal production of red blood cells, which are important in delivering oxygen to all the cells in the body, and may also decrease the production of thrombocytopenia or platelets. Platelets play a crucial role in order to stop the bleeding.

Chronic Myeloid Leukemia Symptoms: Patients with chronic myeloid leukemia (CML) may be diagnosed at a routine checkup, or after seeking medical care due to lack of energy and fatigue from the anemia, or abdominal pain or discomfort, or bleeding, and rarely bruising from the insufficient platelets. Enlargement of the spleen, called splenomegaly, leads to the left chest and abdominal discomfort, early satiety, or Changement in the bowel patterns. Other possible signs and symptoms include shortness of breath, bone pain, and fever. At diagnosis, most of the patients have a white blood count (the number of white blood cells circulating in the blood) increased above normal.

What are the stages of CML: CML is often divided into three phases. In the case of absence of the intervention, CML typically starts in the chronic phase, and over the course of the progression of several years, it appears in an accelerated phase and ultimately to a blast crisis. Blast crisis phase is the terminal phase of CML and clinically behaves like Acute Leukemia. Early initiation of drug treatment usually stops the progression.
• Chronic Phase
• Accelerated Phase
• Blast Crisis

Chronic Myeloid Leukemia Diagnosis: Diagnosis CML typically presents with leukocytosis, a profound left-shift in WBCs, thrombocytosis, and splenomegaly, although more commonly today is diagnosed on a routine blood test. The differential diagnosis includes other myeloproliferative disorders, chronic myelomonocytic leukemia, and chronic neutrophilic leukemia. The diagnosis of CML is confirmed by demonstration of the Philadelphia chromosome, on bone marrow or peripheral blood samples. This may be achieved by conventional cytogenetics, fluorescence in-situ hybridization (FISH), or polymerase chain reaction (PCR) in either marrow or blood.

What is the best treatment for Chronic Myeloid Leukemia: The treatment should take place only in centers used to treat CML and offering an adequate multidisciplinary infrastructure. Whenever possible, the treatment must be offered in the form of clinical trials. Treatment of CML is tailored to the individuals based on the phase of disease at the time of diagnosis. Unlike rigid tumors, surgical resection and radiation therapy do not serve a role in order to the management of the CML.

• Targeted drug therapy (kinase inhibitors, imatinib mesylate 400 mg)
• Allogeneic stem cell transplant (SCT)
• Chemotherapy (hydroxyurea)
• Clinical trials with new agents

Imatinib (Gleevce): imatinib mesylate 400 mg is the only BCR-ABL tyrosine kinase inhibitor indicated for first-line treatment of CML. It is considered as the standard treatment since FDA approval in 2001. The goal of treatment is to reduce the number of cells containing the Ph chromosome.

The first of this new class of drugs was approved by the US FDA in 2001. gleevec 400 mg has the potential in order to inhibit the progression of Chronic Myeloid Leukemia in the majority of patients sufficiently in order to achieve the regrowth of their normal bone marrow stem cell population (a cytogenetic response) with stable proportions of maturing WBC. Because several leukemic cells persist in about all the patients, so the treatment must be continued indefinitely. Since the advent of imatinib (Veenat 100 mg), CML has become first cancer in which a standard medical treatment may give to the patient a normal life expectancy.

Adverse effects: The most common non-hematologic side effects with Veenat 100 mg (imatinib) are fluid retention and edema, nausea, diarrhea, skin rash, and muscle cramps. Most are grades 1-2. Congestive heart failure/LV dysfunction and pleural effusions have been observed, but their association with imatinib is uncertain. Other side effects may include hepatotoxicity, fatigue. Serious adverse effects are very rare. Low dose diuretics can be very useful for edema. For skin rash antihistamines and topical corticosteroids are helpful, and anti-nauseants for nausea.

What are the differences between CLL (Chronic Lymphocytic Leukemia) and CML (Chronic Myelogenous Leukemia)?

Difference between CML and CLL

• CML stands for chronic myeloid leukemia also known as chronic myelogenous leukemia which is a type of cancer in the bone marrow.
CLL stands for chronic lymphocytic leukemia is a type of cancer of white blood cells in the bone marrow.
• In the case of CML, myeloid stem cells are involved while in CLL lymphoid B or T cells are affected.
• CML generally occurs to middle age people however CLL affects old age people.
• About 20% of the patients suffering from CML do not show any symptoms while in the case of CLL patients range from 50% who are asymptomatic.
• CML is caused by tyrosine kinase pathway chromosomal translocation however CLL is represented by chromosomal abnormalities by chromosome deletion and possible somatic hypermutation.
• Common symptom of CML is splenomegaly whereas in CLL is lymphadenopathy and hepatosplenomegaly

Other Common Drugs to treat Chronic Myeloid Leukemia: The following list of medications are in some way related to, or used in the treatment of Chronic Myeloid Leukemia.

Hydroxyurea: The hydroxyurea medication is used in chronic myelogenous leukemia. It is recommended to be consumed orally (by mouth). 

This antineoplastic family of drug may cause some common side effects include: 

• bone marrow suppression
• fevers
• loss of appetite
• psychiatric problems
• shortness of breath
• headaches

This drug comes in the capsule form as the strength of 500 mg. The hydroxyurea 500 mg is believed to act by blocking the making of DNA. 

Cytarabine: Cytarabine is a chemotherapy medication used in order to treat chronic myelogenous leukemia (CML). It is recommended to be given by injection into a vein, under the skin, or into the cerebrospinal fluid. 

This antimetabolite and nucleoside analog families of drug may cause some common side effects include: 

• rash
• bleeding
• vomiting
• diarrhea
• liver problems
• bone marrow suppression
• ulcer formation in the mouth 

This drug comes in the form of injection, which is believed to act by blocking the function of the DNA polymerase. 

What kind of drug is cytarabine?

The cytarabine 100 mg belongs to the group of medicines named antimetabolites. It works by resisting or blocking the growth of cancer cells. 

Note: Before starting any treatment, please consult a physician. In order to know more about any medication, read full prescription information. 

Metastatic Colorectal Cancer Treatment Guidelines

Metastatic Colorectal Cancer: A cancerous cell is a group of abnormal cells that grow and spread continuously when a cell becomes cancerous in colon or rectum then it is known as colorectal cancer.
The tumor has a property of breaking down. The tumor breaks and spreads to other parts of the body by the bloodstream or using the lymphatic system. Thus this can cause malignancy and the process of spreading and breaking down of tumors is known as metastatic. The cancer is always named by the part where it started originally so when colorectal cancer is spread by the process of metastatic this is known as metastatic colorectal cancer.

The colorectal cancer metastasis and deposits to its most common site which is the liver. Colorectal cancer can also spread through the bloodstream to the brain, bones, lungs, and spinal cord.

Metastatic Colorectal Cancer Symptoms: There are few symptoms of metastatic colorectal cancer which are mentioned below:

• Constipation
• Diarrhea
• Rectal bleeding
• Abdominal cramping
• Anemia
• Fatigue
• Blood in stool
• Stool color becomes black or Maroon
• Unexplained weight loss
• Shortness of breath
• Jaundice
• Abdominal swelling
• Tiredness
• Headache
• Bone pain
• Seizure

A metastatic colorectal cancer diagnosis: Few patients can see the symptoms at the initial stage while in a few cases the symptoms appear at the final stages. The main test of diagnosing metastatic colorectal Cancer is Colonoscopy which is carried by biopsy.

Colonoscopy is used to see the cancerous cell and its activity. A biopsy is done to check whether the tumor is metastatic or not. 

The Colonoscopy or imaging test of metastatic colorectal cancer includes:

• CT scan: CT scan is used to check the spreading of colorectal Cancer to lymph nodes or other parts of the body. CT scan is also very helpful in the case of biopsy as it is used to determine the metastases in organs.

• Ultrasound: Basically ultrasound is done to check whether colorectal cancer has spread to the liver or not.

• MRI: MRI scan is done in the region of pelvic as well as abdominal areas to check the spreading of cancer.

• X-ray: A chest x-ray is done to check the metastases of colorectal cancer to the chest. X-ray is also used in testing the bone metastases.

Metastatic colorectal cancer treatment: The treatment of colorectal cancer depends upon the size of the tumor, location of the tumor, and spreading of tumors. There are several factors that affect the cancer treatment of patients such as overall health, age, and potential.

However, this is a fact that metastatic colorectal cancer is barely curable. The main objective of the treatment of metastatic colorectal cancer is to prevent symptoms and increase the life expectancy of the patient.

Below are mentioned a few treatment methods of metastatic colorectal cancer:

• Surgery: surgery of a tumor is done after a trusted pre-clinical trial which determines whether the tumor is metastasis or not. Surgery is done to avoid blockage of the colon as well as to prevent complications.

• Radiation therapy: High energy X-rays are used to destroy the cancer cell in Radiation therapy. Radiation therapy is generally used in the treatment of rectal cancer as a tumor stay in a nearby location.

• Meditation: Medication used in the treatment of metastatic colorectal cancer is given through the bloodstream which reaches cancerous cells throughout the body. The most common way to give medication is either in the form of pills or inject intravenously. There are few therapies help in the  treatment of metastatic colorectal cancer:

• Chemotherapy 

• Immunotherapy 

• Targeted therapy

Chemotherapy: chemotherapy is the combination of a drug that is used in the treatment of cancer cells. Chemotherapy is used before the surgery to shrink the cancer cell and after the surgery to wipe out all the remaining cancerous cells.

Immunotherapy: The natural immune system of the human body is boosted with the help of different medications to fight against cancerous cells.

Targeted therapy: In targeted therapy the protein formation activity or genetic changes of cancerous cells is detected and its normal functioning is inhibited with the help of drugs. The best drug used in the treatment of metastatic colorectal cancer is regorafenib who has already received chemotherapy and other targeted therapy. The most effective dosage is as regorafenib 40mg.

What is regorafenib used for?

As an oral multi-kinase inhibitor, the drug regorafenib 40 mg is used for the treatment of metastatic colorectal cancer, advanced gastrointestinal stromal tumours and advanced hepatocellular carcinoma. 

Side Effects of regorafenib: The commonly reported regorafenib side effects may include:

• Fatigue
• Diarrhea
• Stomach pain
• Weight loss
• Infection
• Weakness
• Tiredness
• Hoarseness
• Voice changes
• Loss of appetite
• High blood pressure
• Decreased food intake
• Hand-foot skin reaction (HFSR)

Apart from these events, this drug may be responsible for causing liver problems, which may be serious and fatal.

Is regorafenib a chemotherapy?

This medication specifically is a type of targeted cancer medication named a cancer growth blocker. Regorafenib tablets need to be taken once daily. The regorafenib dose should be taken at the same time, every day. Tablets should be swallowed whole with a drink of water and following a low fat food/meal. 

How does regorafenib work? 

Regorafenib is a group of medicines named antineoplastics, or anti-cancer drugs. This medication is believed to prevent the growth as well as spread of cancer cells by interfering with the development of the blood vessel system that basically supplies the tumour.

How much does regorafenib cost? 

The cost of Regorafenib (nublexa 40 mg) 40 mg for pack 28 tablets is about Rs 59,000. This drug should always be purchased from a WHO-GDP and ISO certified pharmaceutical wholesaler company.

Cost of Nublexa: nublexa 40 mg is available at a very decent and affordable price. A pack contains regorafenib 28 tablets. A respective patient can purchase this drug through any authorized pharmaceutical firm. 

 

Note: Before starting treatment with Regorafenib, consult a healthcare professional. In order to know more about this medication, read full prescription information. 

Coronavirus (COVID-19) and HIV

Coronavirus and HIV: Coronavirus and human immunodeficiency virus are connected by medication methods. Antiretroviral medications that are used in the treatment of HIV are also found effective in the case of the treatment of coronavirus.

What is coronavirus: Coronavirus is a common type of virus that originated from Wuhan, China, and on 31st December 2020 WHO declared coronavirus as a Global pandemic. Viruses cause respiratory tract infection, leading to sore throat cough and difficulty in breathing.

What is HIV: Human immunodeficiency virus is a type of lentivirus. HIV virus attacks the CD4 cells of the human body and weakens the immune system. This weakening causes a lot of opportunistic infections leading to AIDS (acquired immunodeficiency virus syndrome).

Difference between HIV and AIDS: Few differences between HIV and AIDS are mentioned below:

• In HIV infection the virus attacks the CD4 cells of the human body and destroys it. It is the initial stage of weakening the immune system. AIDS is the final stage of infection leading a lot of infection and cancer to the human body.

• In the case of HIV infection, the patient suffers minor infection such as flu-like symptoms whereas in AIDS condition the patient suffers from severe symptoms such as cancer.

• If a patient is having AIDS is the person whose immune system has been damaged by the HIV virus.

HIV symptoms in women and men: The initial symptoms of HIV that is flu appear both in women and men. Almost all of these symptoms of HIV are common in men and women.
Some symptoms of men are listed below:

• Flu-like symptoms accompanied by high fever
• Skin rashes
• Vomiting
• Headache
• Tiredness
• Nausea
• Sore throats
• Weight loss
• Fatigue
• Dementia
• Joint pain
• Mouth ulcers
• Ulcer on the genitals
• Swollen lymph nodes

Some common symptoms of HIV in women are:

• Flu-like symptoms along with fever and headache
• Skin Rash
• Swollen lymph gland including back, neck, armpit.
• Skin infection
• Several types of infection
• Night sweats
• Change in the menstrual cycle
• Increase the chances of sexually transmitted infections
• Development of several pelvic inflammatory diseases
• Pain in muscles
• Trouble in swallowing
• Mental confusion
• Short term memory loss
• Problem in breathing
• Chronic coughing

HIV Treatment: After so many recent studies the cure for HIV is still not found. However, there are few medications available in the form of the drug that is used to slow down the process of weakening the immune system. With the help of present medications, the process of secondary infection and complication is avoided. Several out of one antiretroviral medications named Lopinavir and Ritonavir, that is used to slow down the process of further HIV infection. The elaboration is as follows:

Lopinavir and Ritonavir Tablets: The antiretroviral drug lopinavir is a protease inhibitor, which is widely used for the treatment of HIV and is a potential candidate for the treatment of COVID-19. Lopinavir is basically formulated in the combination with another PIs (protease inhibitor), ritonavir (lopinavir/ritonavir, branded as Kaletra, or Aluvia). Ritonavir 100 mg inhibits the metabolizing enzyme cytochrome P450 3A and therefore increases the half-life of lopinavir.

List of HIV drugs: There are several HIV medications available in the form of the drug that is used to avoid secondary infection and complications. These drugs are not the cure of HIV infection rather slow down the rate of infection and stop the virus from further damaging of immunity.
list of HIV drugs medication are mentioned below in the link:

How HIV medicine helps in COVID-19: There are several pieces of evidence and facts are available that shows that HIV medication or antiretroviral medication used in the treatment of HIV infection is found quite effective in the case of coronavirus patients.  Patients having HIV negative reports when treated with antiretroviral medication found to recover fast having coronavirus.

In a few cases, if the patient is having both HIV and coronavirus and when treated with HIV medications and drugs the patient is found to have controlled virus infection as well as recovered from coronavirus.

After the recent study on the physiology of coronavirus, the Russian ministry declared Avifavir as an anti-coronavirus medication after surveying on antiretroviral medications.

Read -TREATMENT OF HUMAN IMMUNODEFICIENCY VIRUS