Materiały źródłowe

• #1 Acute Lymphocytic Leukemia (ALL) Causes, Risk Factors, and Prevention | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/causes-risks-prevention.html

  There is no known way to prevent most cases of leukemia at this time. Most people who get acute lymphocytic leukemia have no known risk factors, so there is no way to prevent these leukemias from developing.

• #2 Can Acute Lymphocytic Leukemia Be Prevented? | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/causes-risks-prevention/prevention.html

  Its not clear what causes most cases of acute lymphocytic leukemia (ALL). Since most people with ALL dont have risk factors that can be changed, for now, there is no known way to prevent most cases of ALL. […] Avoiding known cancer-causing chemicals, such as benzene, might lower the risk of getting ALL. But most experts agree that exposure to workplace and environmental chemicals seems to account for only a small portion of leukemias.

• #3 What Causes Leukemia, Risk Factors and Prevention

  https://www.cancercenter.com/cancer-types/leukemia/risk-factors

  Is leukemia preventable? There is no confirmed way to prevent leukemia. Still, it may be possible to help reduce the risk for this type of cancer by making certain lifestyle changes and following healthy habits, including: […] Don’t smoke. Current smokers should seek help to quit. There are lots of free cessation programs available online or in the local community. Keep trying and find what works. […] Keep a healthy body weight. Lose weight if needed. Ask a doctor for advice on how to start a healthy weight loss program. […] Avoid or lower exposure to chemicals that may raise the risk for leukemia, such as benzene and formaldehyde. […] Lower any exposure to pesticides. […] Stay physically active and follow a healthy diet. Both these lifestyle elements have been proven to reduce cancer risk in general.

• #4 Leukemia Prevention: Tips, Facts, and More

  https://www.healthline.com/health/leukemia/leukemia-prevention

  Unfortunately, without a cause or causes that can be pinpointed, there are no clear ways to prevent leukemia. This is true for both children and adults. […] But there are steps you can take to reduce your risk. Reducing your risk doesnt mean thats impossible for you to get leukemia, but it does make it less likely. […] Until more research is done that finds specific ways to prevent leukemia, the best method is to reduce the risk factors you can control. […] There are a few lifestyle changes you can make to reduce your risk of leukemia. These steps can also reduce your risk of other types of cancer. They include: […] Smoking increases your risk of multiple types of cancer, including leukemia. Never smoking or quitting smoking will lower your risk of leukemia. […] Having obesity is another risk for leukemia that you can control. Taking steps to keep a moderate weight can reduce your risk of leukemia.

• #5 Leukemia Prevention: Tips, Facts, and More

  https://www.healthline.com/health/leukemia/leukemia-prevention

  The chemicals benzene and formaldehyde are known to increase your risk of leukemia. […] These prevention tips can be used to reduce your risk of both types of acute leukemia, acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML). […] But you can make changes to your lifestyle to reduce your risk of leukemia. Quitting smoking and managing your weight are the best steps you can take to lower your risk. These arent guaranteed to prevent leukemia, but lowering your risk is a positive step.

• #6 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  No, it cant. Children with ALL develop the condition because of genetic changes that happened before they were born. But adults with ALL may be able to lower their risk by avoiding carcinogens, including tobacco and toxic chemicals.

• #7 Explore Acute Lymphoblastic Leukaemia Prevention Risk factors and Prevention Measures at HCG Oncology

  https://www.hcgoncology.com/types-of-cancers/acute-lymphoblastic-leukaemia-prevention/

  Maintaining a healthy body weight and making efforts to lose weight if required may also play an important role in possible leukemia prevention. […] Staying physically active with regular exercises is also found to help lower the risk of developing ALL. […] Minimizing exposure to environmental pollutants can contribute to possible acute lymphoblastic leukemia prevention. […] There are no specific foods that can prevent ALL, but having a nutritious and balanced diet can surely contribute to possible acute lymphoblastic leukemia prevention. […] Thus, it is advised to drink only filtered water as an acute lymphoblastic leukemia prevention measure. […] Staying up-to-date with vaccinations helps strengthen a person’s immune system and lower the risk of acute lymphoblastic leukemia. […] Exposure to UV rays can also increase the risk of developing acute lymphoblastic leukemia, so it is highly recommended to practice appropriate sun safety measures for high-risk ALL prevention. […] Understanding the prevention and risk factors for ALL can greatly help in increasing the high-risk acute lymphoblastic leukemia survival rate among patients. Therefore, everyone should pay attention to these risk factors and preventive measures.

• #8 Acute Lymphocytic Leukemia (ALL): Symptoms, Risks, and Survival Rates

  https://www.healthline.com/health/acute-lymphocytic-leukemia-all

  Theres no confirmed cause of ALL. However, you can avoid several risk factors for it, such as: […] radiation exposure […] chemical exposure […] exposure to viral infections […] cigarette smoking […] prolonged exposure to diesel fuel, gasoline, pesticides, and electromagnetic fields.

• #9 Screening/Prevention – Virginia Cancer Institute

  https://www.vacancer.com/cancer/leukemia/childhood-acute-lymphoblastic-leukemia/screening-prevention/

  Acute lymphoblastic leukemia cannot be prevented since we do not know the cause. Nevertheless, it would appear that pregnant women would be prudent to take adequate quantities of folic acid and iron supplementation as needed to avoid anemia. Pregnant women should also prudently avoid any drugs that are not absolutely necessary, especially alcohol, tobacco, marijuana, mind-altering drugs, and stimulants such as amphetamines. Diagnostic X-ray studies during pregnancy should be limited to what is absolutely necessary. […] The data on early infections and risk of ALL would suggest that early exposure to environmental pathogens could be of benefit in reducing several diseases.

• #10 Acute lymphoblastic leukemia (ALL) Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/acute-lymphoblastic-leukemia-all

  The risk for developing ALL may be reduced by avoiding contact with certain toxins, radiation, and chemicals.

• #11

  https://winshipcancer.emory.edu/cancer-types-and-treatments/leukemia/prevention.php

  While little is known about what exactly causes leukemia, researchers are learning more about the disease all the time and hope to establish leukemia prevention guidelines. […] Because we dont know exactly what causes leukemia, the National Cancer Institute doesnt make specific suggestions on how to prevent it. However, its always a good idea to take steps to lower your overall risk of cancer through lifestyle modification. The following guidelines may be useful for leukemia prevention: Not using any tobacco products, Not drinking alcohol, Maintaining a body mass index below 25, Being physically active every day, Eating a diet rich in fruits and vegetables and low in processed meats.

• #12 Landmark paper sets out ‘unified theory’ for cause of acute lymphoblastic leukemia – Oncology Central

  https://www.oncology-central.com/landmark-paper-sets-out-unified-theory-for-cause-of-acute-lymphoblastic-leukemia/

  A landmark paper has outlined, for the first time, a possible cause of most cases of childhood leukemia, following more than a century of controversy about its origins. […] They discovered that ALL arises through a two-step process of genetic mutation and exposure to infection, which means that it may be preventable with treatments to stimulate or prime the immune system in infancy. […] The population studies also highlighted that early exposure to infection in infancy such as day care attendance and breast feeding can protect against ALL, most probably by priming the immune system. This suggests that childhood ALL may be preventable. […] The most important implication is that most cases of childhood leukemia are likely to be preventable. It might be done in the same way that is currently under consideration for autoimmune disease or allergies perhaps with simple and safe interventions to expose infants to a variety of common and harmless bugs, Greaves concluded.

• #13 Prevention of childhood leukaemia by lifestyle changes | Leukemia

  https://www.nature.com/articles/s41375-021-01220-6

  If we consider from these observations that most cases of childhood ALL may be preventable, it should be advertised as such by wide-scale promotion of beneficial yet modifiable lifestyle changes, including early social mixing and extended breast-feeding. […] Overall, this Perspective presents credible preliminary evidence that gut microbiome boosting by simple life style changes or dietary supplements might present viable strategies for risk reduction or prevention of childhood ALL and potentially other serious diseases; the Greaves group have the ability to convincingly persuade us.

• #14 Acute lymphocytic leukemia Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/report/acute-lymphocytic-leukemia

  Both chemotherapy and transplantation increase the risk for infection. People must take strict precautions to avoid exposure to germs. Ways to prevent infection include: […] It is very important to take precautions to prevent infection following chemotherapy or transplantation. Guidelines for infection prevention and control include: […] Preventing Central Nervous System Disease (CNS Prophylaxis) […] This is called CNS prophylaxis. […] A maintenance regimen is usually less toxic and easier to tolerate than induction and consolidation. Maintenance treatment lasts for about 2 to 3 years for most people with ALL. It is not clear if maintenance therapy benefits people who have certain specific types of ALL, such as T-cell ALL or mature B-cell ALL (Burkitt leukemia).

• #15 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  Patients with ALL have an increased chance of CNS involvement; therefore, intrathecal (IT) methotrexate is given as CNS prophylaxis. […] CNS prophylaxis consists of methotrexate 12 mg IT on day 2 and cytarabine 100 mg IT on day 8 of each cycle, or similar regimens. […] Patients with a high risk for CNS disease (mature B-cell, high proliferative index, and/or lactate dehydrogenase [LDH] level 600 U/L [normal range, 25225 U/L]) receive 16 IT methotrexate treatments. […] Patients with low LDH level and unknown proliferative index receive eight treatments of intrathecal methotrexate.

• #16 Adult Acute Lymphocytic Leukemia (ALL): Types and Treatment | OncoLink

  https://www.oncolink.org/cancers/blood-cancers/leukemia-acute-lymphocytic-leukemia-all/adult-acute-lymphocytic-leukemia-all-types-and-treatment

  Less than 10 out of 100 patients have CNS involvement of leukemia (leukemia found in the spinal fluid) at the time of diagnosis. But, 50 to 75 out of 100 patients will have this by 1 year if they dont have preventive therapy. The most effective therapy to prevent CNS disease in adults with ALL is intrathecal chemotherapy. This means that chemotherapy is given directly into the spinal canal. This can be done by a lumbar puncture (spinal tap), or through a catheter called an Ommaya reservoir that is surgically placed in the head. This catheter allows you to have many intrathecal infusions without needing many lumbar punctures. The number of intrathecal infusions given depends on the subtype of ALL and the risk of CNS disease that subtype has.

• #17

  https://link.springer.com/article/10.1007/s11864-022-01032-5

  Different intrathecal prophylaxis regimens have been explored in ALL, including triple intrathecal therapy (methotrexate, cytarabine, prednisone) which has been demonstrated to decrease CNS relapse however without improvement in EFS compared to IT methotrexate alone in pediatric ALL patients. […] At our institution, we generally administer 2 doses of prophylactic IT cytarabine for patients with AML and one or more high-risk features: WBC 50 109/L, elevated LDH, and/or a FLT3-ITD mutation.

• #17

  https://link.springer.com/article/10.1007/s11864-022-01032-5

  Optimal CNS prophylaxis in the setting of modern induction regimens with improved CNS penetrance is unclear, though use of high-dose (HD) systemic and intrathecal (IT) chemotherapy results in CNS relapse rates similar to regimens that include cranial radiation. Given concerns for long-term toxicity related to radiation, chemotherapy-based prophylaxis is often preferred. […] Routine prophylaxis in AML is generally not indicated due to the overall low risk of CNS relapse, although it may be considered in certain clinical scenarios. Modern induction and consolidation regimens with stem cell transplant for AML are associated with CNS relapse rates 1%. […] The role of CNS prophylaxis was also explored in an analysis of 4 consecutive trials conducted at MD Anderson Cancer Center for patients with ALL, with (I) pre-VAD (no CNS prophylaxis), (II) VAD with high-dose systemic therapy for prophylaxis, (III) modified VAD with high dose systemic therapy for all patients and additional IT chemotherapy for high risk patients after achieving a CR, and (IV) hyperCVAD with early high dose systemic therapy and IT chemotherapy during induction (with 16 IT chemotherapy treatments for the high risk group vs. 4 for the low-risk group).

• #18 Acute Lymphocytic Leukemia

  https://fpnotebook.com/HemeOnc/Leukemia/ActLymphcytcLkm.htm

  CNS Prophylaxis (prevents Leukemic Meningitis) […] Whole Brain Radiation (18 to 24-Gy) […] Intrathecal Methotrexate […] […] […] Vaccinations […] See Hematopoietic Stem Cell Transplant for Vaccination precautions […] Do not administer live Vaccinations during Chemotherapy […] Maintain age appropriate Vaccinations if not contraindicated […] Maintain Covid19 Vaccine, Influenza Vaccine, Pneumococcal Vaccine if not contraindicated

• #19 Acute Lymphocytic Leukemia (ALL): Treatment Choices 

  https://healthlibrary.uwmedicine.org/library/PreventionGuidelines/34,BALLT2

  Chemotherapy may also be put right into your cerebrospinal fluid (CSF) to prevent cancer growth or to kill cancer cells around your brain and nervous system. This is called intrathecal chemotherapy. Its also called central nervous system (CNS) prophylaxis. […] Radiation therapy may be used to kill or prevent the spread of cancer in your central nervous system (brain and spine).

• #20 Antibiotic prophylaxis in acute childhood leukemia: What is known so far? | Hematology, Transfusion and Cell Therapy

  https://www.elsevier.es/pt-revista-hematology-transfusion-cell-therapy-396-articulo-antibiotic-prophylaxis-in-acute-childhood-S2531137922014572

  Antibiotic prophylaxis during neutropenia periods in those undergoing chemotherapy have already been proven in adults with acute leukemias (ALs). […] Among the possible available therapeutic options for bacterial prophylaxis in children with cancer, fluoroquinolones emerged with the most amount of evidence. […] Therefore, the use of levofloxacin seems to be indicated in very specific situations: in children who are known to be neutropenic for a long time, secondary to intensive chemotherapy; in children with AL undergoing chemotherapy to induce remission; or in children undergoing hematopoietic stem cell transplantation (HSCT). […] The likelihood of fever and neutropenia was lower in the levofloxacin prophylaxis group than in the control group in children with AL (71.2% vs. 82.1%; 95% IC, p = 0,002), as was the risk of bacteremia (21.9% vs. 43.4%; 95% IC, p = 0.01).

• #21 Antibiotic prophylaxis: a chance to reduce infections during childhood leukemia treatment | Zaj | Acta Haematologica Polonica

  https://journals.viamedica.pl/acta_haematologica_polonica/article/view/AHP.a2023.0012

  Literature data shows that antibiotic prophylaxis reduces bacteremia and improves outcomes of adult patients during aggressive chemotherapy. However, the use of antibiotic prophylaxis in pediatric cancer is still controversial. There is a lack of evidence regarding its effectiveness and the best choice of antibiotic. […] The use of antibiotic prophylaxis in pediatric cancer is still controversial, and there is a lack of clear evidence of its effectiveness and the best choice of antibiotic. […] Many studies have shown that the prophylactic use of levofloxacin in patients with ALL and AML has resulted in a significant reduction in bacteremia. […] The introduction of antibiotic prophylaxis is associated with an increased risk of fluoroquinolone-resistant Gram-negative strains development, which has been demonstrated among patients receiving fluoroquinolone prophylaxis.

• #22 Antibiotic prophylaxis in acute childhood leukemia: What is known so far? | Hematology, Transfusion and Cell Therapy

  https://www.elsevier.es/pt-revista-hematology-transfusion-cell-therapy-396-articulo-antibiotic-prophylaxis-in-acute-childhood-S2531137922014572

  Currently, the FN prevention is not the only implementation goal of antibiotic prophylaxis. It is also important to consider the cost-effectiveness of its use, as an episode of FN can have an important budgetary impact due to hospitalization in an ICU, use of expensive antibiotics and death. […] These data supported the publication of a guideline, in July 2020, by the Infectious Diseases Society of America (IDSA) on antibacterial prophylaxis in pediatric cancer and hematopoietic stem cell transplantation. The recommendation is that antibiotic prophylaxis should not be routinely used in children who are first diagnosed with ALL in the induction phase, due to the low body of evidence presented so far. […] Despite this consideration, the group suggests the use of levofloxacin as the antibiotic of choice for those patients who have severe neutropenia (absolute neutrophil count [ANC] < 500 cells/mm³) for at least 7 days.

• #23 Incidence of invasive fungal infection in acute lymphoblastic and acute myelogenous leukemia in the era of antimold prophylaxis | Scientific Reports

  https://www.nature.com/articles/s41598-021-01716-2

  The incidence of invasive fungal infection (IFI) in patients with acute myeloid leukemia (AML) has decreased with the introduction of antimold prophylaxis. […] Although acute lymphoblastic leukemia (ALL) has a lower risk of IFI than does AML, the incidences of IFI in both AML and ALL in the era of antimold prophylaxis should be re-evaluated. […] A lack of antimold prophylaxis and prolonged neutropenia were independent risk factors for IFI. […] Clinicians should remain highly suspicious of IFI in ALL patients who are not receiving antimold prophylaxis, especially those with prolonged neutropenia. […] In addition, antimold prophylaxis could be considered in patients with ALL who are expected to have a longer duration of neutropenia than usual occasion. […] Therefore, in the current era of antimold prophylaxis, clinicians should also be on guard for the occurrence of IFI in patients with ALL, especially those with characteristics that put them at higher risk.

• #24

  https://haematologica.org/article/view/haematol.2024.285428

  Infections lead to substantial morbidity during the treatment of acute lymphoblastic leukemia (ALL) in which the adaptive immune system is severely affected, leading to declining serum immunoglobulin levels. We performed a trial to investigate whether intravenous immunoglobulin (IVIG) prophylaxis in pediatric patients with ALL could prevent admissions for fever. […] In conclusion, in pediatric patients with medium-risk ALL, IVIG prophylaxis was associated with significantly fewer admissions for fever with negative blood cultures during maintenance treatment, resulting in fewer courses of antibiotic treatment and fewer chemotherapy adaptations. […] The trial reported here investigated the role of IVIG prophylaxis in children with newly diagnosed ALL, treated according to the DCOG ALL-11 protocol.

• #25

  https://haematologica.org/article/view/haematol.2024.285428

  IVIG prophylaxis likely prevented viral infections in our cohort of patients. There was no difference in the number of positive blood cultures, but there was a significant decrease in admissions for fever with a negative blood culture in the IVIG prophylaxis group. […] To conclude, in pediatric patients with medium-risk ALL, IVIG prophylaxis leads to a significant reduction of admissions for fever with negative blood cultures during maintenance treatment, and leads to a decrease in the use of empirical antibiotic therapy and chemotherapy adaptations.

• #26 Prophylaxis and treatment of acute lymphoblastic leukemia relapse afte | OTT

  https://www.dovepress.com/prophylaxis-and-treatment-of-acute-lymphoblastic-leukemia-relapse-afte-peer-reviewed-fulltext-article-OTT

  Relapse of acute lymphoblastic leukemia remains a major cause of death in patients following allogeneic hematopoietic stem cell transplantation. […] The mainstay of relapse prevention and treatment is donor leukocyte infusions, targeted therapies, second transplantation, and other novel therapies. […] We also make recommendations for critical strategies to prevent relapse after transplantation and challenges that must be addressed to ensure success. […] Patient survival is greatest when relapse does not occur post-allo-HSCT, so early detection of relapse and prediction of relapse based on contributing factors is the best approach for overall patient survival. […] Based on previous data, we provide our recommendations for critical strategies to prevent relapse after transplantation.

• #27 Prophylaxis and treatment of acute lymphoblastic leukemia relapse afte | OTT

  https://www.dovepress.com/prophylaxis-and-treatment-of-acute-lymphoblastic-leukemia-relapse-afte-peer-reviewed-fulltext-article-OTT

  The GVL effect in ALL is probably one of the most potent strategies with curative potential, and DLI is an attractive option for prophylaxis against relapse of ALL after transplantation. […] Modulation of immunosuppression may reduce relapse risk and improve ultimate outcome. […] Administration of imatinib early after allo-HSCT could be an effective approach for preventing recurrent Ph+ ALL. […] Interleukin-2, a very-well-characterized T-cell growth factor, has also been administered to patients with ALL for relapse prophylaxis. […] Targeting these mutated genes with specific treatments may be a possible strategy to prevent relapse. […] The prevention and treatment strategies for relapse of ALL after allo-HSCT continue to evolve, with advancing developments using a variety of novel approaches.

• #28 Tertiary Prevention and Treatment for Reducing Leukemia Relapse

  https://www.scientificarchives.com/article/tertiary-prevention-and-treatment-for-reducing-leukemia-relapse

  We have found little available information in the medical literature on the prevention and treatment of tertiary leukemia or patients’ prognosis. […] From the perspective of prevention, there are four levels of disease onset and progression: primary, secondary, tertiary, and quaternary. Primary prevention aims to prevent the initiation of illness or injury; examples include immunization to prevent infections associated with the development of leukemia and avoiding exposure to known risk factors, such as certain chemicals or ionizing radiation. […] Tertiary prevention focuses on reducing the effects of the disease once it has been established, rehabilitation after significant illness, and prevention of comorbidity. […] Tertiary prevention of leukemia includes the use of chemotherapy and other treatments aiming for its control or remission, as well as supportive care measures to minimize the side effects of treatment and improve the patients overall well-being.

• #29 Tertiary Prevention and Treatment for Reducing Leukemia Relapse

  https://www.scientificarchives.com/article/tertiary-prevention-and-treatment-for-reducing-leukemia-relapse

  Given the nature of leukemia, it is difficult to follow the standards of each level of prevention perfectly. However, the primary and tertiary levels have been substantially addressed. […] It is recommended that high doses of radiation, exposure to benzene, smoking or other tobacco use, and obesity/obesity-related lifestyles be avoided to decrease ones chances of developing leukemia. […] Although we found limited information in our literature search specific to tertiary prevention of leukemia and its relapse, we understand the potential bias of the search strategy we used in terms of the possibility of missing relevant articles with the limited data sources we searched. However, continuing research into more innovative treatments is needed to prolong the lifespan for all patients with leukemia. Further, we call for more research on immunotherapies to explore their effectiveness in tertiary and quaternary prevention of leukemias in populations of even more diverse age groups, including the elderly.

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