{"id":5235,"date":"2024-12-11T17:55:41","date_gmt":"2024-12-11T16:55:41","guid":{"rendered":"https:\/\/irccs.com\/patologie\/acute-leukemias\/"},"modified":"2026-03-26T11:18:29","modified_gmt":"2026-03-26T10:18:29","slug":"acute-leukemias","status":"publish","type":"pathology","link":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/","title":{"rendered":"Acute leukemias"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><span  id=\"pathology\" class=\"h2_anchor\"><\/span>Pathology<\/h2>\n\n\n\n<p>Acute leukemias represent a <strong>heterogeneous group of<\/strong> <strong>blood cancers <\/strong>that<strong> arise from stem cells in the bone marrow<\/strong>. Under normal conditions these cells give rise to red blood cells, white blood cells and platelets, which are essential for life. In leukemias, however, stem cells lose the ability to mature and <strong>become immature cells<\/strong> called <strong>blasts<\/strong>. These blasts accumulate in the bone marrow and can circulate in the blood or spread to other organs.<\/p>\n\n\n\n<p>The term <em>leukemia<\/em> comes from Greek and literally means &#8220;white blood,&#8221; precisely because these immature cells are found circulating in the bloodstream. For this reason, acute leukemias are also called <strong>&#8220;liquid&#8221; tumors<\/strong>.<\/p>\n\n\n\n<p>Acute leukemias can affect both<strong> adults<\/strong> and <strong>children<\/strong>.  <\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Types<\/h3>\n\n\n\n<p>Blasts can develop following two different lines of maturation: <strong>myeloid<\/strong> or <strong>lymphoid<\/strong>. Based on this, we distinguish two main forms of acute leukemia:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Acute Myeloid Leukemia (AML)<\/strong>: there is an alteration in the development process of stem cells of the myeloid line, which normally give rise to most white blood cells, platelets, and red blood cells. It accounts for about <strong>25 percent of all leukemias<\/strong> and about <strong>3 percent of all cancers<\/strong>, and<strong> <\/strong>is the <strong>most frequent<\/strong> form <strong>in adults<\/strong>, with a higher incidence in people over 65 years old;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Acute Lymphoid Leukemia (ALL)<\/strong>: the alteration affects the cells of the lymphoid lineage, from which lymphocytes (B and T), which are essential for immune defense, are derived. It accounts for about <strong>9.5 percent of all leukemias<\/strong>, and is the <strong>most common cancer in children<\/strong>, while it is less common in adults. It has a minimal incidence after age 25, with a new increase in cases starting at age 50.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">The numbers in Italy<\/h3>\n\n\n\n<p>According to the <a href=\"https:\/\/www.registri-tumori.it\/cms\/pubblicazioni\/i-numeri-del-cancro-italia-2023\"><strong>AIRTUM<\/strong> (Italian Association of Cancer Registries)<strong>registry<\/strong>,<\/a> to date leukemias and lymphomas account for <strong>about 50 percent of all childhood cancers<\/strong>. In 2024, an estimated <strong>9,181 new <\/strong>leukemia <strong>diagnoses <\/strong>(5,408 men and 3,773 women) are estimated.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"symptoms\" class=\"h2_anchor\"><\/span>Symptoms<\/h2>\n\n\n\n<p>The most common sign that acute leukemia may be suspected is an<strong>alteration in blood cell values<\/strong> found on a simple blood test<strong>(CBC<\/strong>). However, the disease does not always give obvious symptoms: in some cases the patient may feel well, in others he or she may seek medical attention for<strong> very general complaints<\/strong>:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>persistent fever;<\/li>\n\n\n\n<li>Bone pain;<\/li>\n\n\n\n<li>unexplained weight loss;<\/li>\n\n\n\n<li>Unusual night sweats (more rare).<\/li>\n<\/ul>\n\n\n\n<p>In <strong>more advanced situations<\/strong> or where the disease evolves rapidly, symptoms may be more pronounced and related to malfunction of the <a href=\"https:\/\/irccs.com\/aree-mediche\/centro-trapianti-midollo-osseo\/\">bone marrow<\/a>, which normally produces blood cells. In such cases they may appear:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Intense fatigue<\/strong> due to anemia (decreased red blood cells);<\/li>\n\n\n\n<li><strong>Ease of bleeding or bruising<\/strong> due to reduced platelet count;<\/li>\n\n\n\n<li><strong>Increased susceptibility to infection<\/strong> due to alterations in white blood cells.<\/li>\n<\/ul>\n\n\n\n<p>Leukemia cells can also accumulate in other organs of the immune system, causing enlarged <strong>lymph nodes, liver, or spleen<\/strong>. Symptomatology, when it becomes significant, may lead the patient to go directly to the emergency room.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"risk-factors\" class=\"h2_anchor\"><\/span>Risk factors<\/h2>\n\n\n\n<p>Having a risk factor does not mean getting sick, and in most cases an exact cause cannot be identified.<\/p>\n\n\n\n<p><strong>In adults,<\/strong> the most important risk factors are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Age:<\/strong> the risk increases especially after the age of 65;<\/li>\n\n\n\n<li><strong>Cigarette smoke:<\/strong> contains carcinogens such as benzene;<\/li>\n\n\n\n<li>Prolonged exposure to<strong> chemicals <\/strong>(solvents, pesticides, benzene);<\/li>\n\n\n\n<li><strong>Prior cancer therapies<\/strong>: some types of chemotherapy or radiation therapy may increase the risk;<\/li>\n\n\n\n<li><strong>Ionizing radiation<\/strong>: high exposures (environmental or therapeutic);<\/li>\n\n\n\n<li><strong>Some blood diseases<\/strong>, such as myelodysplastic syndromes.<\/li>\n<\/ul>\n\n\n\n<p><strong>In children,<\/strong> the most relevant risk factors are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Genetic predispositions<\/strong>: for example, Down syndrome or Fanconi anemia;<\/li>\n\n\n\n<li><strong>other rare hereditary syndromes:<\/strong> which can make cells more vulnerable to mutations.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"diagnosis-and-examination\" class=\"h2_anchor\"><\/span>Diagnosis and examination<\/h2>\n\n\n\n<p>The diagnostic pathway of acute leukemia can begin in different ways. Sometimes the disease is suspected from a simple blood test, other times by the appearance of symptoms that lead the patient to the family doctor or directly to the emergency room.<\/p>\n\n\n\n<p><strong>When there is suspicion of leukemia<\/strong>, it is critical that the patient be <strong>sent immediately for specialized evaluation<\/strong> by an <strong>oncohematologist<\/strong>. This makes it possible to quickly stabilize the clinical condition and perform the necessary investigations to initiate appropriate therapy as soon as possible.<\/p>\n\n\n\n<p>To arrive at a diagnosis, the specialist first prescribes tests on the <strong>peripheral blood<\/strong> and <strong>bone marrow<\/strong>, which can detect the presence of leukemic cells and define their characteristics.<\/p>\n\n\n\n<p>Unlike other cancers, in leukemias it <strong>is not necessary to establish a &#8220;stage<\/strong>&#8221; of the disease because it is a &#8220;liquid&#8221; tumor that involves the blood and marrow from the very beginning. Instead, it is crucial to determine the <strong>prognostic risk category<\/strong>: this allows the medical team to choose the most suitable and individualized course of treatment for each patient.<\/p>\n\n\n\t<div id=\"block_69c507f4946c8\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Blood tests<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"123\" data-end=\"352\">Blood tests are the <strong>critical first step<\/strong> in confirming the suspicion of acute leukemia and, more importantly, in assessing whether the patient is in a condition that can quickly become life-threatening.<\/p>\n<p data-start=\"354\" data-end=\"392\">In particular, the following are checked:<\/p>\n<ul data-start=\"393\" data-end=\"726\">\n<li data-start=\"393\" data-end=\"603\">\n<p data-start=\"395\" data-end=\"603\"><strong data-start=\"395\" data-end=\"409\">CBC<\/strong>: to check for <strong data-start=\"441\" data-end=\"451\">anemia<\/strong> (decreased red blood cells), changes in <strong data-start=\"501\" data-end=\"520\">white blood cells<\/strong> (which may be too low or too high), and decreased <strong data-start=\"587\" data-end=\"600\">platelets<\/strong>;<\/p>\n<\/li>\n<li data-start=\"604\" data-end=\"726\">\n<p data-start=\"606\" data-end=\"726\"><strong data-start=\"606\" data-end=\"640\">coagulation parameters<\/strong>: to identify any blood clotting problems<strong data-start=\"706\" data-end=\"722\">(coagulopathy<\/strong>).<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"728\" data-end=\"1007\">These data allow the physician to know immediately whether urgent supportive therapies, such as transfusions of blood, platelets, or plasma, are needed, which can be <strong data-start=\"900\" data-end=\"913\">life-saving<\/strong> and stabilize the patient pending further investigation and specific treatment.<\/p>\n<p data-start=\"178\" data-end=\"578\">There are forms of acute leukemia that require the <strong data-start=\"229\" data-end=\"274\">most rapid diagnosis and intervention<\/strong>. These include <strong data-start=\"290\" data-end=\"329\">acute promyelocytic leukemia (APL<\/strong>): a rare disease that, in its early stages, carries a very high risk of severe, even potentially fatal, hemorrhage. The good news is that, if recognized and treated early, LAP is a <strong data-start=\"547\" data-end=\"575\">potentially curable<\/strong> leukemia.<\/p>\n<p data-start=\"580\" data-end=\"740\">For this reason, it should be suspected and confirmed as quickly as possible in patients with altered blood counts and coagulation.<\/p>\n<p data-start=\"771\" data-end=\"873\">The specialist may request further follow-ups to evaluate:<\/p>\n<ul data-start=\"874\" data-end=\"1196\">\n<li data-start=\"874\" data-end=\"978\">\n<p data-start=\"876\" data-end=\"978\"><strong data-start=\"876\" data-end=\"917\">kidney and liver function<\/strong>, organs that are also critical for tolerance to treatment;<\/p>\n<\/li>\n<li data-start=\"979\" data-end=\"1196\">\n<p data-start=\"981\" data-end=\"1196\">the level of certain substances in the blood, such as <strong data-start=\"1028\" data-end=\"1057\">lacticodehydrogenase (LDH)<\/strong> and <strong data-start=\"1060\" data-end=\"1075\">uric acid<\/strong>, which give information about how quickly the disease develops and the possible involvement of other organs.<\/p>\n<\/li>\n<\/ul>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Smear and immunophenotype on peripheral blood<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"170\" data-end=\"432\">Even today, <strong data-start=\"182\" data-end=\"222\">light microscope observation<\/strong> remains one of the main tools for diagnosing and classifying acute leukemias. The goal is to <strong data-start=\"326\" data-end=\"351\">identify blasts<\/strong>, the immature cells typical of the disease, in the patient&#8217;s blood.<\/p>\n<h3 data-start=\"434\" data-end=\"475\">Cytomorphological examination (smear)<\/h3>\n<p data-start=\"478\" data-end=\"558\">After a simple blood draw, a few drops are spread on a slide. The slide is stained with special reagents and then observed under a microscope.This allows <strong data-start=\"664\" data-end=\"709\">the leukemic cells<\/strong> to be <strong data-start=\"664\" data-end=\"709\">seen directly<\/strong> and their shape and size assessed.<\/p>\n<h3 data-start=\"752\" data-end=\"809\">Cytofluorimetric examination (immunophenotyping)<\/h3>\n<p data-start=\"812\" data-end=\"876\">Analyze the <strong data-start=\"824\" data-end=\"873\">proteins present on the surface of blasts<\/strong>. It uses specific antibodies that bind to these proteins and make them visible with specialized instruments. It helps <strong data-start=\"1003\" data-end=\"1038\">determine the type of leukemia<\/strong> (lymphoblastic or myeloid) and provides crucial information for planning the most appropriate therapy.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Needle aspiration and bone marrow biopsy<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400\">In both cases of acute leukemia (AML and LAL), there are identifiable <\/span><b>Different subtypes with different clinical features and prognosis<\/b><span style=\"font-weight: 400\">, which should be taken into account in therapy planning. This requires a  <\/span><b>further investigation of bone marrow blood<\/b><span style=\"font-weight: 400\">, with the aim of characterizing bone marrow blasts. <\/span> <\/p>\n<p><span style=\"font-weight: 400\">During the procedure, which is performed under local anesthesia, the doctor inserts a needle into the upper part of the buttocks with which he penetrates the pelvic bone and aspirates a small sample of blood; he also extracts a small bone fragment in the same way if bone marrow blood cannot be extracted (punctio sicca). The collected specimens are then sent to the pathology laboratory for appropriate analysis:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><b>cytomorphologic examination<\/b><span style=\"font-weight: 400\">: as with peripheral blood, some drops are used to make a smear on a slide, which, after appropriate staining, is viewed under a microscope;<\/span><\/li>\n<li style=\"font-weight: 400\"><b>cytofluorimetric examination<\/b><span style=\"font-weight: 400\">: with immunophenotyping, the expression of certain antigenic proteins on blast cells is identified using monoclonal antibodies, premising an initial classification of acute leukemia into AML or LAL;<\/span><\/li>\n<li style=\"font-weight: 400\"><b>cytogenetic examination<\/b><span style=\"font-weight: 400\">: a laboratory method that studies alterations in the chromosomes of blastic cells, either by analysis of the global chromosome stock (karyotype) or more selective analyses such as FISH (fluorescent in situ hybridization), which allows identification of the presence of specific altered DNA sequences of chromosomes using fluorescent probes. The latter method is, for example, behind the rapid identification of the genetic lesion of LAP, as previously mentioned a subtype of AML with totally different prognosis and therapy, and of the Philadelphia chromosome, which is present mainly in some forms of LAL and, more rarely, in some forms of AML;<\/span><\/li>\n<li style=\"font-weight: 400\"><b>molecular biology examinations<\/b><span style=\"font-weight: 400\">: laboratory methods that can identify specific genetic alterations in the DNA or RNA of blast cells.<\/span><\/li>\n<\/ul>\n<p data-start=\"189\" data-end=\"417\">In acute leukemias, certain <strong data-start=\"218\" data-end=\"256\">genetic and molecular alterations<\/strong> are associated with particular cell characteristics observed under the microscope or by immunophenotyping. This information is critical to, confirm the diagnosis, identify the specific subtype of leukemia, establish the prognosis and risk class, and choose the most effective and personalized therapy.<\/p>\n<p data-start=\"622\" data-end=\"842\">Some of these alterations also represent <strong data-start=\"671\" data-end=\"701\">targets for targeted therapies<\/strong> and are used to monitor <strong data-start=\"728\" data-end=\"761\">minimal residual disease <\/strong>(MMR), that is, the presence of any residual leukemic cells after treatment.<\/p>\n<h3 data-start=\"849\" data-end=\"908\">Why it is important to turn to specialized centers<\/h3>\n<p data-start=\"910\" data-end=\"1336\">Diagnosis and classification of acute leukemias require<strong> advanced methods and highly trained personnel.<\/strong><br data-start=\"1028\" data-end=\"1031\">Our institute has all the latest diagnostic technologies and an experienced team, and is recognized as a qualified center for <strong data-start=\"1182\" data-end=\"1232\">integrated diagnostics of myeloid malignancies<\/strong> through the <strong data-start=\"1260\" data-end=\"1281\">LabNet<\/strong> platform <strong data-start=\"1260\" data-end=\"1281\">of GIMEMA<\/strong> (Gruppo Italiano Malattie Ematologiche dell&#8217;Adultores).<\/p>\n<p data-start=\"1338\" data-end=\"1483\">This ensures that each patient receives a comprehensive and individualized evaluation, which is essential to begin the most appropriate therapy immediately.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Rachicentesis or lumbar puncture<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"170\" data-end=\"420\">Acute leukemias are <strong data-start=\"193\" data-end=\"217\">systemic diseases<\/strong>, because blasts, in addition to invading the bone marrow and blood, can <strong data-start=\"291\" data-end=\"344\">circulate and infiltrate other organs and tissues<\/strong>, such as lymph nodes, spleen, liver, testes, and even the <strong data-start=\"398\" data-end=\"417\">nervous system<\/strong>.<\/p>\n<p data-start=\"422\" data-end=\"715\">When blasts cross the <strong data-start=\"454\" data-end=\"489\">blood-brain<\/strong> barrier (BEE)-the natural barrier that protects the brain and spinal cord-they can enter the <strong data-start=\"575\" data-end=\"612\">cephaloroachid fluid (CSF)<\/strong>, which surrounds and nourishes nerve cells, causing what is called <strong data-start=\"689\" data-end=\"712\">leukemic meningosis<\/strong>.<\/p>\n<h3 data-start=\"722\" data-end=\"788\">How to test for leukemia in the nervous system<\/h3>\n<p data-start=\"790\" data-end=\"932\">A CSF examination by spinal <strong data-start=\"895\" data-end=\"929\">tap (lumbar puncture) <\/strong>is performed to confirm the localization of leukemia to the nervous system. The procedure is done under<strong data-start=\"959\" data-end=\"979\"> local anesthesia<\/strong>:<\/p>\n<ul data-start=\"933\" data-end=\"1327\">\n<li data-start=\"983\" data-end=\"1096\">\n<p data-start=\"985\" data-end=\"1096\">the doctor inserts a needle into the space between two lumbar vertebrae to take a small CSF sample;<\/p>\n<\/li>\n<li data-start=\"983\" data-end=\"1096\">\n<p data-start=\"985\" data-end=\"1096\">the fluid is then analyzed by <strong data-start=\"1135\" data-end=\"1155\">cytological<\/strong> (observation of cells under a microscope) and <strong data-start=\"1202\" data-end=\"1222\">immunophenotypic<\/strong> (study of proteins on the surface of blasts) <strong data-start=\"1135\" data-end=\"1155\">examination<\/strong> to confirm the presence of leukemic cells.<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"1329\" data-end=\"1471\">This assessment is critical for choosing the <strong data-start=\"1380\" data-end=\"1413\">most appropriate and targeted therapy<\/strong> and protecting the nervous system during treatment.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Radiological and instrumental examinations<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"168\" data-end=\"297\">Rarely, acute leukemia may manifest as a <strong data-start=\"223\" data-end=\"262\">mass outside the bone marrow<\/strong> (extramedullary localization).<\/p>\n<p data-start=\"301\" data-end=\"412\">In <strong data-start=\"307\" data-end=\"345\">LAL (acute lymphoblastic leukemia)<\/strong>, blasts can infiltrate the lymphatic tissues of various organs.<\/p>\n<p data-start=\"415\" data-end=\"519\">In <strong data-start=\"421\" data-end=\"454\">AML (acute myeloid leukemia)<\/strong>, this &#8220;solid&#8221; form is called <strong data-start=\"496\" data-end=\"516\">myeloid sarcoma<\/strong>.<\/p>\n<p data-start=\"521\" data-end=\"679\">To assess involvement of other organs of the immune system (liver, spleen, lymph nodes) or other tissues, the following tests may be useful:<\/p>\n<ul>\n<li data-start=\"521\" data-end=\"679\">Abdominal ultrasound: radiation-free, ultrasound-based radiological examination. It allows detection of any <strong data-start=\"812\" data-end=\"898\">enlarged spleen (splenomegaly), liver (hepatomegaly) or deep lymph nodes<\/strong>. It is performed on an empty stomach at Radiodiagnostics;<\/li>\n<li data-start=\"521\" data-end=\"679\">Testicular ultrasound: indicated in male patients with LAL, it is used to check whether blasts have crossed the <strong data-start=\"1081\" data-end=\"1111\">blood-testicular barrier<\/strong>, localizing in the testes;<\/li>\n<li data-start=\"521\" data-end=\"679\">CT (computed axial tomography) scan: a radiological examination that reconstructs three-dimensional images of tissues and organs. <strong data-start=\"1285\" data-end=\"1303\">Total body CT scan<\/strong> (skull, neck, chest, abdomen, and pelvis) allows checking for lymph nodes or tumor masses. It involves the injection of an intravenous contrast agent;<\/li>\n<li data-start=\"521\" data-end=\"679\">PET (positron emission tomography) scan: a rarer test in acute leukemias, it highlights tumor cells based on their <strong data-start=\"1609\" data-end=\"1632\">abnormal metabolism<\/strong> using a glucose-based contrast agent. Useful especially in some subtypes of LAL.<\/li>\n<\/ul>\n<h3 data-start=\"1742\" data-end=\"1790\">Assessment of cardiac function<\/h3>\n<p data-start=\"1791\" data-end=\"1924\">Some drugs used in acute leukemia therapy may affect the heart.<br data-start=\"1879\" data-end=\"1882\">For this reason, it is important to perform a <strong data-start=\"1927\" data-end=\"1950\">cardiologic examination <\/strong>and<strong data-start=\"1956\" data-end=\"1975\">echocardiogram<\/strong>, to check for any problems and plan therapy in the safest way possible for the patient.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Prognostic evaluation<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"132\" data-end=\"287\">In acute leukemias, physicians assess the presence of internationally recognized <strong data-start=\"187\" data-end=\"210\">prognostic factors<\/strong>. These factors help predict the likelihood of response to therapy and survival.<\/p>\n<p data-start=\"364\" data-end=\"398\">Factors considered include:<\/p>\n<ul data-start=\"399\" data-end=\"692\">\n<li data-start=\"399\" data-end=\"514\">\n<p data-start=\"401\" data-end=\"514\"><strong data-start=\"401\" data-end=\"430\">Extent of the disease<\/strong>: for example, whether there are extramedullary masses or involvement of the nervous system;<\/p>\n<\/li>\n<li data-start=\"515\" data-end=\"602\">\n<p data-start=\"517\" data-end=\"602\"><strong data-start=\"517\" data-end=\"551\">Cytogenetic and molecular data<\/strong>: genetic alterations in leukemic cells;<\/p>\n<\/li>\n<li data-start=\"603\" data-end=\"692\">\n<p data-start=\"605\" data-end=\"692\"><strong data-start=\"605\" data-end=\"639\">Dynamic hematological parameters<\/strong>: assessment of initial response to therapy.<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"694\" data-end=\"812\">Based on these elements, patients are placed in <strong data-start=\"752\" data-end=\"773\">risk classes<\/strong>: <strong data-start=\"775\" data-end=\"809\">standard, intermediate or high<\/strong>.<\/p>\n<p data-start=\"814\" data-end=\"987\">This classification allows the physician to understand <strong data-start=\"866\" data-end=\"901\">how aggressive the disease is<\/strong> and to <strong data-start=\"907\" data-end=\"963\">choose the most suitable and personalized treatment<\/strong> for each patient.<\/p>\n<p>&nbsp;<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"therapies\" class=\"h2_anchor\"><\/span>Therapies<\/h2>\n\n\n\n<p>After diagnosis, the <strong>Interdisciplinary Team<\/strong> evaluates all patient factors (leukemia type, aggressiveness, age, general health) to plan an <strong>individualized course of treatment<\/strong>.  <\/p>\n\n\n\n<p>Therapies for acute leukemia include: chemotherapy, molecularly targeted drugs, immunotherapies, hypomethylating agents, and in some cases stem cell transplantation. In some cases, participation in<a href=\"#studi-clinici\"> <strong>experimental clinical studies<\/strong> <\/a>conducted by the Institute&#8217;s researchers. In case this option is considered viable, it will be proposed and explained to the patient with whom a shared decision will be made.<\/p>\n\n\n\n<p>In some subtypes (especially LAL), blasts can reach the nervous system: therefore, <strong>meningeal prophylaxis<\/strong> is performed by spinal tap, with administration of chemotherapeutic drugs in the cerebrospinal fluid.<\/p>\n\n\n\n<p>In addition to specific therapy for acute leukemia, supportive therapy aimed at <strong>stabilizing the clinical condition<\/strong>, reducing the harmful effects of the disease, and mitigating the toxicity of chemotherapy is essential.  <\/p>\n\n\n\t<div id=\"block_69c507f4947e5\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Chemotherapy<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400\">The term chemotherapy refers to the <\/span><b>drugs that eliminate cancer cells<\/b><span style=\"font-weight: 400\">  Taking advantage of their faster reproduction rate than healthy ones. Because it interferes with the replication mechanisms of cells, chemotherapy also damages the body&#8217;s healthy cells, causing side effects that fortunately often disappear once the treatment is over and are in any case well controlled with appropriate supportive therapies, such as irritation of the mucous membranes of the digestive tract (mucositis).<\/span><\/p>\n<p><b>Patients under the age of 65 years,<\/b><span style=\"font-weight: 400\"> without major other health problems, are considered &#8220;fit,&#8221; that is, suitable for an <\/span><b>intensive chemotherapy<\/b><span style=\"font-weight: 400\">. In most cases, chemotherapy is administered by intravenous injection. For this reason, it is often necessary to place a cannula into a large vein (such as the subclavian vein or jugular vein), called a Central Venous Catheter (CVC). The duration of each administration, which is carried out on an inpatient or day hospital basis depending on the scheme used involving the combination of various drugs, can vary from minutes to hours.<\/span><\/p>\n<p><b>Chemotherapy is received &#8220;in cycles&#8221;<\/b><span style=\"font-weight: 400\">: each cycle can be administered over one or more days and is followed by a few weeks of rest. The number of cycles depends on the type of acute leukemia and, of course, the response to the drugs, which can vary greatly from patient to patient and according to the disease subtype.<\/span><\/p>\n<p><span style=\"font-weight: 400\"><strong>Following chemotherapy<\/strong>, white blood cell, platelet, and red blood cell counts drop to very low levels (aplasia phase) before normal cells begin to regrow, putting the patient at risk of even severe infections and bleeding, conditions that often necessitate <strong>supportive therapies<\/strong> and hospitalization of the patient.<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Molecularly targeted drugs<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400\">These are drugs <\/span><b>capable of blocking specific molecular alterations<\/b><span style=\"font-weight: 400\">  that underlie the growth of some types of acute leukemias (FLT3 gene mutations and BCL-2 gene alterations in some forms of AML, etc.). These drugs are administered orally, and are usually taken continuously. These include Midostaurin, Gilteritinib, Venetoclax, Glasdegib, etc.  <\/span><\/p>\n<p><span style=\"font-weight: 400\">The eventual use of such &#8220;biologic&#8221; drugs, either in combination with standard chemotherapy or as a substitute for chemotherapy, depends on the subtype of the acute leukemia and proper risk classification of the patient. These therapeutic strategies have reported<strong> benefits in terms of response and survival, <\/strong>and lead to optimal treatment choices, such as the use of trans-retinoic acid (ATRA) and arsenic trioxide (ATO) in LAP, which spares the use of chemotherapy altogether while still being able to cure the disease.  <\/span><\/p>\n<p><span style=\"font-weight: 400\">Finally, in some forms of LAL characterized by the <strong>Philadelphia chromosome<\/strong>(an alteration that promotes the formation of the tumor protein BCRABL) tyrosine kinase inhibitors (such as Imatinib, Dasatinib, etc.) are used in addition to the steroid alone, allowing complete remission to be achieved in the vast majority of cases and minimizing the severe toxic effects of chemotherapy.<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Immunotherapy<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"134\" data-end=\"378\">Immunotherapy uses drugs that can <strong data-start=\"179\" data-end=\"280\">restore the immune system&#8217;s ability to recognize and destroy cancer cells<\/strong>. In patients with acute leukemia, these drugs are mainly <strong data-start=\"350\" data-end=\"375\">monoclonal antibodies<\/strong>.<\/p>\n<p data-start=\"380\" data-end=\"606\">Monoclonal antibodies act like our body&#8217;s natural antibodies: they bind to specific receptors on leukemia cells, stimulating the immune system to eliminate them. Some examples include:<\/p>\n<ul data-start=\"607\" data-end=\"762\">\n<li data-start=\"607\" data-end=\"678\">\n<p data-start=\"609\" data-end=\"678\"><strong data-start=\"609\" data-end=\"634\">Gemtuzumab ozogamicin<\/strong>, which binds to the CD33 antigen in AML,<\/p>\n<\/li>\n<li data-start=\"679\" data-end=\"762\">\n<p data-start=\"681\" data-end=\"762\"><strong data-start=\"681\" data-end=\"706\">Inotuzumab ozogamicin<\/strong>, which binds to the CD22 antigen in B-cell LALs.<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"764\" data-end=\"1094\">Some antibodies, called <strong data-start=\"788\" data-end=\"803\">bispecific<\/strong>, have a dual function: they bind to blasts and simultaneously activate the patient&#8217;s T lymphocytes to attack the leukemic cells. One example is <strong data-start=\"962\" data-end=\"978\">Blinatumomab<\/strong>, which binds CD19 of blasts to CD3 of T lymphocytes, promoting the selective destruction of cancer cells.<\/p>\n<p data-start=\"1096\" data-end=\"1230\">Monoclonal antibodies can be given alone or together with chemotherapy, increasing the effectiveness of treatment.<\/p>\n<p data-start=\"1232\" data-end=\"1701\">Finally, in particularly aggressive or resistant forms of B-cell LAL, <strong data-start=\"1340\" data-end=\"1354\">CAR T cells<\/strong> may be used. These are T lymphocytes taken from the patient, modified in the laboratory to recognize the CD19 antigen on leukemia cells and then reinfused so as to selectively attack them. This therapy is reserved for selected patients, generally up to 25 years of age, and requires special attention for possible serious side effects.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Hypomethylating agents<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><b>In elderly patients<\/b> (older than 65-70 years) or<b> very frail <\/b><span style=\"font-weight: 400\">due to other concomitant diseases (defined from a general point of view in oncology by the term &#8220;unfit&#8221;), or in patients with very unfavorable genetic alterations indicative of poor response to conventional chemotherapy, <\/span><b>conservative therapy<\/b><span style=\"font-weight: 400\">may be considered <\/span><span style=\"font-weight: 400\">, with the goal of <\/span><b>temporary disease control<\/b><span style=\"font-weight: 400\"> to avoid potentially fatal toxic effects. <\/span> <\/p>\n<p><span style=\"font-weight: 400\">This treatment is based on agents called hypomethylating agents (such as 5-azacytidine and decitabine), which act by intervening in an epigenetic (i.e., associated with a change in DNA function without genetic variation) biological process called hypermethylation. Through this phenomenon, the function of certain genes important for controlling cell evolution in a tumor-like direction (oncosopressor genes) is deactivated in blastic cells. Because it is not genetic, however, this variation is reversible, thus representing a potential therapeutic target. Such drugs function as inhibitors of the enzyme that determines DNA methylation, thereby restoring antitumor activity in cells.  <\/span><\/p>\n<p><span style=\"font-weight: 400\">With these therapies it is possible to achieve not only an <\/span><b>appreciable proportion of complete remission,<\/b><span style=\"font-weight: 400\"> but also a <\/span><b>stabilization<\/b><span style=\"font-weight: 400\"> and an <\/span><b>improvement of the disease<\/b><span style=\"font-weight: 400\">  (CBC values and transfusion need). This avoids worsening the frailty of such patients, and exposing them to risky therapies that would not lead to improved life expectancy.<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Supportive therapies<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"125\" data-end=\"275\">Along with specific therapy for acute leukemia, <strong data-start=\"198\" data-end=\"221\">supportive therapy<\/strong>, which can have life-saving effects, is essential. This includes:<\/p>\n<ul data-start=\"277\" data-end=\"1071\">\n<li data-start=\"277\" data-end=\"433\">\n<p data-start=\"279\" data-end=\"433\"><strong data-start=\"279\" data-end=\"328\">Transfusions of blood and blood components<\/strong> (red blood cells, platelets, plasma) to prevent bleeding problems or cardiovascular complications;<\/p>\n<\/li>\n<li data-start=\"434\" data-end=\"552\">\n<p data-start=\"436\" data-end=\"552\"><strong data-start=\"436\" data-end=\"471\">hematopoietic growth factors<\/strong> to improve blood values and reduce the risk of anemia or infection;<\/p>\n<\/li>\n<li data-start=\"553\" data-end=\"682\">\n<p data-start=\"555\" data-end=\"682\"><strong data-start=\"555\" data-end=\"579\">Adequate hydration<\/strong> to prevent tumor lysis syndrome, which is related to the release of toxic substances from blasts;<\/p>\n<\/li>\n<li data-start=\"683\" data-end=\"817\">\n<p data-start=\"685\" data-end=\"817\"><strong data-start=\"685\" data-end=\"710\">Antimicrobial drugs<\/strong> (antibiotics, antifungals, antivirals) to prevent or treat infections due to immunodepression;<\/p>\n<\/li>\n<li data-start=\"818\" data-end=\"941\">\n<p data-start=\"820\" data-end=\"941\"><strong data-start=\"820\" data-end=\"846\">Parenteral nutrition<\/strong>, if needed in case of weight loss or reduced caloric intake due to mucositis;<\/p>\n<\/li>\n<li data-start=\"942\" data-end=\"1071\">\n<p data-start=\"944\" data-end=\"1071\"><strong data-start=\"944\" data-end=\"970\">Pain<\/strong> relief <strong data-start=\"944\" data-end=\"970\">therapy<\/strong> to relieve bone pain or discomfort in the digestive tract caused by the disease or treatments.<\/p>\n<\/li>\n<\/ul>\n<p data-start=\"1073\" data-end=\"1237\">This supportive therapy is essential to <strong data-start=\"1117\" data-end=\"1150\">keep the patient stable<\/strong>, reduce risk, and improve tolerance to leukemia-specific therapies.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Stem cell transplantation<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"160\" data-end=\"520\"><strong data-start=\"180\" data-end=\"198\">Good-prognosis<\/strong> acute leukemias, which respond well to drug therapy, <strong data-start=\"248\" data-end=\"329\">usually do not require hematopoietic stem cell (HSC) transplantation<\/strong>. Transplantation is considered only if, during treatment, the disease reappears<strong data-start=\"418\" data-end=\"430\">(relapse<\/strong>) or if the response to treatment is <strong data-start=\"470\" data-end=\"517\">incomplete or absent (refractory disease).<\/strong><\/p>\n<p data-start=\"522\" data-end=\"1152\"><strong data-start=\"542\" data-end=\"556\">Allogeneic<\/strong> HSC transplantation, in which stem cells come from a <strong data-start=\"603\" data-end=\"627\">matched donor<\/strong> (familial or unrelated), is an effective strategy to improve <strong data-start=\"702\" data-end=\"735\">long-term survival<\/strong> in patients with intermediate- or high-risk acute leukemia, or in relapsed or refractory cases. These healthy cells replenish the bone marrow and help the immune system eliminate any remaining leukemia cells. Before transplantation, a <strong data-start=\"1030\" data-end=\"1088\">good preliminary response to drug therapies<\/strong> must be obtained to increase the likelihood of success and reduce risks.<\/p>\n<p data-start=\"1154\" data-end=\"1381\">In summary, transplantation is used as a <strong data-start=\"1201\" data-end=\"1230\">consolidation therapy<\/strong> to strengthen care in the most at-risk patients, providing them with the best chance of stable remission and long-term survival.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Reassessment of therapy  <\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p data-start=\"137\" data-end=\"403\">After the treatment cycles, it is crucial to check <strong data-start=\"192\" data-end=\"237\">how the leukemia has responded to the therapy<\/strong>. This is done by<strong data-start=\"264\" data-end=\"286\">bone marrow aspirate<\/strong>, which allows us to determine whether the disease is in <strong data-start=\"334\" data-end=\"367\">complete or partial remission<\/strong> or whether it persists<strong data-start=\"383\" data-end=\"399\">(nonresponse<\/strong>).<\/p>\n<p data-start=\"405\" data-end=\"666\">During this examination, it is also possible to detect <strong data-start=\"456\" data-end=\"478\">any recurrences<\/strong> by monitoring <strong data-start=\"512\" data-end=\"545\">Minimal Residual Disease (MMR)<\/strong>, a very sensitive analysis that detects residual leukemia cells before the disease becomes clinically evident.<\/p>\n<p data-start=\"668\" data-end=\"905\">The results are discussed by the <strong data-start=\"701\" data-end=\"729\">Interdisciplinary Group<\/strong>, which decides whether the treatment can be considered completed or whether it needs to be <strong data-start=\"804\" data-end=\"833\">modified or continued<\/strong>, thus ensuring the best chance of controlling the disease.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"ongoing-support\" class=\"h2_anchor\"><\/span>Ongoing support<\/h2>\n\n\n\n<p>At our institute, we ensure <strong>constant support before, during and after treatment <\/strong>to accompany each patient throughout the entire course of treatment and recovery.<\/p>\n\n\n\t<div id=\"block_69c507f494872\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Management of side effects<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>All cancer treatments involve <strong>side effects<\/strong>that impact the patient&#8217;s quality of life more or less severely. Treatments for acute leukemia also involve major side effects, both physical and psychological, that change the way people cope with daily life.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>At the Candiolo Institute, attention to the patient&#8217;s quality of life remains a priority throughout the entire course of treatment: the physicians and nurses of the multidisciplinary team are available to provide the patient with all the support needed to manage the various side effects, particularly through nutritional counseling, psychological support, and pain therapy.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Psychological support  <\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<h3><span style=\"font-weight: 400\">The impact of cancer in a person&#8217;s life also affects the<\/span><b> psychological sphere:<\/b><span style=\"font-weight: 400\"> falling ill with cancer is in fact always a <\/span><b>traumatic event<\/b><span style=\"font-weight: 400\"> that affects all dimensions of the person and can generate anxiety, fear, anger, depression.<\/span><\/h3>\n<h3><span style=\"font-weight: 400\">At the Candiolo Institute, alongside cutting-edge therapies, the treatment and care pathway always includes a<\/span><b> qualified psycho-oncological support <\/b><span style=\"font-weight: 400\">that helps the patient cope positively not only with treatment but also with the delicate phase of physical and psychological recovery.<\/span><\/h3>\n<h3><b>It is also possible to participate in support groups <\/b><span style=\"font-weight: 400\">psychological to compare with other people who have gone through or are going through the same experience.<\/span><\/h3>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Direct line to specialists<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><span style=\"font-weight: 400\">To ensure <\/span><b>timely and direct support<\/b><span style=\"font-weight: 400\"> and receive timely answers to concerns and questions, a dedicated support service is in place at the Candiolo Institute for all patients.<\/span><\/p>\n<p><span style=\"font-weight: 400\">From Monday to Friday, from 8 a.m. to 5 p.m., you can <\/span><b>contact the secretariat of the oncology day hospital<\/b><span style=\"font-weight: 400\"> at 011.993.3775, reporting the need for urgent consultation.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The patient will be <\/span><b>quickly put in touch with his or her medical specialist<\/b><span style=\"font-weight: 400\">, to receive clear answers and immediate support.<\/span><\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Continuing and palliative care<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>The cancer patient is a person with <strong>complex needs<\/strong> who requires <strong>multidisciplinary support<\/strong> not only for the cancer disease but also for all related issues.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>At the Candiolo Institute, patients who need or request it can access <strong>specialists in different areas<\/strong> to receive nutritional support, physical therapy, pain therapy, and management of other associated conditions.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Social work<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>The Social Service Department of the Candiolo Institute conducts <strong>information and orientation interviews for patients and their families<\/strong> on how to access services in the area and how to obtain welfare and social security benefits provided by law (disability, benefits for aids and prostheses, work leave, etc.).<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>The service operates on Wednesdays and Fridays from 9 a.m. to 1 p.m. (phone: 011 9933059).<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Follow up<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>With the conclusion of the course of treatment, the follow-up period begins during which, through a series of examinations and visits, <strong>the side effects of the therapies performed and their effectiveness are monitored<\/strong> and the patient&#8217;s functional recovery is assessed.<\/p>\n<p>Follow-up examinations are especially important to<strong> intercept any recurrences early<\/strong> so that appropriate therapy can be intervened. For the patient, they are also a valuable opportunity for dialogue with their medical specialist.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>The follow-up course is planned with different timing and modalities depending on the type of acute leukemia, the therapy performed and the response obtained, and the patient&#8217;s own characteristics.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>For patients undergoing stem cell transplantation, initially outpatient monitoring occurs very closely, weekly or several times a week depending on the treatment, type of protocol, and expected or ongoing complications.<\/p>\n<p><!-- \/wp:paragraph --> <!-- wp:paragraph --><\/p>\n<p>Generally, checks become less frequent as time passes.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"interdisciplinary-group\" class=\"h2_anchor\"><\/span>Interdisciplinary Group<\/h2>\n\n\n\n<p>Every cancer requires, in all phases of disease management, a<strong> multidisciplinary approach<\/strong> that at the Candiolo Institute is guaranteed by a team of different specialists, belonging to the various clinical and surgical departments of the Institute: this team is called GIC (Interdisciplinary Care Group). The GIC ensures that<strong> each patient is taken care of throughout the diagnostic-therapeutic process<\/strong>, including prescribing and booking examinations and communicating with the patient and his or her family members. The GIC defines and shares a <strong>personalized care pathway<\/strong> for each patient, based not only on the type and stage of the tumor, but also on the patient&#8217;s own characteristics. The goal is to ensure that he or she has the best outcome both oncologically and functionally and the maintenance of a good quality of life.The Group also<strong> works closely with researchers<\/strong> at the Institute to ensure that patients have rapid access to the latest research-produced innovations in screening, diagnosis and treatment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"clinical-divisions\" class=\"h2_anchor\"><\/span>Clinical divisions  <\/h2>\n\n\n\n<p>The diagnostic and therapeutic pathway for leukemias at Candiolo involves several clinical divisions, including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/medical-oncology\/\" type=\"medical-area\" id=\"5169\">Medical Oncology<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/hemopoietic-stem-cell-transplantation-and-cellular-therapies-center\/\" type=\"medical-area\" id=\"5191\">Hemopoietic Stem Cell Transplantation and Cellular Therapies Center<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/oncology-day-hospital\/\" type=\"medical-area\" id=\"5183\">Day Hospital<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/radiotherapy\/\" type=\"medical-area\" id=\"5104\">Radiotherapy<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/laboratory-analysis\/\" type=\"medical-area\" id=\"5113\">Laboratory Analysis<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/irccs.com\/en\/divisioni-cliniche\/pathologic-anatomy\/\" type=\"medical-area\" id=\"5118\">Pathologic anatomy<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"clinical-studies\" class=\"h2_anchor\"><\/span>Clinical studies<\/h2>\n\n\n\n<p>Researchers at the Candiolo Institute are actively engaged in <strong>national and international projects<\/strong> on acute leukemia, with the goal of offering patients the best diagnostic and therapeutic options. The Institute is part of the <strong>national GIMEMA network<\/strong>, participating in experimental clinical trials and following the most up-to-date guidelines.<\/p>\n\n\n\n<p>Through these collaborations, patients can gain access to <strong>next-generation drugs<\/strong> not yet available on the market, including new antibodies and &#8220;smart&#8221; molecules that target specific molecular or antigenic targets. Some examples already used in clinical practice are <strong>FLT3, BCL-2, and tyrosine kinase inhibitors<\/strong>, used alone or in combination with chemotherapy to increase treatment efficacy and improve prognosis.<\/p>\n\n\n\n<p>The Institute&#8217;s main goal is to <strong>cooperate with as many researchers as possible<\/strong>, collecting useful data to objectively evaluate the effectiveness of therapeutic strategies and bring innovation to the treatment of acute leukemia.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span  id=\"why-choose-us\" class=\"h2_anchor\"><\/span>Why choose us<\/h2>\n\n\n\n<p>At the Candiolo IRCCS Institute, acute leukemia patients are<strong> followed according to highly specialized standards, <\/strong>thanks to the synergistic work of a dedicated Interdisciplinary Care Group (ICG).<\/p>\n\n\n\t<div id=\"block_69c507f4948a8\" class=\"accordion-block acf-block\">\n\t\t<div class=\"my-4 lg:my-6\">\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Clinical experience and tailored approach<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>Due to the high number of cases treated each year, the Candiolo Institute is a <strong>national reference for taking care of esophageal cancer.<\/strong> Our experience enables us to deal with even the most complex situations, always with a <strong>personalized approach<\/strong> built on the clinical and personal profile of each patient.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Imaging technologies and advanced diagnostics<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p><!-- wp:paragraph -->Establishing the treatment plan always starts with an <strong>accurate and timely diagnosis<\/strong>. Patients have access to <strong>state-of-the-art imaging technologies<\/strong> that allow accurate assessment of the extent of the disease.<\/p>\n<p><!-- \/wp:paragraph --><\/p>\n<p><!-- wp:paragraph -->In addition, the Institute offers <strong>advanced and sophisticated laboratory investigations<\/strong>, including molecular and genomic analyses, which are critical for identifying biological features of cancer and guiding therapeutic decisions.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Minimally invasive surgical techniques and multidisciplinarity<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>When indicated, surgery is performed with <strong>minimally invasive techniques<\/strong> (laparoscopic or thoracoscopic), which reduce operative trauma, promote faster recovery, and improve postoperative quality of life. Every treatment choice is defined within the GIC, ensuring a consistent and integrated approach.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Clinical research and access to trials<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<h3 class=\"wp-block-heading\"><\/h3>\n<p><!-- \/wp:heading --><\/p>\n<p><!-- wp:paragraph -->As an IRCCS, the Candiolo Institute combines clinical practice with a <strong>strong vocation for scientific research.<\/strong> Patients can be evaluated for inclusion in active <strong>clinical trials<\/strong>, which represent a real chance to access <strong>innovative therapies<\/strong> not yet available in standard practice. Collaboration between care and research is a distinctive value that translates into <strong>concrete opportunities for the patient<\/strong>.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t<div class=\"accordion group border-b border-white\/5\">\n\t\t\t<div class=\"flex items-center cursor-pointer group-hover:text-blue-light group-[.accordion--open]:text-red transition-colors\">\n\t\t\t\t<div class=\"rotate-90 text-blue-lighter group-[.accordion--open]:rotate-180 group-[.accordion--open]:text-red transition-all\">\n\t\t\t\t\t<svg width=\"18\" viewbox=\"0 0 500 500\" fill=\"currentColor\">\n\t\t\t\t\t\t<polygon points=\"250,60 100,400 400,400\"\/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/div>\n\t\t\t\t<h3 class=\"font-bold ml-5\">Care and support every step of the way<\/h3>\n\t\t\t<\/div>\n\t\t\t<div class=\"accordion-content max-h-0 overflow-hidden transition-all\">\n\t\t\t\t<div class=\"pb-5 pl-[38px] pt-1\">\n\t\t\t\t\t<p>The Interdisciplinary Care Group takes care of the person at every stage: from diagnosis to treatment to <strong>follow-up<\/strong>, with attention to <strong>nutritional support<\/strong>, <strong>psychological health<\/strong>, and <strong>reintegration into daily life<\/strong>. The organization of checkups, visits and treatment is designed to ensure <strong>continuity and serenity<\/strong>, always valuing the human dimension of care.<\/p>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<\/div>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-5235","pathology","type-pathology","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Acute leukemias - Istituto di Candiolo<\/title>\n<meta name=\"description\" content=\"Acute leukemias: learn about symptomatology, classification, therapies and the full care pathway at the Candiolo Institute, Piedmont.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Acute leukemias - Istituto di Candiolo\" \/>\n<meta property=\"og:description\" content=\"Acute leukemias: learn about symptomatology, classification, therapies and the full care pathway at the Candiolo Institute, Piedmont.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/\" \/>\n<meta property=\"og:site_name\" content=\"Istituto di Candiolo\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/istitutodicandiolo\/\" \/>\n<meta property=\"article:modified_time\" content=\"2026-03-26T10:18:29+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@fpoirccs\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/\",\"url\":\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/\",\"name\":\"Acute leukemias - Istituto di Candiolo\",\"isPartOf\":{\"@id\":\"https:\/\/irccs.com\/en\/#website\"},\"datePublished\":\"2024-12-11T16:55:41+00:00\",\"dateModified\":\"2026-03-26T10:18:29+00:00\",\"description\":\"Acute leukemias: learn about symptomatology, classification, therapies and the full care pathway at the Candiolo Institute, Piedmont.\",\"breadcrumb\":{\"@id\":\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/irccs.com\/en\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Acute leukemias\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/irccs.com\/en\/#website\",\"url\":\"https:\/\/irccs.com\/en\/\",\"name\":\"INOC\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/irccs.com\/en\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Acute leukemias - Istituto di Candiolo","description":"Acute leukemias: learn about symptomatology, classification, therapies and the full care pathway at the Candiolo Institute, Piedmont.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/","og_locale":"en_US","og_type":"article","og_title":"Acute leukemias - Istituto di Candiolo","og_description":"Acute leukemias: learn about symptomatology, classification, therapies and the full care pathway at the Candiolo Institute, Piedmont.","og_url":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/","og_site_name":"Istituto di Candiolo","article_publisher":"https:\/\/www.facebook.com\/istitutodicandiolo\/","article_modified_time":"2026-03-26T10:18:29+00:00","twitter_card":"summary_large_image","twitter_site":"@fpoirccs","twitter_misc":{"Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/","url":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/","name":"Acute leukemias - Istituto di Candiolo","isPartOf":{"@id":"https:\/\/irccs.com\/en\/#website"},"datePublished":"2024-12-11T16:55:41+00:00","dateModified":"2026-03-26T10:18:29+00:00","description":"Acute leukemias: learn about symptomatology, classification, therapies and the full care pathway at the Candiolo Institute, Piedmont.","breadcrumb":{"@id":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/irccs.com\/en\/patologie\/acute-leukemias\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/irccs.com\/en\/"},{"@type":"ListItem","position":2,"name":"Acute leukemias"}]},{"@type":"WebSite","@id":"https:\/\/irccs.com\/en\/#website","url":"https:\/\/irccs.com\/en\/","name":"INOC","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/irccs.com\/en\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/irccs.com\/en\/wp-json\/wp\/v2\/pathology\/5235","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/irccs.com\/en\/wp-json\/wp\/v2\/pathology"}],"about":[{"href":"https:\/\/irccs.com\/en\/wp-json\/wp\/v2\/types\/pathology"}],"version-history":[{"count":5,"href":"https:\/\/irccs.com\/en\/wp-json\/wp\/v2\/pathology\/5235\/revisions"}],"predecessor-version":[{"id":6663,"href":"https:\/\/irccs.com\/en\/wp-json\/wp\/v2\/pathology\/5235\/revisions\/6663"}],"wp:attachment":[{"href":"https:\/\/irccs.com\/en\/wp-json\/wp\/v2\/media?parent=5235"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}