Acute Myeloid Treatment Cost in Turkey

What is the Cost of Acute Myeloid Leukaemia Treatment in Turkey?

Myeloid cells, one of the blood-forming stem cells, develop in the bone marrow and mature into diverse blood cell types like erythrocytes, macrophages, platelets, etc. However, sometimes, due to some genetic defect, they start dividing uncontrollably without differentiating. This leads to the formation of undifferentiated defective cells called myeloblasts. 

This condition is known as acute myeloid leukaemia (AML) which accounts for 80% of acute leukaemia in adults.

The average cost of acute myeloid leukaemia treatment in Turkey ranges between USD 35,000 to USD 75,000. This cost includes doctor’s fees, anaesthesia charges and operation theatres charges, medical consumables, and hospital stays for 6-8 days. 

What is Acute Myeloid Leukaemia?

In healthy bone marrow, blood-forming stem cells called myeloid and lymphoid cells differentiate into various blood cells.

However, in acute myeloid leukaemia (AML), these stem cells become abnormal and fail to mature properly. This leads to a significant reduction in the number of healthy blood cells and the accumulation of abnormal blast cells in the bone marrow.

The risk factors triggering mutation resulting in AML are listed below.

• Exposure to harmful radiation

• Smoking cigarettes

• Exposure to carcinogenic (cancer-causing agents)

• Pre-existing genetic defect by birth

AML is often caused by multiple genetic defects, which can only be identified when noticeable symptoms appear. These symptoms can vary, but some common ones include:

• Swollen gums, lymph nodes, liver, or spleen

• Profuse bleeding

• Random bruising

• Recurrent fever with fatigue

• Frequent infections

• Shortness of breath

• Blurred vision and dizziness

Through various lab tests, diagnostics are confirmed. Then , the haematologist strategically plans the treatment approach.

What are the Types of Acute Myeloid Leukaemia Treatment?

After the confirmation of acute myeloid leukaemia (AML), doctors assign a risk status to the patient. They also determine whether there is any sign of its spread to other parts of the body to plan the treatment. The therapies involved in the treatment of AML are:

Chemotherapy

Cytotoxic drugs and their combination are used to target rapidly dividing cancer cells. The drugs circulate throughout the body via blood to inhibit proliferation and multiplication of cancer cells.

Bone Marrow Transplant

Patients diagnosed with acute myeloid leukaemia may require a stem cell transplant if the healthy bone marrow has significantly reduced. Then, those defective cells are replaced with healthy bone marrow. After this, complications associated with the disease significantly reduce. Based on the donor, stem cell transplant can be categorised into:

Autologous Hematopoietic Stem Cell Transplant

For patients with AML in remission, sometimes they lack a suitable unrelated donor. In this situation, an autologous transplant is often the preferred option.

In this procedure, the patient's stem cells are collected before their chemotherapy. These cells are then processed in a laboratory to remove any residual cancer cells, a process known as purging. 

Then the stem cells are re-infused into the patient's body which replaces the damaged bone marrow so that they can generate healthy blood cells.

Allogeneic Hematopoietic Stem Cell Transplant

In contrast, an allogeneic transplant involves the transplantation of healthy stem cells from a matched sibling or unrelated donor.

This procedure aims to replace the patient's diseased bone marrow with healthy donor cells, which can produce normal blood cells. 

While allogeneic transplants offer the potential for a cure, they also carry significant risks, including graft-versus-host disease (GVHD), graft rejection, infections, and other complications.

The therapies performed to treat AML can be classified into three phases: Induction therapy, post-remission therapy, and maintenance.

Induction Therapy

The first step in treating AML, Induction therapy involves administering therapeutic drugs at regular intervals to manage symptoms associated with the AML. Apart from this, Induction therapy focuses on:

• Reducing the number of abnormal blasts cells to less than 5%

• Restoring the normal blood cell counts

When these goals are achieved, it's called complete remission of leukaemia.

Post-Remission Therapy

Even after successful induction therapy, AML can return. Consolidation therapy aims to prevent relapse by further reducing or eliminating any remaining leukaemia cells. Without this treatment, the leukaemia is likely to relapse within a short time.

Long-Term Maintenance

Maintenance therapy is a long-term approach to keep AML from returning. After intensive chemotherapy is complete, less toxic treatments are used to prevent relapse of leukaemia.

What are the Key Factors that Affect the Acute Myeloid Leukaemia Treatment Cost in Turkey?

AML treatment being a lengthy procedure,necessitates to inform the patients and their families about the factors that may significantly impact the overall cost of AML treatment in Turkey. Some of the factors affecting the cost of AML treatment in Turkey are discussed below.

Treatment approach and intensity

The specific drug used during the chemotherapy and immunotherapy,, the need for targeted therapy, the duration of treatment cycles or stem cell transplantation- all these factors determine the cost of AML treatment in turkey.

Hospital facility and doctor's experience 

The choice of hospital for the AML treatment in Turkey, with the expertise of doctors, infrastructure, and amenities such as catering services provided may impact the treatment cost and hence should not be overlooked.

Type of donor in bone marrow transplant

In critical cases where the combination of chemotherapies is harmful for cancer patients, doctors may suggest a bone marrow transplant. In AML, allogeneic BMT are preferred. 

Duration of treatment

AML is treated with chemotherapy and hematopoietic stem cell transplantation. However, each patient responds to these treatments differently based on the severity of the cancer. Some may require additional treatment cycles more than what was initially planned to control the disease effectively. These factors significantly influence the duration of treatment, hospital and consequently affect treatment costs.

Additional stay at ICU

In certain medical situations post AML treatment, patients may require extended hospitalisation or ICU stays for post-operative care. Thus, the additional hospital stay costs USD 400 to USD 500 on a per-day basis.

Considering these factors become essential as they influence how one can financially manage the acute myeloid leukaemia treatment in Turkey.

What is the Acute Myeloid Leukaemia Treatment in Turkey Vs. Other Countries?

What are Pre-treatment and Post-treatment Expenses in Acute Myeloid Leukaemia Treatment?

Some diagnostic questions related to the patient's family history or any possible exposure to toxic agents are asked by the doctors. Then they refer for blood tests, lumbar puncture, and CT scans to examine the spread of cancerous cells. Then, the therapies such as chemotherapy or targeted treatments are planned. The patient must consider these additional costs under the treatment.

• Pre-treatment examination cost (complete blood count, bone marrow biopsy, cytogenetic and molecular testing, bone imaging studies, serum and urine protein electrophoresis etc.): USD 1500 to USD 1800

• Post-treatment cost for initial 2 months (bone marrow biopsy with follow-up consultations and medications): USD 1200 to USD 1600

What should be Post-treatment Care after Acute Myeloid Leukaemia treatment?

In acute myeloid leukaemia (AML), effective management following treatment becomes crucial. Some lifestyle changes and additional care may help patients with reduced risk of recurrence after treatment. Some of the common suggestions are listed below.

Adopting healthy lifestyle

Patients recovering from AML may face anaemia as there is severe destruction of healthy blood cells. Hence, it's highly recommended to maintain a healthy lifestyle post- AML treatment for faster recovery.

• Consume a healthy diet

• Take a good sleep

• Quit smoking and alcohol

• Avoid exposure to toxic carcinogens

Long term follow-up

After the AML treatment, it is crucial if any signs or symptoms are there indicating a recurrence of leukaemia. This involves a thorough physical examination with regular blood tests to check for abnormal levels of white blood cells, blasts, or other indicators. You should regularly consult your doctor even after the AML treatment and inform them about any unusual change immediately.