What is meant by refractory leukemia?

Refractory leukemias are a group of such leukemias:

  • Not effective after 2 courses of chemotherapy with standard regimens;
  • Rapid relapse (within 12 months) after complete remission;
  • Relapses that are not rapid (>12 months) but have failed after conventional chemotherapy;
  • 2 or more relapses;
  • Persistent with chemotherapy after leukemic invasion of organs other than bone marrow.

Refractory leukemia has a poor prognosis and develops primarily because leukemic cells become resistant to chemotherapeutic agents. Current treatment strategies for refractory leukemia include combination chemotherapy regimens consisting of new drugs without cross-resistance, hematopoietic stem cell transplantation, and novel targeted therapeutic agents and biologic therapies.

Dr. Xin Li, Department of Hematology, Shanghai Renji Hospital South Hospital, also contributed to this Q&A