Professor Kim Dong-wook of Seoul St. Mary’s Hospital

By Bae Ji-sook
Staff Reporter

Leukemia used to be a deadly disease.

Professor Kim Dong-wook of Seoul St. Mary's Hospital declared those days are gone. "Now with good medication and other treatments, I see more than 70 percent of the patients survive for more than five years," he said.

Leukemia is a cancer that originates in bone marrow and spreads in cells that in a healthy person would have turned into white blood cells.

Leukemia is classified as either acute or chronic. Acute leukemia is caused by the rapid increase of immature blood cells, which makes the bone marrow unable to produce healthy blood cells.

It takes only a couple of months for the acute form of leukemia to develop into a more serious illness. "It needs swift treatment; it doesn't take long till it gets fatal and may affect other organs," Kim said.

Chronic leukemia is caused by the excessive build up of relatively mature but abnormal white blood cells.

While acute leukemia is more common among youths, the chronic form is detected more in older people.

Chronic leukemia is detected more in Caucasians, affecting about 1.8 people in every 100,000 in the U.S. while it is between 0.6 and 0.8 in Korea.

For chronic leukemia, it's prevalent among those over 55 years old in the Western hemisphere, but, in Asia, the age bracket goes down to between 40 and 45 years old.

Also, men are more likely to get the disease with odds of about 1.6:1.

"We haven't yet found what causes the cancer in blood. What we have figured is just a matter of chances," Kim said when asked what causes these differences.

There are several factors that are believed to be related to the disease ― excessive drinking, smoking, use of solvents and exposure to radiation.

There are currently about 30,000 leukemia patients in Korea, with several symptoms.

"Some women experience menstruation for more than 10 days. Sometimes nose bleeding won't stop," he said.

Acute leukemia takes up about 85 percent of the patients.

When one suffers from chronic cases, fatigue and excessive cold sweats linger for a long time. "It usually takes about five years for cells to develop into cancer," Kim said.

For many years, bone marrow transplantation seemed to be the only treatment for the disease. Finding the perfect person ― usually a family member or relative ― was quite difficult.

Kim was the first person in Korea to conduct transplantation between people with different blood types.

"The operation brought light to many people who couldn't find a sibling, parents and others who have the matching bone marrow," he said.

Still, he conducts less than 100 surgeries a year because he finds the operation quite risky. "About 20 percent suffer from various complications that could eventually cause death within three years from the surgery. Also, the recovery process takes about a year. Side effects occur from time to time, which can be quite risky," he said.

These days, medication has made up the largest portion of treatment.

Gleevec has replaced most bone marrow transplantation and interferon treatment.

According to its distributor Novartis, it acts by "specifically inhibiting a certain enzyme, tyrosine kinase, that is characteristic of a particular cancer cell, rather than non-specifically inhibiting and killing all rapidly dividing cells."

In chronic myelogenous leukemia, tyrosine kinase is active. Imatinib attaches to the problem, and prevents the enzyme's activity. The drug doesn't necessarily stop the disease, but instead controls it.

As much as Gleevec has been called the "magic bullet" by Western media, Kim has also said that the drug has contributed a lot to human lives. "The drug has lifted up the two-year-survival rate to 99 percent. These days, only about 50 people die of the disease a year, which is less than 5 percent of the total number of the newly diagnosed," he said.

For those not helped by Gleevec, Sprycel is prescribed.

"The drug has, I think, covered about 80 percent of what Gleevec left out," said Kim, who has been involved in clinical tests for both drugs here.

In fact, Novartis is gearing up for a so-called Super Gleevec, which will cover all cases of leukemia. Kim is now directing the second stage of clinical tests for the Asian market.

Also, Kim is conducting a third stage clinical test for domestic drug maker Ilyang Pharmaceutical Co. on leukemia medicine. It has already earned patents in both the U.S. and Korea, and the future is quite bright.

"The development of the drug will relieve patients from the high price of Gleevec. It costs about 30 million won for patients and a lot more is covered by the national health insurance. However, they will be able to benefit from the equivalent effect for a much lower price once it gets the Korea Food and Drug Administration's approval," he said.

Kim says the current medication technique has already brought quite a benefit to patients' lives. What he is striving to do is to find the root and cause of the disease and prevent it.

"I am afraid we aren't quite up to that stage yet because Korea lacks foundational research," he said.

"But there are some aspiring doctors dedicated to the disease and I am sure we can figure it out."

bjs@koreatimes.co.kr

Who is Kim Dong-wook? Kim graduated from Catholic University. Having studied under professor Kim Chun-soo, who is the pioneer of oncology studies in Korea, Kim became a renowned figure in the circle in the 1990s. He has worked for the Fred Hutchinson Cancer Center, Samsung Medical Center and many other top-class facilities. He is now one of the board members of the International Chronic Myelogenous Leukemia Foundation. Seoul St. Mary's Hospital has joined forces with KIST to develop a third-generation drug for leukemia. Specific plans have not been decided yet. Among the developers will be one of the developers of the original Gleevec, which raises the hopes for a positive outcome. Kim is also working on establishing a pan-Asia database of leukemia patients in Thailand, Taiwan, the Philippines, China, India and Indonesia. The standardization of molecular analysis and clinical practice is expected to accelerate research for conquering the disease.