At first you feel tired and ignorant, putting everything under stress, then start to get dizzy, you are getting weaker and the colds are more frequent and more aggressive. That's how leukemia starts, a disease whose causes are not fully understood by doctors. Once you receive your blood tests, you get certain questions and questions, because the diagnosis of leukemia is not so easy.
Complex analyzes are required, many doctors' visits, many interventions, because infections are much easier in your weakened immune system - this in Romania, according to the site CSID.ro.
In other countries, specialists have a well-established protocol, know exactly how to proceed, what analyzes to ask and where to send the patient to get the treatment as soon as possible. And the patient has another mentality: he goes to the doctor as soon as he notices that something is wrong, he does not wait until the last moment, he does not care for his ear and does not care about the money that needs to enter the right pockets. But this is a long discussion and will find its place at some point.
Our guide is Prof. Univ. Dr. Paul Knobl, MD at the Medical University of Vienna, an expert haematologist at the Oncology Center at Vienna Private Hospital.
Prof. Dr. Knobl: Leukemia is installed when there are too many white blood cells in the blood, in other words, the spinal cord produces too many leukocytes. In many cases, these cells reach the blood, but there are cases where these cells stick to the bone marrow and replace the remaining healthy ones. In a laboratory analysis, we can see the opposite: the leukocyte level is normal or even very small.
Until now, chronic and acute leukemia have been diagnosed. Depending on how affected the bone marrow is, they are divided into: myeloid leukemia, lymphoid s.a.m.d, but also in leukemia with mature or immature cells. The most common types are: lymphocytic leukemia (represents 30-40% of all forms of leukemia), chronic myeloid leukemia, acute myeloid leukemia and acute lymphoblastic leukemia. At the opposite end, the most rare types are hair cell leukemia and plasma leukemia (2-4%).
Prof. Dr. Knobl: We can see that something is wrong and we should consult a doctor as soon as one or more of the following occurs:
- anemia (low red blood cells or red blood cells) that gives a state of weakness, difficulty breathing, palpitations and very fast pulse;
- thrombocytopenia (low platelet or blood platelets) that causes bleeding, most of the skin or nose;
- infections, feverishness or gingival infections caused by the low level of healthy white cells.
In some cases of leukemia, other signs for a correct diagnosis would be the elevated and abnormal dimensions of the liver, spleen or lymph nodes. You have to ask your doctor if you feel an unexplained weakness, breathing is difficult, night sweats appear, the face is pale, you have fever that does not decrease even with antibiotics, lymph nodes are enlarged or there are abnormalities of the gums. At this point, you should go to the doctor for a set of blood tests.
The first step in diagnosis is given by blood testing - cell counting and even differential blood analysis (white cell count - number, shape, etc.). If the values are normal, there is little chance of talking about leukemia. But if abnormalities occur, the recommendation is to go to a haematologist.
Prof. Dr. Knobl: Chronic leukemia progresses slowly, so it may be delayed in a few days to examine the spinal cord. However, for acute leukemias, diagnosis and treatment are needed as quickly as patients can die within a few days due to very serious infections, brain bleeding or organ failure.
Prof. Dr. Knobl: There is a wide range of therapies for each type of leukemia, but a personalized treatment is required, closely related to the patient's history, because each individual has a specific leukemia disease. We can not speak of a common procedure for all types of leukemia. For example, lymphocytic leukemia - you can live with this condition many years without the need for therapy. Regarding chronic myelogenous leukemia, it is treated with tyrosine-kinase inhibitors in the form of pills to be taken for many years.
However, cytotoxic chemotherapy remains the main treatment for acute leukemia, sometimes even in association with stem cell transplantation. Treatment strategies, as well as new molecules appear more and more, studies are conducted even at this time. Therefore, there is a need for well-thought-out oncology centers, not only with oncology specialists, but also from the rest of the medical disciplines to address the patient individually, such as the Vienna Private Hospital (WPK) Oncology Center.
Prof. Dr. Knobl: Immunotherapy with antibodies targeting diseased cells is now part of several treatment strategies. New forms of immuno-oncological treatments (eg immune system inhibitors) are still available only to treat certain forms of leukemia, but this can change. With regard to stem cell transplantation, I can say that it is the result of a multitude of factors and it is never an easy decision to take, because of the very complex and expensive logistics, but especially the very high risks for the patients' lives.
Plus Medical collaborates with top hospitals in the world: TURKEY (Liv Hospital, Acibadem, Anadolu, Medicana, Hisar si Medipol), AUSTRIA (Wiener Privatklinik) and ISRAEL (Herzliya and Assuta).
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