Hematology

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Hematology

Hematology (Blood Disorders)

Conditions Treated

Acute Myeloid Leukemia:

What is acute myeloid leukemia?

Acute myeloid leukemia (called "AML") is a type of blood cancer. AML is usually fast-growingand needs to be treated quickly.

Blood is made up of different types of cells. These cells are made in the center of your bones, in a part called the bone marrow. When people have AML, their bone marrow makes abnormal blood cells instead of normal blood cells. These abnormal blood cells grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body.

When the bone marrow makes abnormal blood cells, it does not make the normal blood cells a person's body needs. This can cause symptoms.

What are the symptoms of AML?

The most common symptoms of AML include:

Feeling very tired and weak
Bleeding more easily than normal
Getting sick from infections more easily than normal

Is there a test for AML?

Yes. Your doctor or nurse will talk with you and do an exam. They will also do:

Blood tests
A bone marrow biopsy – A doctor will take a very small sample of your bone marrow. Then, another doctor will look at the cells under a microscope to see if abnormal (cancer) cells are present.

There are different types of AML. The test results can show which type you have. The right treatment for you depends a lot on your age and the type of AML that you have.

How is AML treated?

Treatment for AML usually includes 2 parts.

The first part of treatment is called "induction of remission" and lasts about 4 weeks. During this part, people stay in the hospital and get chemotherapy. Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.

For people who are not well enough to get this much chemotherapy, there are other treatments. But they are generally not as effective.

Many people are in "remission" after chemotherapy. This means that doctors do not see any abnormal blood cells in the blood or bone marrow. But even though doctors do not see any abnormal cells, there are still abnormal cells in the body. To kill these cells and prevent AML from returning, people need more treatment.

The second part of treatment is called "post-remission therapy." During this time, people can have 1 or more of the following treatments:

More chemotherapy – People might need to stay in the hospital for a few days each month to get chemotherapy. This treatment can last 3 or 4 months.
A bone marrow transplant (also called "stem cell transplant") – This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. These "donor" cells can come from different places, including:
- People who are related to you, and whose blood matches yours
- People who are not related to you, but whose blood matches yours
- Blood (that matches yours) from a newborn baby's umbilical cord

One type of AML, called "acute promyelocytic leukemia" (or "APL"), is treated differently from other types. People with APL might get other types of medicine, either with or without chemotherapy.

Acute Lymphoblastic Leukemia (ALL):

What is acute lymphoblastic leukemia?

Acute lymphoblastic leukemia, or "ALL," is a type of blood cancer. ALL grows very fast and needs to be treated quickly.

Blood is made up of different types of cells. These cells are made in the center of bones, in a part called bone marrow.

When people have ALL, their bone marrow makes abnormal blood cells. These abnormal cells grow out of control, get into the blood, and travel around the body. Sometimes, they collect in certain parts of the body.

When bone marrow makes abnormal blood cells, it does not make the normal blood cells a person's body needs. This can cause symptoms.

What are the symptoms of ALL?

The most common symptoms include:

Feeling very tired and weak
Bleeding or bruising more easily than normal
Getting sick from infections more easily than normal

Is there a test for ALL?

Yes. Your doctor or nurse will talk with you and do an exam. They will also do:

Blood tests
Bone marrow biopsy – A doctor removes a small sample of bone marrow using a needle. Then, the sample is examined under a microscope to see if ALL cells are present.

How is ALL treated?

Treatment for ALL is usually made up of 3 parts.

The first part of treatment is called "induction of remission." It lasts about 4 weeks. During this part, people generally stay in the hospital and get chemotherapy. Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
Depending on your specific type of ALL, you might also get other treatments:
- "Immune therapy" works with your body's infection-fighting system to kill cancer cells.
- "Targeted therapy" involves medicines that work only for cancers with certain characteristics.
Most people are in "remission" after getting chemotherapy. This means that doctors do not see any more abnormal ALL cells in their blood or bone marrow. But even though doctors do not see any abnormal cells, there are still ALL cells in the body. To kill these cells and prevent the ALL from returning, people need more treatment.
The second part of treatment is called "consolidation/intensification therapy." It lasts a few months. During this part, people generally have more chemotherapy. But it is given at a lower dose than before, and you might not need to stay in the hospital overnight.
The third part of treatment is called "maintenance therapy." It might last 2 or more years. During this part, people get chemotherapy once a month. They also take other medicines (pills) on certain days of the month. Many people can return to their usual activities during this part.

Chronic Lymphocytic Leukemia

Chronic Myeloid Leukemia(CML):

What is chronic myeloid leukemia?

Chronic myeloid leukemia (called "CML") is a type of blood cancer. Blood is made up of different types of cells. Blood cells are made in the center of your bones, in a part called the bone marrow.

People with CML have an abnormal gene in some of their blood cells. This gene causes the bone marrow to make abnormal blood cells. These abnormal blood cells can grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body.

When the bone marrow makes abnormal blood cells, it does not make enough of the normal blood cells a person's body needs. This can cause symptoms.

There are 3 stages, or "phases," of CML:

During the chronic phase, the cancer grows very slowly. Most people are in this phase when their CML is diagnosed. This phase can last for years.
During the accelerated phase, the cancer begins to grow faster.
During the blast phase, the cancer is fast-growing and can be fatal.

Treatment depends, in part, on the phase of your CML.

What are the symptoms of CML?

CML does not always cause symptoms, especially at first. When it does cause symptoms, the most common ones are:

Feeling very tired and weak
Sweating much more than usual
Losing weight without trying
Feeling full after eating a small amount of food
Bleeding more easily than normal

Is there a test for CML?

Yes. Your doctor or nurse will talk with you, do an exam, and do blood tests. They might also do a bone marrow biopsy. For this test, a doctor takes a small sample of your bone marrow. The sample is then examined under a microscope to see if abnormal (cancer) cells are present.

How is CML treated?

Doctors can treat CML in different ways. When CML is first diagnosed and in the chronic phase, it is treated with pills called "tyrosine kinase inhibitors" (or "TKIs"). TKIs kill the blood cells that have the abnormal CML gene. When these blood cells are gone, the bone marrow can work normally again. TKIs do not cure CML, but they can control it for many years. If you take a TKI, it is very important to take every single dose. Skipping pills can allow the CML to grow out of control. Most people with CML must take a TKI for the rest of their life.

People who have too many side effects from their TKI, or whose CML starts to grow faster, can have other treatments. These can include:

Another TKI – Different TKIs have different side effects. Also, one TKI might work better to control your CML than another. If one TKI doesn't work for you, another might.
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
Bone marrow transplant (also called "stem cell transplant") – This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. These "donor" cells can come from another person whose cells match yours in specific ways.
A type of medicine called "interferon alfa"

Treatment also involves regular follow-up visits, exams, and blood tests. Some people, but not everyone, might need additional bone marrow biopsies.