Tuesday, 20 December 2016

Diagnosis and treatment of leukemia

Diagnosis and treatment of leukemia
Diagnosis
In addition to a medical history and a physical exam to look for signs of leukemia, the diagnosis of leukemia typically involves laboratory studies of a blood sample. Abnormal numbers of blood cells may suggest a diagnosis of leukemia, and the blood sample may also be examined under the microscope to see if the cells appear abnormal.
·         Physical exam. The doctor will look for physical signs of leukemia, such as pale skin from anemia, swelling of the lymph nodes, and enlargement of the liver and spleen.
·         Blood tests. By looking at a sample of the blood, the doctor can determine if the patient has abnormal levels of white blood cells or platelets — which may suggest leukemia.
·         Bone marrow test. A sample of the bone marrow may also be obtained to establish the diagnosis. For a bone marrow aspirate, a long, thin needle is used to withdraw a sample of bone marrow from the hip bone, under local anesthesia. A bone marrow biopsyinvolves insertion of a thick, hollow needle into the hip bone to remove a sample of the bone marrow, using local anesthesia.
Treatments for leukemia
As the various types of leukemias affect patients differently, their treatments depend on what type of leukemia they have. The type of treatment will also depend on the patient's age and his state of health. As treatment has improved, the aim of virtually all health care professionals should be complete remission - that the cancer goes away completely for a minimum of five years after treatment. Treatment for patients with acute leukemias should start as soon as possible, this usually involves induction therapy with chemotherapy, and takes place in a hospital. When a patient is in remission he will still need consolidation therapy or post induction therapy. This may involve chemotherapy, as well as a bone marrow transplant (allogeneic stem cell transplantation). If a patient has Chronic Myelogenous Leukemia (CML) his treatment should start as soon as the diagnosis is confirmed. He will be given a drug, probably Gleevec (imatinib mesylate), which blocks the BCR-ABL cancer gene. Gleevec stops the CML from getting worse, but does not cure it. There are other drugs, such as Sprycel (dasatinib) and Tarigna (nilotinb), which also block the BCR-ABL cancer gene. Patients who have not had success with Gleevec are usually given Sprycel and Tarigna. All three drugs are taken orally.

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