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Suggest Treatment For AML And Mouth Ulcer

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Posted on Thu, 9 Oct 2014
Question: Hi Doctor,
My Mom aged 45 is diagnosed AML - M2.
She had mouth ulcer and irritation on eating food. We went for check up, they have done endoscopy and a blood test. In the blood report, Platelets count was less. Followed that we did Peripheral Smear and Bone Marrow test in XXXXXXX They confirmed it as leukemia (AML - M1). Then for reconfirmation we have checked in XXXXXXX and they say it is AML-M2. We asked why there is a difference in sub type. But the doctor told not much of difference with M1 and M2 and not to worry on that. As XXXXXXX is our home town we have admitted her in hospital today for treatment.
1.Wanted to know why there is difference in subtype? Will the subtype M1 and M2 will cause any issue?
2. Are the treatment and medicines same for M1 and M2?

Bone marrow again done today for some genetic (Chromosome) test.
we have been informed that Chemotherapy will be first step treatment.
2. Wanted to know are we on direct direction?

Looking forward a reply.
Thanks in advance
doctor
Answered by Dr. Indranil Ghosh (41 minutes later)
Brief Answer:
It is treatable disease

Detailed Answer:
Hi
Thanks for your query. I am sorry to hear about your mom.
My responses to your queries...
1.Wanted to know why there is difference in subtype? Will the subtype M1 and M2 will cause any issue?
A. No, this is old classification and not important nowadays because of genetic classification. Cytogenetic study has already been done in her.

2. Are the treatment and medicines same for M1 and M2?
A. Yes they are the same.

3. Wanted to know are we on direct direction?
A. yes, you are on the right track.

I am sure she will do well. However, because of the disease per se and the effect of chemo, there may be fever, other infections, requiring antibiotics and need for blood and platelet transfusions.

Hope this helps. I will be available to answer further followup queries, if any.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (11 minutes later)
Thanks a Lot Doctor for a such a quick response.

Your reply helps me to be more positive.

She has tiredness and no fever till now. But there is red spots in body.
1. Is this because of low platelet count?

2. As per the blood report, Doctor told not to worry on the low count ,anyways that will be treated. But he told that the challenge for us now is low Neutrophil(not sure) count - is just 3. So he says there is high chance of infections.
So how do we manage this? Will we get this in control by Chemotherapy treatment.

Morning bone marrow is done post that she is taken for cardiac test, after which they told we cant start the treatment.

Thanks once again for such a positive reply.
doctor
Answered by Dr. Indranil Ghosh (3 hours later)
Brief Answer:
please refer below

Detailed Answer:
yes, the red spots may be due to low platelets

neutrophil count is low because of the disease. after treatment, it will recover but will take around three weeks. This period is critical. Will need to treat any fever or infections with prompt antibiotics.

regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (2 days later)
Thanks a lot for the reply Doctor.

Treatment is going on fine. She is getting Shivering and Fever now and then. Doctor told it will be like that only, no need to worry. They give some injection for the shivering to stop.

Some medicine is given as trips 24/7.


1.Her Face is swollen. Does it indicate anything? or it is just because of this treatment.Is everything fine?
2.She says she feels hungry but not able to eat if we give food. She hardly takes few. But she is fine in taking liquid foods like juices,milk, horlicks. Is this fine?
doctor
Answered by Dr. Indranil Ghosh (8 hours later)
Brief Answer:
nothing to worry

Detailed Answer:
shivering may be because of blood transfusion, chemo or infection. Her doctor will treat accordingly.

face may be swollen because of low hemoglobin or excess fluid therapy. Please check this with your doctor.

Because of chemo there may be aversion to food. If she is able to take nutritious liquids plenty then it is fine.

Regards
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Suggest Treatment For AML And Mouth Ulcer

Brief Answer: It is treatable disease Detailed Answer: Hi Thanks for your query. I am sorry to hear about your mom. My responses to your queries... 1.Wanted to know why there is difference in subtype? Will the subtype M1 and M2 will cause any issue? A. No, this is old classification and not important nowadays because of genetic classification. Cytogenetic study has already been done in her. 2. Are the treatment and medicines same for M1 and M2? A. Yes they are the same. 3. Wanted to know are we on direct direction? A. yes, you are on the right track. I am sure she will do well. However, because of the disease per se and the effect of chemo, there may be fever, other infections, requiring antibiotics and need for blood and platelet transfusions. Hope this helps. I will be available to answer further followup queries, if any.