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Suggest treatment for blood cancer

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Posted on Fri, 31 Oct 2014
Question: The attached lab report is for my wife. Kindly suggest whether she is negative or positive for blood cancer. Please go through all seven pages of the report. At present she is pregnant and it is done through IVF.Pregnancy is 2 months old. Kindly let me know whether she is positive or negative to blood cancer.
doctor
Answered by Dr. Monish De (35 minutes later)
Brief Answer:
Bone marrow biopsy to rule out blood cancer.

Detailed Answer:
Hi,

Thanks for the query.

I have gone through the reports in detail.

Since your wifes WBC count has increased and 4% atypical cells are seen along with increased lactate dehydrogenase I would advise your wife to do a bone marrow biopsy to rule out blood cancer.

After getting the bone marrow biopsy, please upload the reports to discuss on the further management.

Regards

DR De
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Monish De (16 minutes later)
Sir,
i thought they done the bone marrow biopsy. I get a doubt that last two pages of the uploaded report is bone marrow biopsy?. Kindly clarify.

Sir,
If the last two pages of the uploaded report is not for bone marrow biopsy,then kindly let me know what the report is for
doctor
Answered by Dr. Monish De (24 minutes later)
Brief Answer:
mutation test

Detailed Answer:
Hi

The last 2 pages of the report are certain mutation test in blood whose presence may indicate blood cancer such as leukemia but in your wifes case both are negative.

However the confirmatory test to rule out blood cancer is bone marrow biopsy.

If you have no more clarifications then please rate the answer and close the thread.

Regards

DR De
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Monish De (18 hours later)
Sir,
i would like to know the following test is for bone marrow biopsy.
"AML-COMBOQUEST III
Panel of inversion 16, translocation AML 1/ETO, translocation PML-RARa and FLT3 Mutation analysis"

This one i copied from the receipt of the XXXXXXX paid for the test.
doctor
Answered by Dr. Monish De (23 minutes later)
Brief Answer:
prognosis of blood cancer

Detailed Answer:
Hi

Once leukemia is diagnosed prognosis can be assessed with the help of these mutation tests such as Panel of inversion 16 which can be done from blood or from bone marrow and in your wifes case it is negative.

If bone marrow test is done then it should mention about leukemic cells which it has not been mentioned.

Regards

DR De
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Monish De (48 hours later)
Sir,

Please find here the Biopsy Report from the hospital/Lab. Kindly give a proper feed back on the same.

Attached : report 2 & report 3
doctor
Answered by Dr. Monish De (2 hours later)
Brief Answer:
Acute myeloid leukemia

Detailed Answer:
Hi

As per the report 2 and 3 of bone marrow your wife is suffering from type of blood cancer called acute myeloid leukemia.

It is a treatable disease.

The first treatment required is induction chemotherapy. This aims to get rid of all signs of the leukaemia. If it works, then she is said to be in remission.

Then you need treatment to lower the chance of your wifes leukaemia coming back.

Regards

DR De
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Monish De (9 minutes later)
Sir,

Is the condition is worst at present as per report or it is in the early stage or later stage?
doctor
Answered by Dr. Monish De (1 hour later)
Brief Answer:
Complete response to chemotherapy

Detailed Answer:
Hi

Their is no stage for such type of blood cancer.

Chemotherapy drugs will kill off many of your wifes normal bone marrow cells as well as the leukaemia cells.

If the treatment works, normal bone marrow cells come back in 2 to 3 weeks and start making blood cells again.

Overall, between 5 and 7 out of 10 people with adult acute myeloid leukaemia go into remission with induction chemotherapy meaning chemotherapy will provide complete response.

Even if she is in remission after the treatment a very small number of leukaemia cells may survive.

Although there may be too few to see in blood or bone marrow tests, the leukaemia is likely to come back without further treatment.

To try to stop this, she will have to go to the next stage of treatment, which is called consolidation therapy.

After she has her treatment finished she will need to have regular check ups. .

At first, they will be every few weeks.

If all is well, then she will go for follow up checkup every monthly for 3 months, then 2 monthly for 6 months, then 3 monthly for up to 3 years after her treatment.

If you have no more clarifications then please rate the answer and close the thread.

Regards

DR De
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Dr. Monish De

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Suggest treatment for blood cancer

Brief Answer: Bone marrow biopsy to rule out blood cancer. Detailed Answer: Hi, Thanks for the query. I have gone through the reports in detail. Since your wifes WBC count has increased and 4% atypical cells are seen along with increased lactate dehydrogenase I would advise your wife to do a bone marrow biopsy to rule out blood cancer. After getting the bone marrow biopsy, please upload the reports to discuss on the further management. Regards DR De