question-icon

What does my lab test report indicate?

default
Posted on Thu, 19 May 2016
Question: i want answer by Dr parth XXXXXXX desai
5 days back i ask questions to parth desai
l attached report
doctor
Answered by Dr. Anil Parth Desai (31 minutes later)
Brief Answer:
Hi....I would recommend following

Detailed Answer:
Dear sir,
Thank you for your query.
The immuno diagnosis is anaplastic large cell lymphoma. It is a special type of T cell lymphoma.
The next step is to confirm ALK ( Anaplastic lymphoma kinase) mutation status that occurs in this lymphoma and determines type of chemotherapy. Also a PET ( Positron emission tomography) scan is needed to see extent of nodal or extranodal involvement.
I hope this helps.
Let me know if you have more concerns sir.
Wish you all the best.
Sincerely,
Dr parth XXXXXXX desai.
Above answer was peer-reviewed by : Dr. Deepak
doctor
default
Follow up: Dr. Anil Parth Desai (16 hours later)
Sir
Dr XXXXXXX shah write tablet for one week
And suggest 6 chemo to be taken in
Interval of 14 days than blood change
doctor
Answered by Dr. Anil Parth Desai (1 hour later)
Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Sir,

Thank you for your reply query.

It is good to know that Dr Shah has started chemotherapy and seems like the right chemotherapeutic schedule. Also blood transfusions may be necessary in between since the blood count is low. But, Kindly let me know what specific chemotherapy has been initiated.

The PET scan report showed multiple bony involvement and splenic involvement.Also, the ALK-1 immunohistochemistry stain is negative so ALK mutation study is not needed.

From the complete analysis of the report it seems that this is a lymphoma of anaplastic type non hodgkins lymphoma. However, I would recommend the following more immunohistochemistry panel if you can suggest to the reporting pathologist-
I would recommend a panel for XXXXXXX (EBV Virus related immuno marker), CD8 and CD 138 and CD 38 to confirm whether it is a ALK negative Anaplastic lymphoma or Plasmablastic Lymphoma.

I wish you all the best for the chemotherapy.
Let me know if you have any more questions or concerns Sir.
Sincerely,
Dr Parth Desai

Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Anil Parth Desai (3 hours later)
Hi, I have provided some attachments. Please review them.

I provided attachment pl answer me
doctor
Answered by Dr. Anil Parth Desai (1 hour later)
Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Sir,
Thank you for your reply query.

As you uploaded, these are the standard NCCN guidlines followed by most institutions for cancer treatment. We also follow the same schedules at MD XXXXXXX cancer center. For ALK- ALCL which the pathologist seems to consider as 1st possibility the best treatment in this case would be chemotherapy using CHOEP, CHOP-14 or CHOP-21 regimens followed by assessement of complete response. IF there is a complete response there several options one of which your hematologist is choosing is high dose chemotherapy with stem cell rescue which is autologous transplantation, where patient's own stem cells previously collected will be instilled in his body after giving him very strong chemotherapy. But before that the tumor load needs to be cleared with any of the regimens I previously mentioned and the bone marrow needs to be cleared of tumor. These chemotherapy regimens are moderatly toxic and you might experience weakness, some loss of hair and fatigue. But with good supportive care these can be taken care of.

The most important thing is to maintain personal hygiene in and around the treatment center and home and eat healthy food and take proper rest but at the same time keep yourself active with moderate amounts of walking. Also keep drinking lot of water and keep yourself hydrated.

I hope this helps.
Wish you all the very best.
Let me know if you have any more questions or concerns.
Sincerely,
Dr Parth Desai
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Anil Parth Desai (28 hours later)
Sir
I hard that born marrow transplant
Succes ratio only 30 %
It is true
doctor
Answered by Dr. Anil Parth Desai (1 hour later)
Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Sir,

Thank you for your reply sir.

Bone marrow transplant as a procedure has evolved over years and now is a much safer procedure especially autologous transplant which will be mostly done in your case. It uses your own stem cells to rescue your bone marrow after giving high dose chemotherapy to wipe out all the malignant cells.

However, the success also depends on how good the first chemotherapy regimen works for the patient and we hope it works the best in your case. If it works fine and there is no or minimal residual disease then tranplant can yield good results as high as 44% success rate which is a good percentage given the aggressiveness of these disease. The most important thing is to maintain good discipline with chemotherapy, eat healthy, stay active and keep good hygiene to prevent infections and then wish for the best possible results.


I hope this helps sir.
Let me know if you have any more questions or concerns.
Wish you all the best.
Sincerely,
Dr Parth Desai
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Anil Parth Desai

Pathologist and Microbiologist

Practicing since :2009

Answered : 593 Questions

premium_optimized

The User accepted the expert's answer

Share on
What does my lab test report indicate?

Brief Answer: Hi....I would recommend following Detailed Answer: Dear sir, Thank you for your query. The immuno diagnosis is anaplastic large cell lymphoma. It is a special type of T cell lymphoma. The next step is to confirm ALK ( Anaplastic lymphoma kinase) mutation status that occurs in this lymphoma and determines type of chemotherapy. Also a PET ( Positron emission tomography) scan is needed to see extent of nodal or extranodal involvement. I hope this helps. Let me know if you have more concerns sir. Wish you all the best. Sincerely, Dr parth XXXXXXX desai.