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Doctors Lounge - Oncology Answers

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Forum Name: Leukemia

Question: Newly diagnosed with leukemia


 flammia - Thu Jul 01, 2004 1:10 pm

Right now I am having an episode of something. It happens very often. I can be doing anything and breathing just fine and then the next second, I am very thirsty for air. I can not get enough air. The result, dizziness. What is going on. It also feels funny, it feels like someone is squeezing my throat.
HELP.
 Dr. Tamer Fouad - Wed Jul 07, 2004 7:02 pm

User avatar Flammia,
I am sorry to hear that it turned out to be leukemia.

Best regards.
 flammia - Sat Jul 10, 2004 6:12 pm

the type that I have is called CML
 Dr. Tamer Fouad - Sun Jul 11, 2004 12:31 am

User avatar Dear flammia,
You can read more about this disease on our CML page. cml.htm" class="postlink">Click here!
Bone marrow transplantation will be one of the most important therapeutic option to take into consideration since you are young.
 flammia - Mon Jul 12, 2004 9:28 am

Well. I have learned about the possible side effects in my nursing class, so I am kind of nervous about any move I make about treatment.
 Dr. Tamer Fouad - Mon Jul 12, 2004 11:09 am

User avatar Flamina,
If you check the drug info on any drug you will find a huge list of side effects that can all really scare you. Chemotherapy is no different than drug info in that respect. You will hear alot of really alarming side effects. This is where an oncologist comes in. He weighs the benefits with the side effects and chooses the regimen that best suites you. An important point is that you are young and a lot of the side effects you will hear about will be well tolerated by you.

Post the treatment options you have been given and your fears about them and we can discuss them here and try to help you reach a decision.

Best regards,
 flammia - Mon Jul 12, 2004 12:35 pm

I have been givin the following options:

Combination therapy of daunorubicin and gleevec.
Immunotherapy
allogeneic bone marrow transplant
radiation



First of all. the nausea with chemo gets me. I know very little about immunotherapy and radiation.
 Dr. Tamer Fouad - Mon Jul 19, 2004 12:22 am

User avatar Besides the obvious side effects you must weigh out the benefits of each type of therapy. Let me start by telling you that CML like any other cancer requires tough therapy. However, unlike many other types of cancer it is curable, especially in young patients.

All the options you have mentioned have side effects. However, they all have varying success rates and some are more promising than others. Like most cancer therapy, treatment is still experimental and so many questions remain unanswered.

We really don't know which option would be best for your case. We do however, know some very useful facts. In terms of benefits:

First as outlined in the article, CML is caused by a gene translocation which leads to an abnormal protein production (tyrosine kinase) which leads to the manifestations of this disease. The gene translocation is called Philadelphia chromosome and can be detected easily by sampling blood or bone marrow.

The only consistently successful curative treatment of CML for more than half of eligible patients has been allogeneic bone marrow or stem cell transplantation. Long-term data beyond 10 years of therapy are available and most long-term survivors show no evidence of the BCR/ABL translocation by any available test. However, many patients are not eligible for this approach because of age, comorbid conditions, or lack of a suitable donor. In addition, there is substantial morbidity and mortality from allogeneic bone marrow or stem cell transplantation; a 15% to 30% treatment-related mortality can be expected, depending on whether the donor is related and on the presence of mismatched antigens.

Long-term data are also available for patients treated with interferon alfa (immunotherapy). Approximately 10% to 20% of these patients have a complete cytogenetic response with no evidence of BCR/ABL translocation by any available test and the majority of these patients are disease-free beyond 10 years. Maintenance of therapy with interferon is required, however, and some patients experience side effects that preclude continued treatment.

Gleevec (Imatinib mesylate), a specific inhibitor of the BCR/ABL tyrosine kinase, produces a complete cytogenetic response in more than 60% of previously untreated patients with very few side effects. No long-term data exist as yet in regards to the durability of this response, and there is no information about the efficacy of salvage strategies using interferon alfa or allogeneic stem cell transplantation after failure of Gleevec. In addition, almost all completely responding patients still show detectable evidence of the BCR/ABL translocation by some tests. The clinical implication of this finding is unknown.

As can be seen most therapeutic options are toxic but the good news is that there is hope for complete cure from this disease.

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