CAMAGÜEY.- To address the issue of leukaemia, we turned to Dr. Félix Leandro Morfa Viamontes, specialist in Hematology at the Amalia Simoni Clinical Surgery Hospital, from this city, which was built 18 years ago.
Our consult started this way:
"Leukemia may be acute and chronic. Acute leukemia is a clonal proliferation of immature cells that infiltrate the bone marrow. These are called blast cells. From the epidemiological point of view, in the case of adults, there is an increasingly tendency to the acute myeloid rather than to the acute lymphoid. The variants of the latter are most common in children".
- What is its prognosis?
- Myeloid leukemia is the most serious one, although some cases I do not consider appropriate to mention medical definitions, they can evolve favorably.
- Symptoms?
- The symptoms of acute leukemia are very singular, and start from the damage to blood elements. A patient may have a decrease in hemoglobin with anemia as the first symptom and a low level of leukocytes in blood (leukopenia), and besides, platelets below normal levels (thrombocytopenia).
“An individual may have bicytopenia, which is a decrease in two cell lines in blood, for instance: hemoglobin and platelets. And if there is an acute leukemia, all the blood elements must drop. And it is called pancytopenia.
“White blood cells dropping causes fever, chills, infectious manifestations, because the person does not have defensive mechanisms to guard against the infections, and it is difficult for the blood to clot when platelets are reduced and so he sees a doctor due to petechiae (tiny cutaneous vascular effusions the size of a pinhead), bruising, bleeding may start in the gums, the ears, the urine, the rectum, the vagina, the eyes, and the evidence of a more advanced condition would be splenic and liver enlargement”.
- How are they diagnosed?
- For acute leukemia, it is detected through medulogram (bone marrow aspiration) and biopsy, based on medical judgment, and it is always taken into account when the red cell level is low. Nowadays, the type of leukemia the patient suffers is determined by using technology with monoclonal antibodies, in line with the immunological markers and not visible technologies. We never abandon the clinic; however, technology is essential.
“Acute myeloid responds well to treatment with medicines used at the hospital. Another alternative is the bone marrow transplantation, and a good prediction of the disease positively influences on performing it”.
- Do external factors have any impact on the appearance of leukaemia?
- Yes, as happens with respect to electromagnetic waves, nuclear accidents, and exposures to certain activities from Health professionals and which are neither protected nor checked systematically. That is another risk, it is a work-related illness.
- What are the most severe implications?
- Hemorrhagic and infectious ones.
- And the behavior of the chronic ones?
- In the chronic ones, especially the myeloid leukemia, survival is much higher and complications are a result from infections. There are very effective medicines and are appreciated in its entirety to therapeutic ones, with the inclusion of monoclonal antibodies.
- By age, race and gender?
- Acute ones come on more often in people over the age of 35, gender and race are not important.
- Is the number of new cases getting higher over the years?
- Yes. External exposures may influence, but unlike today, 60 years ago there was not current access to qualified staff, technology, and drugs. And we get the essential drugs in the basic list. We diagnose between eight or ten cases per year, but we have had other years with 14.
"The bone marrow transplant takes place at the Hermanos Ameijeiras hospital, we have the mechanisms established to achieve them. It costs a quarter of a million dollars anywhere in the world, apart from the fact that it should be gone to the bone marrow bank to find a compatible donor, and it would all costs half a million dollars. It is all free of charge for the Cubans”.
- Translated by Keila Novoa Ricardo/Estudent