Fever: This one is the most common blood transfusion side effect. This adverse effect is caused mainly by the WBCs present in the transfusion. Fever after blood transfusion is generally accompanied by chills and shivering. This fever might appear during transfusion or within a few hours of undergoing the procedure. Medically this fever is termed as febrile reaction.

Acute hemolytic reactions: This side effect of blood transfusion is extremely rare, but is extremely serious in nature. A recipient develops these reactions when his blood type does not match with that of the donor. In such cases human body destroys new blood cells producing substances that cause severe damage to the kidneys. The signs of acute hemolytic reactions after a transfusion include: dark urine, check or back pain, nausea, fever and chills.

Delayed hemolytic reactions: These reactions occur when the body of the blood recipient slowly starts attacking the transfused blood cells; this usually occurs within a few days or even weeks following the transfusion. Delayed hemolytic reactions usually do not get indicated by many symptoms; the only significant change experienced by the patient is drop in his blood count. Blood cancer patients who had to undergo quite a few transfusions are more susceptible towards developing these reactions.

Infections: Infections after blood transfusion are quite rare. The infections that might be spread through transfusion of blood include hepatitis b, hepatitis C, vCJD (a rarely occurring fatal medical condition often described to be the human variant of the mad cow disease) and HIV. On very rare occasions, a blood transfusion may result in passing on of infections like malaria, syphilis and cytomegalovirus.

Licorice root: Licorice is a plant widely grown in different parts of Europe, Asia and Mediterranean terrains. Several Chinese medicines include use of this herb. The root of Licorice possesses the ability of killing cancer cells and is also known for preventing mutations within the DNA. It is believed that the active ingredient of licorice roots i.e. licrocoumarone is responsible for anti-cancer effects of the herb.

Shark cartilage: The reports from Leukemia and Lymphoma Society suggest that consumption of supplements prepared from shark cartilage helps in boosting our immune system. The strengthened immune system allows us to fight the cancer cells more efficiently.

Ginseng: This herb is a source of natural compounds known as ‘ginsenosides’, which are known to possess properties similar to that of the steroid hormones. Ginsenosides work by strengthening our immune system, which in turn slow down growth of the cancer cells.

Flaxseed oil: The oil extracted from flaxseeds is known for its anti-cancer properties since the mid 20th century. This oil helps in making our immune system stronger; which enables us to fight cancer more effeciently. You can consume flaxseeds in form of supplements or can add the oil directly to your diet. You can also consume cereals and breads containing flaxseed extracts.

Although the above mentioned natural agents are beneficial for leukemia patients, there are some natural supplements which should be avoided by these patients. A person receiving treatment for leukemia should not use herbs like St John’s Wort. These patients should also stay away from the dietary antioxidant therapy.

The Leukemia Lymphoma Society has as many as 64 chapters in United States and 4 more in Canada. The organization arranges several fundraising events all through the year. Among many activities organized by LLS, one is the ‘team in training’ program. This program will require the participants to perform strength training activities under the guidance of the volunteers while fundraising is done for fighting against and supporting blood cancer. Another exciting event arranged by LLS is the Light the Night Walk. This one is a community walk, in which the people combating blood cancer, their supporters and families are celebrated. Each chapter of the Leukemia Lymphoma Society has their own fundraising events taking place in different times of the year.

From the day the Leukemia Lymphoma Society was founded, it has provided blood cancer researches worth over 600 million US dollars. Moreover, the organization has also dealt with patients, medical professionals and caregivers successfully. Currently, people associated with the organization are working meticulously for transforming lives of individuals suffering from blood cancer. Every other day they come up with new ideas for helping the patients lead a better life.

Swollen glands: Lymph glands of a healthy infant being a component of his endocrine system helps in filtering toxins from the bloodstream. When leukemia occurs, the patient’s white bloods cells might accumulate within his lymph glands resulting in swelling of the glands. It is a common leukemia sign in the infants. The swollen glands indicating occurrence of leukemia usually appear in body parts like armpits, groin or neck.

Bruising of skin: As the number of normal white blood cells starts decreasing in infants with leukemia the time required by their body to heal wounds might increase. Often you’ll find skin bruises in the infants suffering from leukemia.

Pale skin: The number of normal red blood cells in the blood of an infant also decreases due to leukemia. This might lead to paling of skin of the ailing infant. If you find that your child is feeling sick all the time and has developed unusually pale skin, you must take him to the doctor immediately and get him checked for leukemia.

Body ache and fever: Frequent and persistent episodes of fever are also indicators of leukemia in infants. We get fever when our immune system tries to fight an infection. A fever caused by leukemia is mostly accompanied by other signs like chills, sweating, headache, severe fatigue and body aches.  As the infants cannot express the discomforts caused by these leukemia symptoms verbally, they tend to become unusually irritable and fussy.

Recurrent infections: As the number of normal white blood cells starts decreasing in the body of the leukemia affected infants, their immune system fails to fight the infectious pathogens effectively. This results in occurrence recurrent infections in them.

In case TKIs are failing to show results and the person is not an entrant for stem cell transplant then several therapy choices entail:

• Chemotherapy medications administered orally for killing irregular cells all through the body.
• Biological therapies such as interferon for stimulating the person’s immune system for fighting cancer.
• Novel investigative CML therapies that sufferers could register in during clinical trials.

Supervising CML Therapy

Typically, CML patients would essentially be seeing their physicians in a time interval of a couple of months for monitoring their therapy and checking for side-effects. Tests entail:

• CBC, bone marrow tests for measuring platelet, WBC and RBC counts.
• PCR test also known as Polymerase chain reaction testing that searches for presence of the bcr-abl gene.
• FISH test or (Fluorescent in situ hybridization) for checking the number of cells containing the offending Philadelphia chromosome.

Queries Regarding Your CML Therapy

Patients could pose the following queries in front of their doctors when undergoing CML therapy:

• In which stage of CML am I presently in?
• What are my therapy choices and associated side-effects that I may be experiencing?
• Must I go in for another doctor’s opinion?
• Could I register in clinical trials for an investigational therapy?

Staying Active throughout CML Therapy

For patients undergoing CML therapy here are some tips on feeling better.

• Not missing out on any of the health check-up appointments with the physician so that a particular treatment could be changed in case it fails to show favourable results.
• Notifying the physician regarding any side-effects that one might experience.
• In case one is having a hard time coping with one’s sickness then getting support from buddies, kin members or the doctor’s panel.

Indications that Your Therapy is Shows Positive Results

When one goes for routine health check-ups, the physician would check for indications that one’s therapy is showing favourable outcomes.

• Cytogenic response – Lesser numbers of cells showing affirmative presence of Philadelphia chromosome in the bone marrow & bloodstream.
• Molecular response – Lesser cells having bcr-abl cancerous gene presence.
• Hematologic response – Improved counts of normal WBCs & platelet.

A CML patient is deemed to be remission in case:

• There is normalization of blood cell counts or CHR (Complete hematologic response).
• No irregular gene presence in the bloodstream which is indicative of complete molecular response.
• Total absence of cells having Philadephia chromosome in the bone marrow or bloodstream which is indicative of CCyR (Complete Cytogenic Response).

It is erroneous to assume that remission stage means total cure as the cancer could recur.

Being Watchful about Indications of Cancer Recurrence

Despite successful treatment, CML could still recur and indications like weariness, feeling weak, weight reduction, night-time sweating, bone pains, swell-up or pains felt on the side when spleen is located (on the left) indicating an enlargement in that organ and a sense of abdominal fullness. In case one has any of such symptoms it is best to promptly re-visit the physician.

Reasons for CML Treatment not showing favourable results

CML treatment appears to be working favourably for majority of the individuals, though not for all. Therapy might not show results due to several reasons like cancerous cells mutating or inadequate medications being able to gain entry into the blood.

In case therapy is ineffective then the physician might modify the medication dosage or change to another treatment.

Coping Strategies for Chronic Myelogenous Leukemia – Part I

When they start accruing in the bone marrow & blood, the irregular cells swarm out the platelet, RBC and WBC counts.

Philadelphia Chromosome

Philadephia chromosome is an irregular chromosome present in the bodies of CML patients. Chromosomes are gene carriers that instruct the cells about their tasks.

The fragments of chromosome number 9 as well as 22 rip apart and swap positions. The altered chromosome 22 is known as the Philadelphia chromosome and is the carrier of a novel gene known as bcr-abl which requests for the manufacture of tyrosine kinase protein that activates irregular WBC creation by the stem cells noted in CML.

CML Stages

Chronic Stage

The chronic stage is the foremost CML stage wherein largely patients are asymptomatic and generally their diagnosis occurs at the time of regular blood tests. Since there are solely a miniscule quantity of irregular WBC present in the bone marrow & blood hence the body is yet capable of fighting infections. Although one may not be feeling ill at present, it is still crucial to undergo treatment for CML so that it is prevented from advancing to later stages.

Accelerated Stage

In this stage, the person might become symptomatic with feelings of weariness, weight reduction, fever or breathlessness which are all indicative of an augment in the irregular WBC count. No sooner has a person entered this stage, it could become trickier to attain remission with existent therapies. The accelerated stage could end in a far grave and belligerent cancerous stage known as blast stage.

Blast Stage

In this stage, the amounts of irregular WBCs present in the bloodstream and bone marrow are soaring. In the interim, normal counts of platelet, WBC, RBC have dipped. Also due to the lesser numbers of ailment-combating WBCs, the body is far more susceptible to contracting infections. One might become anemic or have uninhibited blood loss. Such a phase is acute and life-menacing.

Targeted Treatment – The Irregular CML Protein

The foremost treatment for acute CML stage is with TKI (tyrosine kinase inhibitors). These targeted therapies obliterate chronic myeloid leukemia blood cells by obstructing the protein manufactured by the irregular bcr-abl gene. Side-effects could entail rash formations, swelling in skin, feeling nauseous, muscle cramping and loose bowels. Even though tyrosine kinase inhibitors are incapable of controlling the ailment, there are several therapy choices.

Stem Cell Transplant

For patients not responding to TKIs the subsequent line of treatment is stem cell transplant. Firstly, the person is given elevated chemotherapy dosages for killing stem cells (blood forming ones) present in the bone marrow. Subsequently, these patients would be receiving stem cells from matching donors which would be forming novel blood cells in good health.

Stem cell transplant is the sole means of curing CML; however evolving therapies targeting bcr-abl could additionally cause normalization of the Philadephia chromosome and assist several CML sufferers to attain remissive stage.

Candidacy for Stem Cell Transplant

Candidacy for stem cell transplant involves fulfilling the following conditions.

• Is the person under sixty years of age?
• Is he/she in the chronic stage of chronic myeloid leukemia?
• Is the person in general good health?
• Does the person have any matching stem cell donors (generally blood relations)?

Elevated chemotherapy dosages required for transplants carry risks and associated side-effects entail infections and becoming anemic. As one recovers, majority of the side-effects would subside, but there is always a likelihood of becoming permanently infertile.

In case one is mulling over enrolling – the procedure is quite uncomplicated, however needs serious pledge. Bone marrow donation is moderately pain-free, converse to what is widely believed. And in case the transplant is successful, the outcomes are astounding.

A miniscule quantity of bone marrow donation – around five percent of the donor’s entire number – could not just refill disease-ridden supply of leukemia patients but the contributed cells additionally are capable of seeking out and obliterating any remnant cancerous cells and then continue developing, transforming the receiver’s blood type to that of the donor’s for the remaining part of his/her existence.

But, there needs to be a nearest genetic matching in-between donors and recipients, on the basis of the determining factor – HLAs or human leukocyte antigens that mirror section of the immune system being passed down through generations. A patient’s brother or sister has a twenty-five percent greater likelihood of being a well-matched donor. In around seventy percent of the cases, there are none in the kin that are compatible donors; hence a patient and his/her physician have then to seek assistance from major global registries hoping to locate a match. The ‘Be the Match’ registry is the biggest in the United States having over eight million sample types. It could also link to several registries in the United States and abroad for an entirety of almost fifteen million probabilities.

In patient types with antecedents being Caucasians hailing from N. Europe, Japan and other regions that remained cognate for generation, the likelihood of unearthing a near heritable match is over ninety percent. It is just around sixty percent for patient populace having forebears that are from Africa, Latin America or S. Asia as such sets are far more diverse.

The chances are protracted for individuals from assorted ethnic backgrounds. Hence, such global registries require individuals from all races and mixes for joining up with them.

Enrolling in a Registry

For signing up in a registry merely cheek swabs and a basic health survey is necessary. The donor has to be between eighteen to fifty-five years of age and not suffering from cancer, cardiovascular ailment, epilepsy, AIDS, hepatitis or other ailments. There are several associations which conduct bone marrow drives or have locally placed donor centers. Optionally, one could ask for kits online at ‘marrow.org’. No sooner has one enrolled in a registry, one is bound to it till one reaches sixty-one years of age or requested to be taken off.

In case cells of the person match with that of the patient, then he/she would be requested to go through additionally testing for assessing his/her health and compatible nature. The donor would not have to bear any costs and even those which are travel-related are re-payed; however the testing and donating could take time.

Nowadays, around seventy percent of bone marrow transplants do not necessitate real bone marrow. The blood collected from donors are passed via a piece of equipment where it circulates and sieves out marrow-manufacturing cells known as PBSC (peripheral blood stem cells) then the remnant blood is then infused back to the donors. Some degree of lightheaded feeling is experienced when blood is withdrawn for the stem cells. Every PBSC donor is administered shots of a protein that helps in stimulating marrow-development every day for 5 days prior to extracting it that leads to flu-similar symptoms.

There is 12-month privacy time period wherein a donor and recipient are not notified much regarding each other. However beyond that time frame, it is up to both sides whether they intend to get in touch with one another.

In case recipients need conventional bone marrow then the donors are administered general/local anesthesia after which needles are introduced inside the pelvic bone of the donors in numerous spots for extracting liquid-similar marrow within. The method would last around 2 hours. The donors could be discharged the analogous day from the facility and might sense some soreness in the tail bone region for some days.

Many times donors at the last minute change their minds on undergoing the method hence all donor registries request all who enrol to keep them informed about any modifications in their accessibility, health or location so that they could be tracked easily. Often registries that make the call are in dire need for patients who might have merely a couple of weeks to survive.

In the recent past, umbilical cord blood has become yet another medium of bone marrow transplant. Umbilical cords of newly born infants are classically thrown away as medical wastes.

Merely duo tablespoonfuls of umbilical cord blood has around a billion stem cells that have such versatility that they could be employed for creating bone marrow and  treat any array of cancers and ailments. Also they do not need a near matching in-between donors and recipients.

Donation of a newly born baby’s umbilical cord has no impact on maternal-fetal health or the birthing process, however it does need some advance preparation, as the cord preservation soon following its clamping and cutting is a must.

The procedure is au-gratis in case the birthing process is in a hospital that is part of a civic cord-blood program. In case not, parents could still do the donation though bearing some expenses, for instance, several gynaecologists would be charging 150 dollars to do the method.

All donation to public banks are unidentified and one would not know whether or when one’s infant’s cord blood is being utilized.

Parents could opt for preserving their newly born baby’s cord blood in private banks in case the child or other kin members might need bone marrow cell transplantation or some life-rescuing therapy in future. The preliminary costing for preserving cord blood is around two thousand dollars and two hundred dollars for storing it.

The study authors claim that umbilical cord blood transplant procedure is a workable alternative in adult leukemia cases with urgent requirement for bone marrow transplantation to reinstate cells obliterated as a result of chemo or radiation therapies, however often failing to locate a donor.

Helming the study, Dr. Mary Eapen from the Medical College of Wisconsin explicates how their study finding pointed towards outlook of leukemia free existence being analogous irrespective of whether transplant was done from an umbilical cord blood unit or adult donors.

During a telephonic talk, Dr. Eapen stated that cord blood functioned despite not being a perfect match. Merely around one-half of all Caucasian adult patients were able to track an apt donor and the chances appear to diminish even more in case the ethnicity was Afro-American or Asian. She added that generally when there is no suitable tissue matching with a donor then the odds of experiencing a complication are elevated and it could lead to fatality. However, that risk appears to be lesser in case of stem cells drawn from the umbilical cord blood. The body is observed to have greater tolerance to cells from the placenta blood, in spite of not having a totally ideal match.

During the study which has been published in the journal Lancer Oncology, Dr. Eapen and associates did a comprehensive analysis of data taken from over two hundred transplant clinics across the globe. They did a comparison of the outcomes of 165 study entrants in the ages of sixteen years or more, having chronic leukemia that were given cord blood stem cell transplant against 888 grownups that were offered disparate stem cell transplantations and 472 patients that were offered separate bone marrow from donors.

Subsequent to 2 years, every one of the patients from these sets had an equal likelihood of surviving and being disease-free irrespective of the grafting source.

Dr. Eapen stated that the best part about umbilical cord blood stem cell transplant is that it could be employed for transplant cases that are not an ideal match and yet capable of arriving at a satisfactory ending, that is a disease-free existence.

Speaking in detail, Dr. Eapen stated that majority of the transplants being conducted employing cord blood are from public cord blood banks where the parents have done blood donation from their baby’s umbilical cord. The blood donated then undergoes stringent tests for ensuring the cell safety and well preservation.

She spoke about how several privately run cord blood banks classically do collection and storage of cord blood for personal usage by individuals or kin members.

This study analysis is bound to boost endeavours at increasing contributions to publicly run cord blood banks, especially by minority types that face the maximum difficulty locating a matching donor.

A public cord blood bank would provide coverage incurred during collection, testing and storing umbilical cord blood.

Normal bone marrow

Bone marrow is the soft-textured, internal component of several bones like those present in the cranium, clavicles, rib area, pelvis and back-bones. The stem cells present in the bone marrow after undergoing division form new-fangled cells. A number of such cells continue to be stem cells whereas there are those which modify into one of the three forms of blood cells, namely: RBC (red blood cells), WBC (white blood cells) or platelets.

The RBCs are responsible for carrying oxygenated blood to all over the body from the lungs and carrying away carbon-dioxide. The WBCs assist the body in combating infection. Platelets are necessary for blood clotting and aid in sealing the harmed portions of the blood vessels that occur due to some form of cut or bruising.

Myelodysplastic Syndrome

Due to MDS or myelodysplastic syndrome the cells present in the bone marrow become incapable of producing blood cells. Also several of the blood cells produced in the bone marrow are abnormal. The body obliterates such irregular blood cells which renders the individual with a deficit of normal blood cells and squat blood counts.

MDS could transform into a swiftly-developing cancer affecting the bone marrow cells known as AML or acute myeloid leukemia. This occurs in one among 3 individuals having MDS. Earlier MDS was known as smoldering leukemia or pre-leukemia. As majority of those affected with MDS do not develop leukemia hence such terminologies are no more in use.

MDS Types

The system employed for categorizing MDS is called as World Health Organization or WHO system which segregates MDS into eight groups mostly based on the microscopic appearance of the bone marrow and blood cells. Since the disparities could be quite miniscule, physicians might disagree regarding which set a person’s ailment actually lies in. The physician could explicate to the patient the precise type of MDS that he/she has.

MDS cases could additionally be categorized on the basis of the cause of the disease. In case a cause could not be identified then it is called as primary MDS and dubbed as secondary MDS when the reason has been ascertained. Secondary MDS is mostly known as treatment-related since the most prevalent reason is sooner management for cancer. There is less likelihood of secondary MDS showing response to therapy.

MDS Prevalence

According to the latest approximates provided by the ACS (American Cancer Society), there are around ten to fifteen thousand newly surfacing MDS cases annually in the U.S. and the figures of such new-fangled cases annually only seem to rise as the average age of the populace has augmented. Nearly eighty to ninety percent of all MDS cases affect the elderly people over sixty years of age and it rarely afflicts young age adults.

Dr. Dindial Ramotar, a scientist at the Maisonneuve-Rosemont Hospital and lead author of the study explained the uncovering of a novel gateway that is present in human-beings which permits cancer-combatant agent like Bleomycin in entering the system so that reaching and attacking the leukemia cells was possible.

Dr. Ramotar, prof. at esteemed Université de Montréal started conducting tests on his conjecture nearly ten years back employing baker’s yeast that has astonishing similarity to human cells. He elucidated that their husking transcended model method to cells from human beings and would imminently become accessible at one’s bed side via translational treatment. Dr. Ramotar enthusiastically mentioned about being on the verge of doing tests on patients.

Acute myeloid leukemia or AML is a form of cancer affecting the white blood cells and the new-fangled finding of gateway dubbed SLC22A16 could be a lifesaving discovery for patients with this condition. Acute myeloid leukemia treatment is exceedingly tricky as majority of these patients fail to show response to cancer-combatant solutions. Dr. Ramotar stated that they were finally capable of streamlining cancer-combatant agents for acute myeloid leukemia treatment.

Dr. Ramotar gave an instance of when they discovered cancer-combatant agent Bleomycin has favourable outcome on lymphoma cells drawn from leukemia patients and is dependent on the existence of SLC22A16 gateway. This is particularly a significant finding as Bleomycin fails to operate as an immunosuppressant.

But the senior author caveats that the novel recognized gateway is solely found in a few cell forms like those drawn from the bone marrow. The conduit additionally fails in functioning in breast and colon cancer which could make it tricky for treating such patients employing Bleomycin.

Dr. Ramotar added that they now intend on examining means of stimulating the gateway for treating a wide-ranging array of cancer types employing Bleomycin and other medications.