Acute Lymphoblastic Leukaemia: How Is It Different To Acute Myeloid Leukaemia?

When it comes to blood cancers, understanding the distinctions between different types is crucial for accurate diagnosis and effective treatment. While Acute Lymphoblastic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML) may sound similar, there are differences between the two blood cancers.

The primary difference between Acute Myeloid Leukaemia and Acute Lymphoblastic Leukaemia is the type of white blood cell in which it originates. AML affects myeloid cells, while ALL affects lymphocytes.

Some may wonder if AML is worse than ALL? Acute Myeloid Leukaemia (AML) and Acute Lymphoblastic Leukaemia (ALL) are both serious forms of blood cancer. The prognosis for both conditions is poorer in adults when compared to children.

 

Risk Factors 

cigarette and ashtray

The main causes of acute leukaemia are unknown and usually there is no specific trigger for this. In rare cases the leukaemia can be familial, which means the leukaemia is passed down from one generation to another, but this is very uncommon.

There are several factors that do increase the risk of developing leukaemia.

Acute leukaemia develops due to mutations within the genetic make-up (DNA) of the bone marrow stem cells. These mutations cause the white cells in the bone marrow to grow faster and often without the ability to function like normal white cells. As the leukaemia cells (blasts) expand, they stop the normal functioning of the bone marrow and lead to the various symptoms usually associated with acute leukaemia.

 

Diagnosis

needle going into arm

Both AML and AML are usually diagnosed from a blood test and bone marrow assessment.

Specific tests, including flow cytometry, karyotyping, cytogenetics-FISH and molecular mutation analysis, will be performed to confirm the diagnosis of ALL and AML, classify the subtype and the prognostic risk group.

Patients may wonder how you would rule out ALL if AML is suspected. When patients with acute leukaemia undergo a bone marrow assessment, the specific tests performed during this assessment will usually be able to distinguish ALL from AML.

 

Staging

Staging for ALL and AML are relatively similar. Unlike some other forms of cancer, Acute Lymphoblastic Leukaemia (ALL) has no standard staging system. Instead, patients with Acute Lymphoblastic Leukaemia are usually classified by risk category. This is determined by factors including the age of the patient, white cell count at presentation, subtype of ALL, response to initial therapy, and any cytogenetic or molecular abnormalities on bone marrow assessment.

For example, high-risk ALL is defined by features including the patient’s age (adults generally are more likely to have higher risk disease), subtype of ALL, and adverse cytogenetic or molecular features. Patients with high-risk ALL are less likely to respond to standard therapy and have an increased risk of disease relapse even after successful initial treatment.

Similarly, AML staging is classified by risk categories (poor risk, standard risk and favourable risk). This is determined by the genetics of the AML at the time of diagnosis by looking at tests such as the cytogenetics and AML specific molecular panel.

 

Treatment Outcomes

The chances of a cure for ALL through modern-day treatments mean that 80-90% of children are alive and well at 5 years with current protocols. The 5-year overall survival is approximately 65% for adolescents, 40% for adults, and 15-20% for older patients.

For patients with standard risk AML, approximately 50% of patients may be successfully treated with existing treatments. For patients with favourable risk AML, approximately 60-70% of patients may have a durable remission. However, for patients with poor risk AML, the chances of a durable remission are less than 25%.

 

Understand Your Treatment Options with CFCH

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Being diagnosed with Acute Myeloid Leukaemia (AML) can be an overwhelming experience, filled with uncertainties. Get in touch with the CFCH team where we provide you with personalised support, answer your questions, and guide you through your treatment journey.

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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What To Expect After Being Diagnosed With AML

Receiving a diagnosis of Acute Myeloid Leukaemia (AML) can be a life-altering and overwhelming experience for both patients and their loved ones. We aim to provide you with valuable insights and information about the journey after an AML diagnosis. Understanding what to expect during this challenging time can help alleviate anxiety and empower you to make informed decisions. Our goal is to help you navigate this journey with knowledge and confidence, offering guidance and support every step of the way.

 

What To Know After Diagnosis

After an AML diagnosis, patients may want to know what are the stages of acute myeloid leukaemia and at what stage does their diagnosis fit in.

As acute myeloid leukaemia is a liquid cancer, it is not classified in stages like the way solid cancers are usually. AML is classified by risk categories (poor risk, standard risk and favourable risk). This is determined by the genetics of the AML at the time of diagnosis by looking at tests such as the cytogenetics and AML specific molecular panel. The poor risk category typically has less favourable outcomes while the favourable risk category has a better prognosis.

After the diagnosis, patients may also wonder what they can expect with acute myeloid leukaemia. In most cases, the diagnosis of AML often comes as a shock to the patient. AML is a serious medical condition that requires months of treatment ahead. It is important that patients are physically and mentally prepared for this battle ahead.

The symptoms of acute myeloid leukaemia often develop over a period of weeks to months as the leukaemia cells gradually increase and affect the function of the normal healthy cells in the bone marrow.

 

What are the First AML Symptoms?

women with headache

The first symptoms of acute myeloid leukaemia are usually related to a decrease in the function of normal blood cells in the bone marrow.

Patients typically present with symptoms related to low red blood cells (anaemia) – such as breathlessness, tiredness, frequent infections (due to lowered or non-functional white cells), and bruising easily (due to low platelet counts). There are also less specific symptoms such as night sweats, unintended weight loss, or swelling of glands in the neck and groin.

However, not all patients may experience these symptoms as AML can be asymptomatic at an early stage of detection. However, the condition progresses over a typical period of several weeks – months. Once the AML becomes more advanced, almost all patients experience symptoms varying from lethargy, shortness of breath, increased infections to easy bleeding or bruising.

If patients are asymptomatic, they may wonder how long before symptoms of acute myeloid leukaemia start to show. Symptoms of acute myeloid leukaemia typically appear 4 to 6 weeks prior to diagnosis. As AML is known to be an aggressive form of cancer, the onset and progression of symptoms happen quickly. However, symptoms such as tiredness or infection may be mistaken for those caused by more common diseases, such as the flu.

 

Treatment Expectations

Once diagnosed, patients will be given a treatment plan that is dependent on the patient’s age, health condition and subtype of cancer. These treatments may include chemotherapy, targeted therapy and stem cell transplant.

Length of Treatment

As AML is an aggressive form of cancer and requires immediate treatment, patients may also be concerned about how long the treatment for AML is.

Intensive chemotherapy remains the treatment of choice for younger and fitter AML patients. Some of these patients may also need an allogeneic haematopoietic stem cell transplantation. As such, the treatment for AML may last for up to 6 months.

In older patients or patients who are not fit for intensive chemotherapy or transplantation, treatment is often less intensive. However, in these cases, while the treatment is usually better tolerated, the duration of treatment is often continuous, with the aim to control the patient’s disease.

Treatment Success

Some patients may wonder if AML is hard to treat. In reality, there have been significant advances in the treatment of AML over the last decade.

Many younger and fit patients may still require intensive chemotherapy to initially treat the AML. However, there are newer forms of more targeted therapies for AML which allows us to treat some types of AML without the need of conventional chemotherapy.

In fact, some forms of AML treatment are now possible as outpatients as well. As a result more AML patients can benefit from disease specific treatments, with higher success rates while experiencing less toxicity.

Unfortunately for some patients with more aggressive AML, they may still need a hematopoietic stem cell transplantation to achieve a longer term remission. Even in these instances though, there have been remarkable advances in the use of drugs, supportive care, and better means of identifying donors.

The overall outlook for AML patients remains positive for the future.

 

Lifestyle Changes 

running shoes

As the condition progresses and patients undergo treatment, AML patients should make lifestyle changes to manage their symptoms. AML and the treatment related to AML will cause your immunity to weaken. As such, you will need to focus on your general well-being and diet.

Patients should make sure they are well-rested but also maintain an active lifestyle as far as possible. Walks or simple exercise are encouraged. It is important that their family (or even close friends) are involved in supporting them, as the battle against AML is often stressful and tiring.

A well-balanced diet can aid patients in coping with AML and its treatment. Patients may find that they are losing weight due to a loss of appetite as a side effect of some treatment options. Patients are recommended to consume healthy fats such as avocado and nut butter to keep their energy levels up.

Patients are also not recommended to drink alcohol as it can worsen the fatigue experienced from AML and AML medications. Additionally, alcohol can limit the bone marrow’s ability to produce blood cells and worsen the gastrointestinal effects of chemotherapy.

 

Get Support for Your AML Treatment with CFCH

Being diagnosed with Acute Myeloid Leukaemia (AML) can be an overwhelming experience, filled with uncertainties. Get in touch with the CFCH team where we provide you with personalised support, answer your questions, and guide you through your treatment journey.

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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Is Myelodysplastic Syndrome A Cancer And Is It Leukaemia?

Introduction

Myelodysplastic Syndrome (MDS) is a condition that often prompts questions about its relationship to cancer and leukaemia. MDS involves abnormalities in the bone marrow that can lead to decreased blood cell production and potentially evolve into more serious conditions. 

Some individuals who are confused about this condition wonder if MDS is an autoimmune disease. MDS is not considered to be an autoimmune disease. However, studies have indicated that MDS patients have a high association with autoimmune conditions such as rheumatoid arthritis, psoriasis, and immune thrombocytopenia.

But is Myelodysplastic Syndrome considered cancer? Myelodysplastic Syndromes are considered to be a form of blood cancer. However, based on the risk group of the MDS, not all patients with MDS will need immediate treatment.

We’ll delve deeper into its connection to leukaemia and the nuances that distinguish these blood cancers. By clarifying these concepts, we strive to provide you with a clearer understanding of MDS and its implications, helping you navigate your health journey with knowledge and confidence.

 

Stages of MDS

The reason why MDS is usually confused with leukaemia is because advanced stages of MDS can transform into Acute Myeloid Leukaemia (AML).

MDS is staged using the IPSS-R (International Prognostic Scoring System – Revised), which is a scoring system that helps to classify MDS patients at diagnosis into 1 of 5 groups. Patients are categorised from very low risk to very high risk groups based on:

  • their risk of transformation to acute myeloid leukaemia (AML) 
  • risk of mortality.

If MDS is progressing, patients often develop symptoms directly related to the fall in blood counts. This often includes an increased frequency of infections, easy bruising or bleeding, and increased lethargy, with shortness of breath and sometimes weight loss.

 

MDS and Leukaemia

So, is myelodysplastic syndrome a form of leukaemia?’. MDS is considered to be a form of blood cancer but it consists of a group of different disorders of varying prognoses. Low-risk MDS patients may not require any treatment or may only require blood transfusions. However, high-risk MDS patients often have a course of the disease which is aggressive, and while the condition is not leukaemia, many of these patients have a high risk of progression to frank leukaemia.

Patients may wonder how they will know when MDS turns into AML? The transformation of MDS to AML is characterised by an increase in abnormal myeloblasts (leukaemia cells) in the blood and bone marrow (to a level of >20% myeloblasts in the bone marrow). Patients’ blood counts often fall at this stage, and patients are more likely to have frank symptoms related to acute myeloid leukaemia, such as increased infections and the need for blood transfusions.

 

Understand Your MDS Treatment Options With CFCH

Myelodysplastic Syndrome treatment singapore, CFCH

While MDS shares certain characteristics with cancer and can sometimes progress into leukaemia, it’s important to remember that MDS exists on a spectrum of disorders with varying degrees of severity. If you or a loved one are grappling with questions or concerns about MDS, seeking expert guidance can make a significant difference. CFCH is here to provide you with comprehensive support, personalised treatment plans, and answers to all your queries. Get in touch with us and we’ll guide you on your treatment journey.

 

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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4 Questions You May Have After Being Diagnosed With Myelodysplastic Syndromes

Being diagnosed with Myelodysplastic Syndrome (MDS) can be both emotionally and physically challenging. In this article, we will provide clear and concise answers to common questions that individuals often have after being diagnosed with MDS. 

1. Why Did I Not Experience Any Symptoms Before My Diagnosis?

As early stage MDS can be asymptomatic, it is possible to have MDS and be unaware. Patients in this situation are often only diagnosed after an incidental finding of low blood counts on a routine blood test.

 

2. What Are The Complications I May Experience In The Future?

The complications are related to the suppression of the bone marrow. This would include: 

  • Anaemia. Low red cell count, resulting in lack of energy, shortness of breath, and poor concentration.
  • Bleeding and bruising due to a lower platelet count.
  • Recurrent infections, having too few white blood cells increases your risk of serious infections.

 

3.Should I Change My Diet And Lifestyle After My Diagnosis? 

Myelodysplastic Syndromes diet, Myelodysplastic Syndromes diagnosis, Myelodysplastic Syndromes treatment singapore, CFCH Singapore

There are no specific foods to avoid with MDS, and there is no evidence that any foods increase the risk of developing MDS. However, MDS patients have a high risk of developing iron overload, so it is best to limit the intake of iron-rich foods if your doctor notices that your iron indices are elevated.

In addition, in patients with low white blood counts, it is important for patients to avoid raw or uncooked foods (such as sashimi or undercooked steak). Patients in these instances are also advised to avoid raw foods such as salads. Patients should instead consume a well-balanced diet of vegetables, fruits, protein and carbohydrates to maintain their energy levels.

As patients manage MDS, they should also adopt healthy habits in their everyday life. This includes not smoking, being physically active and maintaining a healthy weight. Check with your doctor on a safe exercise regime for your condition. 

 

4.Can Myelodysplastic Syndrome Be Cured?

Myelodysplastic Syndrome cure, Myelodysplastic Syndrome treatment, CFCH

At present, an allogeneic haematopoietic stem cell transplantation is the only curative form of therapy for MDS.

There are other treatments to treat MDS, including a class of drugs known as hypomethylating agents (HMAs). These treatments have been shown to be effective in stabilising and, in some cases clearing the underlying MDS. However, drugs like HMAs need to be administered on a regular basis for durable remissions. In the majority of cases, the MDS will recur over time if the treatment is stopped.

How soon it can be cured and how long a patient can live with Myelodysplastic Syndromes also depends on the prognosis which is determined by several factors, including the risk category, the presence of other medical conditions, and age.

The IPSS-R (International Prognostic Scoring System – Revised) is a scoring system that helps to classify MDS patients at diagnosis into 1 of 5 groups. Patients are categorised from very low risk to very high risk groups based on 1) their risk of transformation to acute myeloid leukaemia (AML) and 2) risk of mortality.

Overall, patients diagnosed with Myelodysplastic Syndromes have an average life expectancy which can range from 0.8 to 8.8 years. Patients with very low risk MDS tend to live for longer without the need for intervention. However, patients with very high risk MDS generally require treatment sooner and may have a shorter life expectancy.

 

Get Your MDS Questions Answered With CFCH

Receiving a diagnosis of myelodysplastic syndromes can undoubtedly bring forth a whirlwind of questions and concerns. By seeking knowledge, connecting with support networks, and partnering with experienced healthcare professionals, we aim to support you through your treatment journey.

If you’re looking for comprehensive care and guidance tailored to MDS patients, explore the services offered at CFCH. Our specialised team is dedicated to providing personalised treatment plans, addressing your unique needs, and assisting you every step of the way.

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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Lymphoma diagnosis singapore, CFCH

After a Lymphoma Diagnosis: Everything You Need To Know

A diagnosis of lymphoma can upend lives, triggering a cascade of questions and uncertainties. From understanding the nature of lymphoma to grasping the treatment choices, this article is your guide through the extensive information surrounding this condition. Whether you’re a patient grappling with the diagnosis or a support pillar for someone facing it, this article aims to provide clarity and insights, offering a roadmap for the journey ahead.

 

What is Lymphoma?

Lymphoma is a type of cancer that originates in the lymphatic system, which is a vital part of our immune system. This intricate network of lymph nodes, vessels, and organs like the spleen and thymus plays a pivotal role in defending the body against infections and diseases. 

When lymphocytes, the white blood cells that safeguard our immunity, begin to grow uncontrollably and abnormally, it can give rise to lymphoma. There are two main categories: Hodgkin lymphoma and non-Hodgkin lymphoma, each possessing distinct characteristics and subtypes.

 

Types of Lymphomas

Lymphoma is a type of cancer that originates in the lymphatic system, which is a vital part of our immune system. While there are more than 60 types of lymphomas, the two most common types are Hodgkin Lymphoma and Non-Hodgkin Lymphoma. The difference between the two is the presence of Reed-Sternberg cells in Hodgkin Lymphoma and the absence of them in Non-Hodgkin Lymphoma.

Despite their differences, they both have similar symptoms including swelling of the lymph nodes in the armpits, neck or groin, fever and night sweats, persistent fatigue and unintentional weight loss.

 

Hodgkin Lymphoma VS Non-Hodgkin Lymphoma

Some patients may wonder if Non-Hodgkin’s or Hodgkin’s Lymphoma is worse. The prognosis of Lymphoma depends on a combination of the stage of the disease (which refers to the extent of spread of the Lymphoma), as well as the histology grade of the Lymphoma (which is the biopsy analysis which informs us on the subtype of Lymphoma).

Non-Hodgkin’s Lymphoma is more common than Hodgkin’s Lymphoma, but patients with Hodgkin’s Lymphoma tend to be younger and present earlier in disease stage.

In general, patients with Hodgkin’s Lymphoma tend to have a better response to treatment and an improved overall outcome compared to patients with non-Hodgkin’s Lymphoma.

Similarly for survival rates, Hodgkin’s Lymphoma is known to be one of the most treatable forms of cancer and often has a better outlook than Non-Hodgkin’s Lymphoma. However, various factors contribute to one’s prognosis, including the stage and specific type of cancer, along with age and overall health.

 

How Does Lymphoma Affect The Body?

Lymphoma Symptoms, Lymphoma Treatment Singapore, CFCH

Lymphoma can affect the body as it spreads, causing certain symptoms that can disrupt everyday life. 

While lymphoma begins in the lymphatic system, it tends to spread first to the lungs, bone marrow and liver. Lymphoma can also affect the immune system as it might not work as well as it should for several reasons. The lymphocytes that grow out of control do not work properly. If you have too many of these abnormal lymphocytes and not enough healthy lymphocytes, your body cannot fight infections as well as normal.

These changes to the body can also cause fatigue. Patients diagnosed with Lymphoma often describe fatigue related to the condition as feeling weak, listless, and drained. Some may even feel too tired to eat or visit the bathroom.

 

What is Lymphoma Treatment Like?

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It is important to consult with your healthcare provider on your treatment plan as certain complications can arise if lymphoma is left untreated. However, this often depends on the sub-type of Lymphoma. Some low-grade forms of Lymphoma can be very slow progressing and may just need observation with no active therapy. However, high-grade sub-types of Lymphoma can be very aggressive, and patients can become unwell in a matter of weeks to months without proper treatment.

Patients may wonder how long treatment is for lymphoma. Most Lymphoma cases are treated with a combination of chemotherapy agents and sometimes targeted therapy. Patients are often treated in cycles of therapy using the same drug combination every few weeks to gradually eliminate the Lymphoma. Patients usually receive 6-8 cycles of treatment depending on the disease stage and sub-type. Upfront treatment for Lymphoma can last typically for 4-6 months. 

Bone marrow transplant is usually offered to lymphoma patients with high risk subtypes or if they have experienced a relapse after going through other types of cancer treatments like chemotherapy or radiation therapy.

Additionally, CAR-T cell therapy has been shown to be effective in patients with B-cell Lymphoma who have relapsed or with refractory diffuse large B-cell Lymphoma, transformed follicular Lymphoma, as well as primary mediastinal B-cell Lymphoma. In Singapore, the current approved form of CAR-T cell therapy is indicated for patients with diffuse large B-cell Lymphoma who have previously failed at least 2 lines of standard treatment.

The prognosis of Lymphoma depends on a combination of the stage of the disease (which refers to the extent of spread of the Lymphoma), as well as the histology grade of the Lymphoma. While stage 3-4 Lymphomas are common, they can still be very treatable and often curable, depending on the NHL subtype. Stage III and IV are now considered a single category because they have the same treatment and prognosis.

 

Find Guidance and Manage Lymphoma with CFCH

Understanding what lymphoma entails, its types, and treatment options empowers you to make informed decisions about your health. If you’re seeking guidance, support, or a comprehensive approach to managing lymphoma, we are here to help. Our experienced team at CFCH is dedicated to providing personalised care, answering your questions, and offering the latest information on lymphoma treatments in Singapore.

 

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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myeloma diagnosis tests, myeloma treatment singapore, CFCH

Myeloma Diagnosis: Exploring Different Tests, Imaging Techniques and Biopsies

When it comes to tackling multiple myeloma, early and accurate diagnosis is essential for effective treatment and improved patient outcomes. However, myeloma may not be easy to diagnose. Multiple myeloma can prove challenging to diagnose as it often presents with little to no symptoms in the early stages. However, blood tests, bone marrow assessment and imaging tests such as x-rays, MRI/PET-CT scans can be used to clarify the diagnosis of myeloma.

Additionally, a bone marrow aspiration and biopsy may also be conducted to assess the amount of myeloma involvement in the bone marrow, as well as to analyse the genes in the myeloma through something known as fluorescence in situ hybridisation (FISH) test.

With various tests available, the most definitive way to confirm a diagnosis of multiple myeloma is through a combination of blood tests and bone marrow assessment. We will delve into the different diagnostic approaches and what you can expect for each test.

 

Blood & Urine Test

A blood and urine test is used as one of the various tests needed for a myeloma diagnosis. It is used to identify an abnormal protein. This protein is known as the monoclonal protein or M-protein. A blood test is also used to examine the levels of different proteins such as M protein, serum-free light chains, beta-2-microglobulin (β2M), albumin, and immunoglobulins, which can help in the diagnosis of Myeloma.

The blood sample is typically taken from the arm or hand while a urine test will require you to provide a urine sample by placing it in a container. In some cases, your doctor might request a 24-hour urine collection, which involves taking a container home to collect your urine throughout the day and night. The blood and urine sample will then be sent to the laboratory for necessary tests.

 

Imaging Tests

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Some patients may wonder if multiple myeloma can show up on X-Ray or MRI. Both an X-ray and an MRI scan are often used to diagnose bone involvement by multiple myeloma. They may show features that are suggestive of myeloma involvement, however it cannot fully diagnose myeloma based on radiological changes alone.

During an X-ray, you will be asked to position yourself according to the specific area being examined, and a technologist will take images using a low dose of radiation. 

On the other hand, an MRI scan involves lying down on a movable table that slides into a tunnel-like machine. The scan is painless and you may be offered earplugs or headphones to make the experience more comfortable.

Currently, a PET-CT scan is most commonly used as an imaging test for myeloma diagnosis. During a PET-CT scan, you will first be given an IV injection of a radiotracer and contrast dye for clearer images to highlight the areas of your body where cells are more active than normal. After that, you will lie on a table that slides into a tunnel machine. The process will take about 30 minutes.

Bone Marrow Procedure

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When it comes to diagnosing myeloma, a bone marrow test is a crucial procedure used by medical professionals. 

Prior to the procedure, patients are administered a local anaesthesia to minimise discomfort. Our doctor will then extract a small amount of bone marrow from the hip bone. Patients can expect the procedure to be relatively quick and painless, similar to drawing blood. 

Once the sample is collected, it is sent to the laboratory for analysis, where specialised tests like flow cytometry, cytogenetics and FISH test are performed to assess the presence of abnormal plasma cells.

Flow Cytometry

A flow cytometry test for myeloma diagnosis is a sophisticated diagnostic procedure that utilises fluorescent markers to analyse and quantify specific proteins on the surface of myeloma cells. By analysing the fluorescence patterns, flow cytometry can accurately identify and count abnormal plasma cells, which are characteristic of myeloma.

This test is also used to track the disease response to treatments and examine minimal residual disease post-treatment.

Cytogenetics (Karyotype)

A karyotype test is a specialised diagnostic procedure that examines the chromosomes in the cells of a patient’s bone marrow. This test focuses on identifying any structural abnormalities or changes in the chromosomes, which are vital in determining the characteristics and aggressiveness of myeloma. 

By analysing the genetic makeup of myeloma cells, cytogenetics helps healthcare professionals make accurate diagnoses, predict disease progression, and tailor appropriate treatment.

FISH Test

A FISH test, or fluorescence in situ hybridisation test, is used to test for gene changes or mutations in cells. Our doctors may order a FISH test to look for specific changes in cells, indicating the presence of myeloma. This may include the production of a particular protein, an increased production of protein, or the lack of a specific protein.

Tissue Biopsy

Sometimes if the myeloma presents as a tissue mass (known as a plasmacytoma) then a tissue biopsy of the affected site may be required. A tissue biopsy will surgically remove the tissue site for testing or via a targeted biopsy like an ultrasound scan or CT guided biopsy. 

Understand Your Diagnostic Options With CFCH

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For advice on which diagnostic tests are suitable for you, contact the CFCH team and we will assist you on your diagnosis and treatment journey. 

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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myeloma questions, myeloma treatment singapore, CFCH

5 Questions Patients Have After Being Diagnosed With Multiple Myeloma

Following a diagnosis of multiple myeloma, individuals may have a myriad of unanswered questions. We will delve into five common questions that patients frequently have after receiving the life-changing news of a multiple myeloma diagnosis. Our goal is to provide you with clarity, knowledge, and reassurance as you embark on this path towards managing and overcoming multiple myeloma.

 

1. Why Did I Not Experience Any Symptoms Before Being Diagnosed?

Understanding the curious absence of symptoms before a multiple myeloma diagnosis can shed light on the subtleties of this complex condition. At an early stage, some of the symptoms of the condition are non-specific and can often mimic myeloma. 

For example, fractures of the spine may be thought to be due to osteoporosis. Anaemia, bone pain and kidney issues could be mistaken for other medical conditions such as autoimmune diseases or kidney disorders. Sometimes myeloma can be mistaken for other blood disorders such as leukaemia or lymphoma.

In such cases, detailed blood tests, bone marrow and other specific investigations are often needed to ensure that the correct diagnosis of myeloma is made.

 

2. How Did I Get Myeloma Even Though I Don’t Have A Family History Of The Condition?

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While myeloma can be genetic, it is not always inherited. Myeloma is not inherited in the same manner as breast cancer is, which is often from a single gene. There is a slightly higher occurrence of myeloma within family members when compared to the entire population, but presently, the inheritance pattern of myeloma is unknown. 

Even if it is not inherited, the main cause of multiple myeloma is still unclear. However, doctors are able to understand that changes in the plasma cell’s DNA can produce abnormal cells, and when these abnormal cells begin to multiply uncontrollably, this results in myeloma. 

In some patients there will be a condition called monoclonal gammopathy of undetermined significance (MGUS) that precedes the development of myeloma. In MGUS, patients have no symptoms but they have plasma cells that produce an abnormal protein known as M-protein. Only 20% of patients with MGUS progress to myeloma.

 

3. Is Multiple Myeloma Painful?

Pain is a common concern among individuals diagnosed with multiple myeloma, and understandably so. Patients who have been diagnosed with multiple myeloma may experience pain related to the disease as myeloma can cause weakness in the bones or compression of nerves due to a tumour. 

If you are dealing with myeloma-related pain, discussing your symptoms with your healthcare team is essential. They can tailor a pain management plan that suits your unique needs and ensures you can maintain the best possible quality of life throughout your journey with multiple myeloma.

 

4. Can Myeloma Cause Tumours To Spread?

Firstly, myeloma itself doesn’t form solid tumours like some other cancers. Myeloma is usually a liquid cancer involving plasma cells in the bone marrow and blood. These tumours may present in the bone marrow, preventing the bone marrow from producing healthy cells. Sometimes these tumours may present in the spine, or in the chest wall (amongst other locations) and can cause symptoms due to the infiltration and pressure effects on surrounding nerves and organs.

However, plasmacytomas can sometimes present as isolated solid tumours without myeloma involvement in the bone marrow. These tumours are known as solitary plasmacytomas and our doctors may recommend radiation therapy to treat and manage these tumours.

Patients who present with myeloma together with plasmacytomas will usually need targeted chemotherapy as well as possibly radiotherapy as treatment.

 

5. Is Myeloma Curable?

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The question of whether myeloma is curable is a significant concern for individuals grappling with this diagnosis. At present myeloma is still considered an incurable disease. However, recent advances in both the diagnosis, monitoring of myeloma as well as treatments have meant that for an increasing number of myeloma patients, they are able to attain very good responses to treatment and also remain in remission for increasingly longer periods.

There are constant advances and development of newer therapies for myeloma which means that we anticipate that the outcomes of myeloma patients will continue to improve over time.

Your Myeloma Journey with CFCH

This article has provided some insights into common questions that arise after a multiple myeloma diagnosis. At CFCH, we provide personalised care, tailored treatment plans, and compassionate support, all designed to help you navigate the complexities of multiple myeloma. Your health is our priority, and we’re here to guide you every step of the way.

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The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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Myeloma Diet, Myeloma Nutrition, Myeloma Treatment Singapore, CFCH

Living Well With Myeloma: Lifestyle & Diet Guide

Living with myeloma presents unique challenges that require a holistic approach to care. In this article, we will explore the role of lifestyle and diet in managing myeloma and enhancing overall well-being. We understand the impact that lifestyle choices and nutrition can have on the progression of myeloma and the quality of life for patients. We aim to provide valuable insights and practical tips to optimise your lifestyle and make informed dietary choices.

 

How Myeloma Affects Your Everyday Life

 

Myeloma, Myeloma Symptoms, Myeloma Treatment Singapore, CFCH Singapore

Once diagnosed, patients may wonder if they can live a normal life with myeloma. Myeloma is a serious medical condition and the diagnosis and its associated symptoms often have an impact on the quality of life of patients. That being said, there have been significant improvements in the treatment of myeloma. Most initial treatments are outpatient based, with manageable side-effects, and many patients are able to continue with their daily activities.

As certain symptoms can affect everyday life, patients tend to be concerned if multiple myeloma affects walking as well. Since myeloma affects the bones, many patients may experience weakness and pain when walking. 

On top of that, myeloma may also cause back pain. Since myeloma can weaken a patient’s bones, it is not uncommon to experience pain in these affected bones – typically the neck, back, hips, or ribs. The pain experienced is often a dull, persistent ache that may be exacerbated by movement. 

Despite experiencing these symptoms, myeloma patients can manage them through simple lifestyle changes. 

 

Lifestyle Changes To Manage Myeloma

 

Myeloma Fitness, Myeloma Exercise, Myeloma Singapore, CFCH Singapore

Since the bones are affected, some may doubt if exercise is good for myeloma patients or if it could cause more harm. 

In reality, exercise is beneficial to one’s health in a multitude of ways. Patients diagnosed with multiple myeloma will find that weight-bearing activities such as walking and climbing stairs can aid in strengthening one’s bones. 

However, patients should always consult with their doctors before taking on a new exercise routine and if they experience pain or a change in their symptoms. Often, the CFCH team will advise that patients with myeloma bone disease initiate a phased exercise programme with a recommended physiotherapist.

For example, certain exercises like weight lifting or sports such as football and rugby have a higher risk of affecting the bones. Myeloma patients should instead opt for less strenuous and risky exercises such as swimming and yoga to maintain their overall health. 

 

Diet Changes To Manage Myeloma

 

Myeloma Diet, Myeloma Nutrition, Myeloma Singapore, CFCH

Since myeloma can cause fatigue and a lack of energy, it’s also important to consume healthy foods, but what exactly is the proper diet for a patient with myeloma?

While there is no specific diet recommended for patients diagnosed with myeloma, patients should follow a healthy diet. This includes recommended servings of carbohydrates, proteins, vegetables, and healthy fats. A well-rounded diet can aid patients with myeloma in keeping their energy and strength up.

Some examples of foods to eat are dried fruits like figs, oatmeal, broccoli and beans. However, with a weakened immune system, certain foods like raw meat and runny eggs should be avoided as they can increase the risk of making you sick. 

 

Find Support at CFCH

You can actively manage myeloma and enhance your overall well-being by prioritising a healthy diet and incorporating beneficial lifestyle habits. Remember, small changes can make a significant impact on your journey with myeloma.

If you have any further questions or require personalised guidance, reach out to us at CFCH. Our team of experienced professionals specialises in treating myeloma patients and is dedicated to providing comprehensive care. Contact us today to schedule a consultation and explore how we can support you in your myeloma management.

Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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World Lymphoma Awareness Day: Is it Possible to Have Lymphoma Without Knowing?

Certain illnesses, including lymphoma, can remain hidden for a significant period without exhibiting obvious signs or symptoms. Lymphoma, in particular, can be a condition that individuals may have without realising it.

It is possible to have lymphoma without knowing as low-grade lymphoma can progress slowly and often without noticeable symptoms. This means that individuals may live with lymphoma without being aware of its presence. Even in more aggressive forms of lymphoma, some patients may not experience initial symptoms until the tumour has reached an advanced stage.

In addition, there are certain conditions that can be mistaken for lymphoma. Generalised swelling of lymph glands can be due to conditions other than Lymphoma. This could be due to an infection such as TB, generalised inflammation (from an autoimmune disorder), or even a drug reaction. Hence a detailed general assessment is required to confirm a diagnosis of Lymphoma.

In this article, we will explore the potential causes of lymphoma and discuss common signs and symptoms associated with the condition. Understanding the underlying factors that can contribute to lymphoma and being aware of the signs can help individuals recognise potential warning signs and seek appropriate medical attention.

 

What Could Cause Lymphoma?

Unfortunately, the cause of Lymphoma is often unknown in the majority of Lymphomas. Some Lymphomas can be triggered by prior infection and inflammation, such as H. Pylori infections which are implicated in gastric MALT Lymphoma, or EBV infection in certain other forms of Lymphoma.

Prior exposure to substances such as cancer-causing agents or radiation can also be a cause in some patients diagnosed with Lymphoma.

Patients often also ask if stress can cause lymphoma. However, within the existing studies and research surrounding Lymphoma, there is not enough clear evidence to determine if stress is responsible for or worsens Lymphoma.

 

Symptoms To Look Out For

Recognising the potential symptoms of lymphoma is crucial for early detection and effective treatment. While these signs can be subtle, it is important not to ignore them.

Some of the most common first signs of Lymphoma include painless swellings in the neck, armpits, or groin, persistent fatigue, and night sweats. 

Patients may also report shortness of breath and unexplained weight loss as some of the first signs of Lymphoma.

 

Seeking Advice

Lymphoma is not hard to diagnose and in the majority of suspected cases, a detailed disease and workout will establish the diagnosis of Lymphoma. A Lymphoma diagnosis is usually confirmed through a detailed clinical assessment, blood tests, a PET-CT scan, and a biopsy of the affected lymph nodes. In many patients, a bone marrow evaluation will also be performed as part of staging to assess whether there is Lymphoma involvement in the bone marrow.

If you are experiencing any of the mentioned symptoms, it is important to seek medical advice to determine whether further investigations are necessary. Contact our team at CFCH to arrange a consultation with one of our experienced doctors who can provide the guidance and assistance you need. Your health and well-being are our top priorities, and we are here to support you on your journey towards better health.

Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

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What is Blood?

Blood is essential to life. Blood circulates through our body and delivers vital substances such as oxygen and nutrients to the body’s cells. Additionally, blood transports metabolic waste products away from those same cells. There is no substitute for blood, and it cannot be made or manufactured artificially. Therefore, patients in need of a blood transfusion can only rely on generous blood donors.
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What are the Components of Blood?

Blood is a bodily fluid that transports substances throughout the body. It is made up of plasma and blood cells..

Plasma constitutes 55% of blood. It is 92% water, and the other 8% is made up of proteins, glucose, mineral ions, hormones, carbon dioxide, and blood cells. Plasma is also the primary medium for the transport of waste products.
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Blood Cells

There are 3 main type of blood cells:

  • Red blood cells (Erythrocytes)
  • White blood cells (Leukocytes)
  • Platelets (Thrombocytes)
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Red Blood Cells
These cells give blood its red colour as they are the most abundant type. Red blood cells contain a substance called haemoglobin which binds to oxygen and transports it around the body.
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White Blood Cells
White blood cells account for only about 1% of blood. They are part of our immune system, and each type of white blood cell has a different role to play in terms of protecting the body against pathogens..

There are 5 main types of white cells: neutrophils, lymphocytes, eosinophils, monocytes and basophils. Neutrophils main function is to attack and destroy and bacteria that enters the blood stream. Lymphocytes attack viruses and other pathogens; they also create antibodies to destroy them.
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Platelets
Your blood also contains platelets. Platelets help the blood to clot at a site of injury, and prevent excessive blood loss.
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Where do Blood Cells come from?


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Blood cells develop from hematopoietic stem cells which are formed in the bone marrow. There are two main types of stem cells within the bone marrow – myeloid and lymphoid – which transform to form the different blood cells in our blood. Once the blood cells are mature, they are released from the bone marrow into the bloodstream. Donor stem cells sources may be used to treat a variety of diseases, including leukaemia, lymphoma, bone marrow failure, and some immune disorders.
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What Does Blood Do?

Blood has many different functions, including:

  • Transportation
    Blood carries oxygen with red blood cells from the lungs to the rest of the body. Then it takes any waste products and transports it to where it can be passed out of the body appropriately.
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  • Regulation
    It balances the acidity and alkalinity of your body. It also helps to regulate your body temperature.
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  • Protection
    White blood cells are responsible for a significant role in helping the body’s immune system by attacking and destroying pathogens. Platelets are responsible for blood clotting, which prevents the excessive loss of blood after an injury.

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Blood Groups

Red blood cells have specific proteins on their surface; they are called antigens. Your plasma also contains antibodies which will attack specific antigens if they are found. While there are various types of red blood cell antigens – the ABO and rhesus types are the most important. Your blood group depends on which antigens which occur on the surface of your red blood cells..

If you have Type A antigens on the surface of your red blood cells, you also have anti-B antibodies in your plasma. You have blood group A..

If you have Type B antigens on the surface of your red blood cells, you also have anti-A antibodies in your plasma. You are blood group B..

If you have both Type A and Type B antigens on the surface of your red blood cells, you do not have antibodies A or B antibodies in your plasma. You are blood group AB..

If you have neither Type A nor Type B antigens on the surface of your red blood cells, you have both A and B antibodies in your plasma. You are blood group O..

The blood group is considered positive or negative based on the presence or absence of the Rhesus antigen respectively.
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Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.

    Contact Us

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