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Diagnosed With Acute Lymphocytic Leukemia After Prolonged Discharge Of Menstrual Cycle. Is It Curable?

Posted on Mon, 2 Dec 2013

Question: hi Doctor, My friend is diagnosed with ALL yesterday after she suffered prolonged discharge of menstrual cycle. Her stage is classified as L2. She's now been treated in a Hospital in India itself. May i know some more info about the disease and about her treatment and whether it is curable. she is 25 yrs old and is married. Kindly reply Thanking you in anticipation \ XXXX

Answered by Dr. Lokesh K N (28 minutes later)

Brief Answer: Needs treatment Detailed Answer: Hi XXXXXXX ALL - L2 subtype is an aggressive disease. The prognosis depends on the percent of blasts in peripheral smear, total count and cytogenetics. If it comes under favourable risk, it is curable with chemotherapy. But it needs frequent followups for early diagnosis of relapse and chemotherapy has it own complications. If it comes under unfavourable risk, then it needs induction with chemotherapy followed by allogenic bone marrow transplant. Hope this helps. Let me know if you need clarifications. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Lokesh K N (37 minutes later)

sir , Her blood count went down to 4.2 and blood platelets to 5000 earlier on the day of diagnosis but eventually increased to hemoglobin at 8 gm and platelets came up to 56000 after two days but today it has again decreased to 7 gm and platelets to 46000. Her chemotherapy has started yesterday. Is this variation acceptable and can 100% remission possible. May i know likely period for which Chemo is given and when she's alright , Can she conceive after that or not? it will be kind help Dr XXXXXXX if you can reply to my query. and may i also know how can you classify "aggressive disease" as you quoted earlier in your answer. Thank you

Answered by Dr. Lokesh K N (2 hours later)

Brief Answer: variations can be seen, 100% Remission possible Detailed Answer: Hi, It's good her total count is normal and it falls under good risk, good response to treatment can be expected. These variation in counts can happen for 1-2weeks, till she show some response to treatment. 100% Remission can only be known following bone marrow examination by your doctor after treatment. The chemo duration is for 4-5months followed by maintenance chemo, depends on the protocol your doctor using. She can conceive, but it has its own complications to mother and baby.This can be discussed with your doctor only after full completion of treatment. Aggressive disease is a rapidly progressive disease which needs treatment soon. Hope I have answered all your questions. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Lokesh K N (36 hours later)

thanks for your advice and word Doctor. Her reports showed the presence of Pre B cells and her chemo is on going. How does we make aware Pre B cells presence and Is it Harmful or makes her fall under Good Risk or Poor Risk factor. Can these Pre B cells make the therapy help her in remission in a better way or make things worse. She has still not shown a line of worry or sadness on her face and is jovial as always. When can we finally be assure that things are in control now? thanks Doctor \ Regards XXXX

Answered by Dr. Lokesh K N (22 hours later)

Brief Answer: Pre B is good risk but cytogenetics is required Detailed Answer: Hi XXXX Pre B ALL is a good risk in most of the protocols it was used for risk stratification. Pre B cells presence is made out with a histology of cells using a microscope. It usually responds to treatment. But you need cytogenetics(chromosomal abnormality) for proper risk categorization. First bone marrow examination after beginning of treatment will help to know whether things are under control. Hope i have answered your all your quiry.

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Above answer was peer-reviewed by : Dr. Shanthi.E