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Is Acute Transformation Of A Myeloproliferative Disorder Terminal?
Question: These two questions are only intended to be general. Is acute transformation of a myeloproliferative disorder ALWAYS terminal? If a 90 year-old nonambulant patient with diabetes, cadiomyopathy, COPD and a pleural effusion had an acute transformation of such a disorder then what would be the approximate life expectancy in days or months? I appreciate that the latter question would be difficult to answer even with an examination of the patient. Even a rough estimate would be helpful.
Brief Answer:
Considerations
Detailed Answer:
things for sending your question.
Your question regarding transformation of a myeloproliferative disorder is a very good one and one that is somewhat difficult answer with specific detail. Generally when we refer to transformation this indicates progression to leukemia.
progression to acute leukemia in this setting generally portends a very grave prognosis. This is especially true in a patient of advanced age and additional comorbid medical conditions.
if left untreated acute leukemia can lead to progressive decline and death within days to weeks.
it is very difficult to predict with detail how this would progress in individual person without the benefit of having additional laboratory studies and the benefit of clinical examination.
if you have additional information including results of laboratory studies or bone marrow biopsy this would be helpful in discussion.
Thanks again for sending your question. Please let us know if we can be of any additional assistance.
Dr. Galamaga
Considerations
Detailed Answer:
things for sending your question.
Your question regarding transformation of a myeloproliferative disorder is a very good one and one that is somewhat difficult answer with specific detail. Generally when we refer to transformation this indicates progression to leukemia.
progression to acute leukemia in this setting generally portends a very grave prognosis. This is especially true in a patient of advanced age and additional comorbid medical conditions.
if left untreated acute leukemia can lead to progressive decline and death within days to weeks.
it is very difficult to predict with detail how this would progress in individual person without the benefit of having additional laboratory studies and the benefit of clinical examination.
if you have additional information including results of laboratory studies or bone marrow biopsy this would be helpful in discussion.
Thanks again for sending your question. Please let us know if we can be of any additional assistance.
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your reply. This may also be a difficult question to answer. But is it generally accepted that there are sometimes grounds for not treating acute leukemia in a 90 year-old comorbid patient? If so, what might they be? Would pneumonia contraindicate treatment? Unfortunately, I cannot provide you with much information about the results of laboratory studies or a bone marrow biopsy.
Brief Answer:
Consideration
Detailed Answer:
pneumonia is not necessarily a contraindication to treatment.
Treatment of leukemia involves use of medications which can be very toxic. Unfortunately some of these treatments place the body at even greater risk for development of infections including viruses bacteria and fungus.
At this point it might be interesting for you to sit down with a specialist in the medical specialty of palliative care. These physicians and practitioners help you and the patient to focus on appropriate goals of care.
using treatment might not necessarily lead to improvement of the disease. Treatment unfortunately has significant potential side effects and I would encourage you to discuss these in detail with the hematologist on the case.
Thanks again for sharing your healthcare concern with us.
Sincerely,
Dr. Galamaga
Consideration
Detailed Answer:
pneumonia is not necessarily a contraindication to treatment.
Treatment of leukemia involves use of medications which can be very toxic. Unfortunately some of these treatments place the body at even greater risk for development of infections including viruses bacteria and fungus.
At this point it might be interesting for you to sit down with a specialist in the medical specialty of palliative care. These physicians and practitioners help you and the patient to focus on appropriate goals of care.
using treatment might not necessarily lead to improvement of the disease. Treatment unfortunately has significant potential side effects and I would encourage you to discuss these in detail with the hematologist on the case.
Thanks again for sharing your healthcare concern with us.
Sincerely,
Dr. Galamaga
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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