Oncology-hematology – is a medical specialty, which deals with diagnostics and treatment of malignant diseases of the blood, bone marrow lymphs and lymphatic system.
Tumors of the hematopoietic and lymphoid tissues are characterized by malignant nature. If those tumors are being formed in the body, natural flow of hematopoiesis is severely disrupted.
Some examples of main oncology-hematology diseases:
- Leukemia, also known as blood cancer, can occur in acute or chronic form. Malignant neoplasm is originated n the bone marrow due to a malfunction in the cells devision mechanism. Acute leukemia occurs most commonly in children. Chronic leukemias can be myelogenous or lymphocytic nature. There are also diseases, which can be classified as subgroups of leukemia diseases, for example myeloma, Waldenstrom macroglobulinemia and 4 forms of heavy chain disease.
- Lymphoma is a group of diseases that affects the human lymphatic system. During this process generation and accumulation of cancer cells originated from lymphatic cells (lymphocytes) occurs.
- Myelodysplastic syndrome – group of diseases, which is charachterized by malfunctions in creation of all types of blood cells .
Causes of the disease
Although the exact cause of Leukemia is currently unknown, the data available allows us to define some risk groups
- Mutagenic factors of exogenous and endogenous origin
- Ionizing radiation
- Family history.
- Down Syndrome
- Chemotherapy received due to another oncological disease earlier
- Work with chemical carcinogens, such as petroleum products, paints, varnishes, certain medications drugs.
Usually it is very hard to can not detect oncology-hematology disorders of the blood system in the early stages, as the clinical manifestations are very generic and they are often attributed to other, less severe illnesses. Thus, patients learn about the disease during a random unrelated diagnostics or a general check-up on a later stage of the disease development.
Common symptoms of cancer blood diseases
- Enlarged lymph nodes.
- Increased body temperature.
- Shortness of breath.
- Incidents of loss of consciousness.
- Painful sensation in bones.
- Internal organs’ size increase.
- Weight loss for no apparent reason.
Tests and diagnosis – oncology-hematology
Determining what kind of evaluation the patient requires is only possible during the course of consultation. After the diagnostics is conculded, the doctor choses an appropreate treatment plan, which may be adjusted and corrected in the future. In order to establish an accurate diagnosis the patient can perform the following diagnostic tests:
- Complete blood count
- Bone marrow examination by puncture or trepanobiopsy.
- Molecular genetic diagnosis.
- Study of the cerebrospinal fluid.
- Cytologic examination.
- CT, PET-CT.
Treatment plan is selected individually for each patient. The therapy may include radiotherapy, chemotherapy, stem cell or bone marrow transplantation and targeted therapy.
The success of the treatment depends on the general condition of the patient, presence of concomitant (secondary) diseases, timely diagnosis and in some cases stage of the disease.
Cancer chemotherapy is effective because cytotoxic agents are able to stop the development of abnormal cells and destroy those that already exist. In combination with chemotherapy antiviral drugs are also usually perscribed, since they are required due to reduced ability of patients’ body to fight infections during the treatment – chemotherapy and other methods of cancer treatment severely weeken, and sometimes distroy the immune system. Antibiotics can also be perscribed as a preventive measure.
Radiation therapy is carried out by remote exposure. The main objective of radiation therapy is the destruction of cancerous cells and lesions, usually in internal organs.
Bone marrow transplantation (and/or stem cell transplantation) requires that antigens of both donor and the patient were compatible. This procedure allows to prolong life, and in many cases completely cure the patient – that’s oncology-hematology radical treatment. In cases of some diseases autologous stem cell transplantation is appropriate, then bone marrow or stemm cells are taken from femoral bones or peripheral blood. Previously stored cord blood can also be used, if available. This procedure is called autologous transplantation – patient received his own cells after all his bone marrow is destroyed.
Allogenic transplantation (allograft) is a bone marrow transplantation from a donor. The donor can be related or unrelated to the patient. Potential donors can be:
Patient close relatives (brother or sister, usually), it their parameters match the parameters of the patient.
Unrelated donor, who can be found with the assistance of world wide donor banks, where donors can be found through a search of HLA typing results.
In the case where the search for a matching donor is not successful, haploidentical transplantation can be used. Haploidentical transplantation is a transplantation, when the donor has 50 percent and higher compatibility and usually it is one of the patient’s parents (due to easy accessibility). Despite the fact that the rate of success in such transplantation is lower than in other options, it is nevertheless successfully used in practice, if no donor is available or waiting for search and donor’s activation results is not an option.
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