Tuesday, May 25, 2010

Why is a bone marrow test conducted if the platelet level in the blood falls?

the patient has suffered from blood cancer (lowest level) in the past and chemotheraphy has been performed twice. What precautions are to be taken with such disease? What is the probability of leading a normal life?
Answer:
With all types of cancer's that are being treated by chemotherapy there is always a risk of bone marrow depression which means that it stops producing blood cells including platelets. if a person's platelets drop suddenly and remain low for a certain period of time even though they have had platelet transfusions then the doctor's will request for a bone marrow test to be performed. the test will show them if the person is still producing their own blood cells or if the bone marrow has ceased production.
Platelets are formed in the bone marrow, along with red blood cells and white blood cells. Blood cancers come in all shapes and sizes. Some are worse than others. Some are called lympocytic, megaloblastic, etc. Without knowing exactly what kind you are describing, I can not say what possibility this patient has for a normal life.
What the test is for: This test is to see whether there are cancer cells in your bone marrow. For this test, the doctor must remove a tiny sample of bone marrow cells to look at under the microscope.Types of cancer it is used for:Bone marrow tests are most often done for cancers that are most likely to affect the bone marrow, such as * Lymphomas (non Hodgkin's lymphoma or Hodgkin's lymphoma)
* Leukaemias
* MyelomaBut it can be done for any type of cancer if your doctor thinks your bone marrow could contain cancer cells, or needs to rule this out for any reason.Types of test:There are two main types of bone marrow test - a bone marrow aspiration and a bone marrow trephine biopsy. Aspiration means the doctor sucks some bone marrow cells up into a syringe. A bone marrow trephine means that the doctor removes a 1 or 2cm core of bone marrow in one piece. You may have both of these done at the same time. They give some of the same information to the doctor, but there are differences and it helps (particularly if you are having the test as part of your diagnosis) to have both. Basically, the bone marrow biopsy shows the doctor the structure of the bone marrow inside the bone, whereas the aspiration gets just the bone marrow cells.Having the test: Either test only takes a few minutes and you can have them done as an out patient. The doctor usually takes the bone marrow sample from your hip bone. You can have a bone marrow aspiration from your breast bone (sternum) but not a bone marrow biopsy.First you have a local anaesthetic injection into the skin over the biopsy site - usually your hip bone - to numb it. When this has worked, the doctor will put the needle in. For a bone marrow aspiration, the needle is quite thin. For a bone marrow trephine, the needle is thicker. Either way, the doctor needs to put the needle through the skin, into the hip bone and into the centre of the bone, where the marrow is. If you are having a marrow aspiration, the doctor will then suck a cubic millilitre of bone marrow cells into the needle. You may feel a sudden, sharp pain when the doctor starts drawing the bone marrow cells out. If you are having a trephine biopsy as well, the doctor will take this needle out and put the second one in.If you are having a trephine, the doctor will turn the needle back and forth while pushing it further into the marrow. The aim is to get a one or two centimetre core of marrow out in one piece. Once it is in far enough, the doctor will draw out the needle, containing its core of marrow. The needle going into the hip bone can be painful, but it doesn't last for too long. Some people prefer to have some type of sedative before the test so that they are a bit drowsy. Sedation of some sort is certainly a good idea for children. If you do have a sedative, you will have to stay at the hospital until it has worn off. And you'll need someone with you so you don't have to go home on your own.After the test, your hip may ache for a couple of days. You may need some mild painkillers to take home or your doctor may suggest you take some paracetamol. The results:It can take time for results to come through. Exactly how long may depend on why you are having the test. The results will not be processed unusually fast if the test is part of your routine check up, for example. The bone marrow sample goes to the medical laboratory as soon as it has been removed. A pathologist examines it under a microscope. To do this, the cells may have to be stained, so that the different types show up more clearly. The staining techniques can take a couple of days, depending on what needs to be done. The pathologist's report on the bone marrow sample will be typed up and sent to your specialist.Understandably, waiting for results can make you very anxious. Especially if it it takes a couple of weeks for the results to come through. Try to remember to ask when you can expect the results when your specialist first suggests you have the test. That way, you will know roughly how long they will take and can try to put the whole thing out of your mind until then. If your doctor needs the test results urgently, he or she will have written that on the request form. If it isn't an emergency and you haven't heard after a couple of weeks, ring your doctor's secretary to check if your results are back.
Blood Cancer or Adult Acute Lymphoblastic Leukemia
Adult acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).Adult acute lymphoblastic leukemia (ALL; also called acute lymphocytic leukemia) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated.Normally, the bone marrow makes stem cells (immature cells) that develop into mature blood cells. There are 3 types of mature blood cells: * Red blood cells that carry oxygen and other materials to all tissues of the body.
* White blood cells that fight infection and disease.
* Platelets that help prevent bleeding by causing blood clots to form.In ALL, too many stem cells develop into a type of white blood cell called lymphocytes. These lymphocytes may also be called lymphoblasts or leukemic cells. There are 3 types of lymphocytes: * B lymphocytes that make antibodies to help fight infection.
* T lymphocytes that help B lymphocytes make the antibodies that help fight infection.
* Natural killer cells that attack cancer cells and viruses.In ALL, the lymphocytes are not able to fight infection very well. Also, as the number of lymphocytes increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. The cancer can also spread to the central nervous system (brain and spinal cord).This summary is about adult acute lymphoblastic leukemia. Refer to the following PDQ summaries for information on other types of leukemia: * Childhood Acute Lymphoblastic Leukemia Treatment.
* Adult Acute Myeloid Leukemia Treatment.
* Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment.
* Chronic Lymphocytic Leukemia Treatment.
* Chronic Myelogenous Leukemia Treatment.
* Hairy Cell Leukemia Treatment.Previous chemotherapy and exposure to radiation may increase the risk of developing ALL.Anything that increases your risk of getting a disease is called a risk factor. Possible risk factors for ALL include the following: * Being male.
* Being white.
* Being older than 70.
* Past treatment with chemotherapy or radiation therapy.
* Exposure to atomic bomb radiation.
* Having a certain genetic disorder such as Down syndrome.Possible signs of adult ALL include fever, feeling tired, and easy bruising or bleeding.The early signs of ALL may be similar to the flu or other common diseases. A doctor should be consulted if any of the following problems occur: * Weakness or feeling tired.
* Fever.
* Easy bruising or bleeding.
* Petechiae (flat, pinpoint spots under the skin caused by bleeding).
* Shortness of breath.
* Weight loss or loss of appetite.
* Pain in the bones or stomach.
* Pain or feeling of fullness below the ribs.
* Painless lumps in the neck, underarm, stomach, or groin.These and other symptoms may be caused by adult acute lymphoblastic leukemia or by other conditions.Tests that examine the blood and bone marrow are used to detect (find) and diagnose adult ALL.The following tests and procedures may be used: * Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
* Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
o The number of red blood cells, white blood cells, and platelets.
o The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
o The portion of the blood sample made up of red blood cells.
* Peripheral blood smear: A procedure in which a sample of blood is checked for the presence of blast cells, number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells.
* Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for abnormal cells.
* Cytogenetic analysis: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if there are certain changes in the chromosomes in the lymphocytes. For example, sometimes in ALL, part of one chromosome is moved to another chromosome. This is called the Philadelphia chromosome.
* Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if malignant (cancerous) lymphocytes began from the B lymphocytes or the T lymphocytes.Certain factors affect prognosis (chance of recovery) and treatment options.The prognosis (chance of recovery) and treatment options depend on the following: * The age of the patient.
* Whether the cancer has spread to the brain or spinal cord.
* Whether the Philadelphia chromosome is present.
* Whether the cancer has been treated before or has recurred (come back).
If the cause for the low platelet count remains unclear, bone marrow biopsy is often undertaken, to differentiate whether the low platelet count is due to decreased production or peripheral destruction. Consult your doctor.
Please see the web pages for more details on Thrombocytopenia.
The bone marrow test is a cytological study of cells which are actually responsible for formation of platelets. To confirm the basic cause of platelet deficiency. Also to assess the response of chemotherapy. You need do follow your oncologist suggestions thoroughly. It is very difficult to tell the life probability.
The Bone Marrow test is conducted to ascertain whether marrow has normal or abnormal/blast cells. Normally, the abnormal/blast cells should not be more than 5%. In case blast cells in marrow are more than 20%, it is classified as Leukemia or Blood Cancer.
As far as levels in blood cancers are concerned, there are no levels or staging. The concept of staging is in Tumour Cancers.
As regards precautions, there are numerous precautions required and mainly depends on condition of the patient.
The probability of a patient of blood cancer leading a normal life is more or less equally divided i.e. he/she may lead virtually normal life with remission or may not lead a normal life if not in remission.

No comments:

Post a Comment

Blog Archive

vc .net