Many medical
students and doctors find haematological malignancies a difficult
subject. I have conceptualize it here so that it become easy to
understand and master this topic
Leukaemia is a cancer of the bone marrow. Leukaemias were first
discovered quite lately in the 19th century. Unlike the solid
tumours, leukaemias are cancers arising from an organ diffusely
distributed through out the long and flat bones of the body
However, bone marrow functions as a discrete organ. This means
cell count are regulated to constant levels and the marrow
responds to stimuli such as infection and inflammation.
The leukaemias invariably involves the
entire marrow, whereas the lymphomas and myelomas exhibit patchy
involvement.
Over the last hundred years, blood film
examination and bone marrow aspiration were routinely used to
diagnose marrow pathology. Two patterns were noticed in leukaemia
patients. Some showed high number of normal looking white cells.
They tended to survive many years, hence diagnosed as chronic
leukaemia. Others showed large numbers of of very primitive
abnormal cells, or blasts, who died within a few months. These are
acute leukaemia. Sub-division of leukaemia is possible when the
leukaemia cells resemble a particular cell ty
Symptons and signs in patients with
haematological malignancies are not limited to the leukaemias and
the lymphomas. The myeloproliferative syndromes and
myelodysplasias, and myeloma can manifest in the same ways.
Symptom complexes are due to the disease
itself such as B symptoms in lymphomas, or arise from deficiencies
of red cells, white cells, and/ or platelets. Therefore they are
best considered as positive or negative.
Positive symptoms include B symptoms,
leukostasis, splenomegaly, and disseminated intra-vascular
coagulation
Negative symptoms basically refer to bone
marrow failure. This includes symptomatic anaemia, bleeding from
thrombocytopenia, and infection from low whit cell counts.
Once you master this concept and approach
you will find this topic extremely exciting and interesting,
unfortunately only as an academic subject. The actual handling of
patients with haematological malignancies is extremely challenging
If you have questions related to this article you may e-mail me
at doctor@soontongkiong.com quoting the contents of the article.
About the author
DR SOON is a medical practitioner. He holds four degrees. MBBS
(University of Malaya), MBA (University of East Asia), LLB (Hons)
(University of Wolverhampton), Master of Medicine (Edith Cowan
University
:
Dr SOON is the owner of AskMyVisitor.com and MyScriptDoctor.com
where you can find the most up-to-date advice and information
on
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