Strange Leukemia

Asmart said:

My grandfather was recently diagnosed with someform of Leukemia. They couldnt say which type it
was though, because it is a strange Atypical type. A well renown Hematologist has taken a look at
his blood and diagnosed it as Atypical chronic Myleoid Leukemia OR Myelodysplastic syndrome. His
blood work as of dec 31 is as follows: <snipped> patient is a 73 y/o Man. Patient has small or no
Blast count, this is why this type of leukemia is Atypical..

Hello,

I'm very sorry to hear about your grandfather. They are so dear to us, yes?

I found this PubMed about atypical chronic myeloid leukemia. <ncbi.nlm.nih.govquOpen ↗
ery.fcgi?cmd=Retrieve&db=PubMed&list_uids=10847463&dopt=Abstract>

The median survival time from diagnosis was only 14 months (range 3-56 months). CONCLUSIONS: These
data suggest that aCML is a rare disease which is characterized by leukocytosis, with
dysgranulopoiesis, BM erythroid hypoplasia, chromosomal, though not recurrent, abnormalities and
poor prognosis.[]

It's considered a Myelodysplastic/Myeloproliferative Disease (bottom section here) <cancer.govwhat are myeloproliferativeOpen ↗
disorders>

cancer.govhealthprofessionalOpen ↗ The median survival times
for aCML are reported to be less than 20 months, and thrombocytopenia and marked anemia are poor
prognostic factors.[1,2] Atypical CML evolves to acute leukemia in approximately 25% to 40% of
patients.[1,3] In the remainder, fatal complications include resistant leukocytosis, anemia,
thrombocytopenia, hepatosplenomegaly, cerebral bleeding associated with thrombocytopenia, and
infection.[3,4]

Treatment overview The optimal treatment of aCML is uncertain, due in part to the rare incidence
of this chronic leukemic disorder. Treatment with hydroxyurea may lead to short-lived partial
remissions of 2 to 4 months duration.[4] It appears that aCML responds poorly to treatment with
interferon-?.[4]

cancer.govpatientOpen ↗ Atypical Chronic Myelogenous
Leukemia Patients will probably receive treatment to relieve symptoms of the disease, such as
anemia or bleeding.

Given the poor prognosis and your grandfather's age, he may well want to consider treating the
symptoms only. Sometimes the trials may just waste his time and give false hope and aggressive
treatments can be hard on his body. (older folks can have more complications). A much younger friend
of mine has spent 8 months fighting lymphoma and a bone marrow transplant but if the effort cleared
her lymphoma (which we won't know for a few weeks yet), will have been well worth her suffering and
all the time spent in hospital. Please help your grandfather and family understand that saying no to
aggressive treatment is a choice. He has to decide how he'd like to spend the rest of his life. He
may well do better treating the symptoms and with palliative care.

If you'd like to be part of a support group, we can be there for you also at news:alt.support.cancer

I'm sorry. J
PS Perhaps doctors here might comment on the bloodwork.

(Asmart) said:

Hi all, My grandfather was recently diagnosed with someform of Leukemia. They couldnt say which
type it was though, because it is a strange Atypical type. A well renown Hematologist has taken a
look at his blood and diagnosed it as Atypical chronic Myleoid Leukemia OR Myelodysplastic
syndrome. His blood work as of dec 31 is as follows:

WBC 53.3C RBC 2.71 HgB 90 HCT 0.26 MVC 95 MCH 33.2 MCHC 348 Platelet 39 patient is a 73 y/o Man.
Patient has small or no Blast count, this is why this type of leukemia is Atypical..

Any thoughts from medical students/ professionals would be appreciated.

An experienced eye of an hematologist over the blood and marrow smears are the best diagnostic tools
in this case.

I wouldn't call this a leukemia...

It's probably a displastic marrow secondary to something else.

High dose B6, B12, folates and EPO is the front line therapy. Low dose sc Ara-C is the second line
with eventual association of oral low dose VP16 and/or Idarubicin. Thalidomide might worth a try.

"Asmart" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hi all, My grandfather was recently diagnosed with someform of Leukemia. They couldnt say which
type it was though, because it is a strange Atypical type. A well renown Hematologist has taken a
look at his blood and diagnosed it as Atypical chronic Myleoid Leukemia OR Myelodysplastic
syndrome. His blood work as of dec 31 is as follows:

WBC 53.3C RBC 2.71 HgB 90 HCT 0.26 MVC 95 MCH 33.2 MCHC 348 Platelet 39 patient is a 73 y/o Man.
Patient has small or no Blast count, this is why this type of leukemia is Atypical..

Any thoughts from medical students/ professionals would be appreciated.

The best advice is "Take the haematologist's advice"

Follow up: Hi all, Just letting you know what has happened in the last couple of weeks. The
Hematologist had intensive lab work done on my grandfathers blood. We just got the latest results
and it turns out that his huge WBC of 110 000 (dec18/03) were made of mainly neurophils75% blasts15%
and the last 10 % I cant remeber but they were normal. This is good news the hematologist could
neither fit him in either CML or MDS, but he simply has a mild dysplastic ( abnormal) bone marrow
which could develop into mild mds in the future. My grandfathers last bloodwork showed that his WBC
are at 49 000 ( Jan2/04). They feel that the reason his WBC went so high is because he had a
blockage in his upper GI, diverticulitis and 4 perforations in his large intestine causing sepsis.
This all led him to being hospitalized in the first place, and after emergency surgery and 2 weeks
in hospital he is recovering nicely. We just got him back new years eve day. He is still tired from
all the surgery though. The hematologist is going to keep a close eye on his Blood work though with
another visist in 2 weeks. His final opinion was that if his WBC continue to drop to a safe level of
around 10 - 33 he should be just fine. RBC and Platelets are rsing back to safe levels as well. We
are extremely fortunate so far.

Follow up: Hi all, Just letting you know what has happened in the last couple of weeks. The
Hematologist had intensive lab work done on my grandfathers blood. We just got the latest results
and it turns out that his huge WBC of 110 000 (dec18/03) were made of mainly neurophils75% blasts15%
and the last 10 % I cant remeber but they were normal. This is good news the hematologist could
neither fit him in either CML or MDS, but he simply has a mild dysplastic ( abnormal) bone marrow
which could develop into mild mds in the future. My grandfathers last bloodwork showed that his WBC
are at 49 000 ( Jan2/04). They feel that the reason his WBC went so high is because he had a
blockage in his upper GI, diverticulitis and 4 perforations in his large intestine causing sepsis.
This all led him to being hospitalized in the first place, and after emergency surgery and 2 weeks
in hospital he is recovering nicely. We just got him back new years eve day. He is still tired from
all the surgery though. The hematologist is going to keep a close eye on his Blood work though with
another visist in 2 weeks. His final opinion was that if his WBC continue to drop to a safe level of
around 10 - 33 he should be just fine. RBC and Platelets are rsing back to safe levels as well. We
are extremely fortunate so far.

Hello,
Last Jan.9 2004 my mother lost her battle with leukemia.
She was only 49 years old, she was diagnosed with it on Dec.27 2002 she had
one of the more aggressive subtypes AML ( Acute Myleoid) I watched her
wither up and die suffering from immense pain. I am 28 and sometimes people
would mistake my mom as being my older sister she was really young looking.
But near the end it was like someone took our beautiful, vibrant, and young
mother and replaced her with a old frail woman. Leukemia is horrible it
robbed me of enjoying the rest of my life with my mother, she will never see
me get married or play with any grand children, she didnt even get a chance
to see me graduate from college. I wouldnt want another family to go through
what my family went through. The only solace i can take from this is knowing
that i had my time with her, talking about good times, laughing at jokes,
crying about letting go, apologizing for past differences. I got to do all
these things plus telling my mother i loved her every night i feel lucky and
grateful for that. But i still feel sadness and emptiness everyday. I watch
people who live "normally" and never have to deal with this take a lot of
things for granted and i think i used to be one of them. I will never be
that way again.
"Asmart" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Follow up: Hi all, Just letting you know what has happened in the last couple of weeks. The
Hematologist had intensive lab work done on my grandfathers blood. We just got the latest results
and it turns out that his huge WBC of 110 000 (dec18/03) were made of mainly neurophils75%
blasts15% and the last 10 % I cant remeber but they were normal. This is good news the
hematologist could neither fit him in either CML or MDS, but he simply has a mild dysplastic (
abnormal) bone marrow which could develop into mild mds in the future. My grandfathers last
bloodwork showed that his WBC are at 49 000 ( Jan2/04). They feel that the reason his WBC went so
high is because he had a blockage in his upper GI, diverticulitis and 4 perforations in his large
intestine causing sepsis. This all led him to being hospitalized in the first place, and after
emergency surgery and 2 weeks in hospital he is recovering nicely. We just got him back new years
eve day. He is still tired from all the surgery though. The hematologist is going to keep a close
eye on his Blood work though with another visist in 2 weeks. His final opinion was that if his WBC
continue to drop to a safe level of around 10 - 33 he should be just fine. RBC and Platelets are
rsing back to safe levels as well. We are extremely fortunate so far.