Monthly Archives: April 2009

Recent studies show that a mild form of chemotherapy with the use of decitabine, administered over a longer period of time, can have significantly advantageous results for patients diagnosed with pre-leukemia. More widely known as Myelodysplastic Syndrome (MDS), pre-leukemia was recognized as a certified form of cancer just recently.

The American Cancer Society’s journal published this study in their latest issue, taking a more detailed look at pre-leukemia and its effects on the human body.

New Research Revelations

Researchers estimate than 45% of the patients with pre-leukemia symptoms and those who go through a relapse respond to a second treatment course. However, they did not get the duration and quality in their second round of treatment, compared to the first few rounds of chemotherapy. With the new findings, researchers are leaning towards the belief that initial treatments given over a longer duration may have more benefits compared to numerous chemotherapy rounds.

It was discovered in the study that an average of three rounds of decitabine treatment had 10 out of the 22 patients exhibiting any type of response. Seven of the patients were observed to have haematological improvements and experienced a 50% decrease in their need for tranfusions, while three of the patients partly or completely had an effect in every one of their three cell lines. Overall, the average survival rate was declared to be 28 months, with those patients treated again with decitabine having a 13-month rate of survival before suffering from any sort of relapse.

In the group where 12 of the patients did not have any response to decitabine, the treatment had one of these two results: no effect whatsoever or the abnormal cells’ suppression, without the normal cells repopulating the bone marrow. Out of the 12 patients mentioned, four developed acute leukemia from the pre-leukemia.

The authors conclude that the most advantageous treatment type for pre-leukemia patients is the initial chemotherapy session given in longer durations, followed by maintenance of shorter treatment rounds.

Pre-leukemia

Pre-leukemia is an affliction that targets the bone marrow, resulting in an increased number of ineffective red and white blood cells. Usually, the cells blast and produce from the stem cells while multiplying in the blood stream, eventually killing the normal blood cells. This results in an irregular production of blood cells, causing fewer blood cells to form (which are needed to circulate and carry oxygen to different body parts).

Although therapy is readily available, pre-leukemia affects adults in their 50s, and researchers still have to find the ultimate cure. Patients suffering from pre-leukemia generally develop leukemia, or cancer of the blood cells. This study shows that this new DNA hypomethylating agent, decitabine, will have the most benefits for patients.

On 28 September 2006, I received an e-mail from a man seeking help for his wife. This is what he wrote:

I write this e-mail to you in order to seek your suggestion regarding my wife’s illness.

My wife had been diagnosed with Acute Myeloid Leukemia (AML) type M5 in late December 2005. I brought her to Singapore General Hospital (SGH) on 1 January 2006 for further management and chemotherapy. She had 3 cycles of chemotherapies in the first 3 months. Later she underwent a Bone Marrow Transplant procedure (BMT) in late April 2006 until mid May 2006. But unfortunately, on the 75th day after BMT, the leukemia cell relapsed. After that my wife had another cycle of chemotherapy and also received donor lymphocytes.

Due to financial consideration, I moved my wife for further treatment to Malaysia in mid August 2006. She was admitted into the Subang Jaya Medical Center (SJMC) until today. At SJMC she got another cycle of chemotherapy and received another donor stem cell on 12 August 2006.

But a week ago the leukemia cells were shown to be active again and they developed quickly before donor stem cells even could work. Five days ago my wife had another cycle of chemotherapy in order to reduce the white blood cell count.

I would like to find possible therapy and treatments that will be suitable for my wife. My wife and I are Indonesians. Within the next few days, I must make a decision whether to bring back my wife home to Jakarta or stay in Malaysia. I really need your help.

Comments

The above is a 33-year-old lady. Before her diagnosis she presented with the following symptoms: fevers for 1 to 2 weeks, gum pain and bleeding, headaches and diarrhea.

Over the years I have encountered many cases of bone marrow transplant (BMT). And all the cases that I know of resulted in death. There was this young lady of eighteen. She underwent BMT in Singapore. After spending so much money, her parents had to bring her home in a coffin. At her wake service, her mother said to me: “If we knew it is like this, we would have stuck to your advice!” She realized her mistake a bit too late!

I know of a person who had to spend well over 1.5 million ringgit (US$1 = 3.5 ringgit) to save his wife from leukemia. She too died. Then there was another young lady who just started to work after graduating from her studies in Australia. She had leukemia and she too underwent BMT. I was told (rightly or wrongly) that she died while on the “operation” table.

Tham is my patient who suffered from kidney lymphoma. After undergoing some initial chemo-treatment he decided to give up chemotherapy due to severe side effects. He opted for herbs. Within nine months, the cancer went into remission. Soon after he was pronounced cancer-free, his doctor suggested that Tham undergo BMT. According to the doctor with BMT he would live ten years longer. Tham declined after consulting me. The question I posed to Tham at that time was: “The aim of the doctor was to prolong his life for ten more years with BMT, but what was not taken into consideration was the risk of dying from BMT due to various complications.” It has been eleven years since Tham was diagnosed with cancer. He is very much alive and well today. Tham is still taking the herbs.

In the case of the lady above, fortunately she did not die from the BMT procedure, but it did not cure her either. Much money had been spent on medical expenses. I only have this to say: Your life is in your hands. Decide wisely!

MDS or myelodysplastic syndromes are a grouping of cancer afflictions that target the white & red blood cells as well as the bone marrow. MDS can develop into leukemia if not diagnosed or controlled early enough. There are types of MDS that are easy to manage and mild, while others can be life-threatening.

Experts in the field are trying their best in finding a cure for MDS; however there are a variety of treatments patients can choose from. There are also a lot of things people can do to help raise awareness and funds for MDS and other fatal types of cancer.

Treatment Options for MDS Patients

A host of treatment options are now available for patients suffering from MDS. These factors should be taken into consideration in deciding what treatment option would be best for a patient: overall illness risk level, type of MDS, age and status of health. The most common treatments are:

* Bone marrow or cord blood transplants

* Chemotherapy

* Drug therapies

* Supportive care

Testing is always being done for new MDS treatments, which is the reason why most patients agree to be a part of the clinical trials as part of their MDS treatment. A patient can have a standard treatment such as chemotherapy combined with alternative treatment options.

Support Care for MDS Patients

Supportive care is an option that is gaining popularity for those who seek MDS treatment. The purpose of this type of treatment is to ultimately get a firm hold of the disease and any issues related to it. There are cases when supportive care is the only treatment a patient requires, combined with regular checkups with physicians to decrease any risks of the disease developing into something more serious in the future.

Supportive care can also be combined with other forms of treatment; this combination works best for those with a more severe type of MDS, or those with an advanced age. Other patients look at the benefits of getting the supportive care from time to time, augmenting the benefits of the other forms of treatment.

Blood Transfusion

A lot of MDS patients require blood transfusion to lessen their symptoms’ adverse effects, and to keep the disease in line. Platelet transfusions decrease the risk of drastic bleeding problems, while red blood cell transfusions assist in reducing the symptoms that include shortness of breath and exhaustion.

When a patient undergoes blood transfusions, additional treatments should also be given to manage the iron build up in the patient’s body. Excessive amounts of iron in the body may cause damage to some organs, which is why a combination of treatments would be the best thing to do. It would not do to treat an existing condition (the MDS) only to have a new problem develop (organ damage) as a result of the treatment

Treatment – Growth Factors

The medications that enable the body to develop healthier blood cells are called growth factors. MDS patients are often given growth factors to lessen their need for red blood cell transfusions. There are some cases, however, when the patient’s bone marrow does not respond effectively.