Why do patients with first-episode leukemia have to undergo many tests?
Patients who first visit the hematology department often complain about too many tests, believing that frequent blood tests or bone punctures are bad for their health and time-consuming. In fact, these laboratory tests are essential, and for veteran hematology patients, many of them will take the initiative to request the relevant tests because the results of these tests play a monitoring role. It is not only easy to understand the efficacy of treatment and adjust the medication, but also easy to draw up the future treatment direction at an early stage.
First of all, learn to read the corresponding laboratory results.
Routine blood tests: When looking at routine blood tests, the three most important indicators to look at are white blood cell count, hemoglobin and platelet count. Usually patients with leukemia will have abnormal blood indicators.
Bone marrow smear: Because leukemia cells are produced in the bone marrow, a bone marrow smear is the main basis for the diagnosis of leukemia. Therefore, for leukemia patients, a bone marrow smear is essential. The principle is simple: 0.5 ml of bone marrow is taken and applied to a glass slide, which is then analyzed under a microscope. Bone puncture can be performed on an outpatient basis and does not interfere with daily life.
Blood smear: It can also be called blood sorting, blood percentage, etc. The principle is similar to that of a bone marrow smear, except that the bone marrow is replaced with peripheral blood. Not all leukemia patients have abnormalities in this test. So why do it? Because it is quick and convenient and allows the doctor to determine the approximate type of disease at the first time and make decisions about treatment and management.
Other bone marrow tests: Often, when hematology patients have bone puncture, they not only ask for a bone marrow smear, but also other bone marrow tests, such as chromosomes, immunophenotyping, fusion genes, etc.
Blood biochemistry: This is equivalent to an assessment of body functions such as liver and kidney function, which facilitates the judgment of diagnosis and the choice of treatment.
Many first-time patients do not understand why these tests are needed? This is because there are many types of leukemia, and each type of leukemia may combine different chromosomes, fusion genes, etc. Based on the results of the tests at the first presentation, acute leukemia is divided into high risk group, standard risk group and low risk group, and there are differences in the treatment plan, efficacy and prognosis of these different types of leukemia. If chromosomal, fusion and genetic, and immunophenotyping tests are done at the beginning of the visit, there are several benefits: ① it helps to determine the diagnosis and further grouping; ② the purpose of grouping is to decide how to use medication, that is, to develop a treatment plan; ③ another purpose of grouping is to determine the prognosis. Many patients and families ask, how is this disease? What is the success rate of treatment? Does it require transplantation? Only with a comprehensive understanding of the disease can the above questions be answered. ④ These test results will be used as a monitoring indicator for comparative analysis before and after treatment to understand the sensitivity to treatment in order to guide the development of future treatment strategies and decide whether treatment needs to be continued.
In short, bone marrow smear is like the tip of the iceberg on the surface of the sea, while other bone marrow tests such as chromosomes and fusion genes are like delving into the bottom of the sea to see just how big and deep this iceberg is; in this way, a comprehensive analysis of the disease can be made at the early stage of treatment to lay the foundation for future treatment and judgment.