At present in China, with the increasing atmospheric and environmental pollution, the impact of food hygiene, the public’s neglect of interior decoration, personal hair and nail dyeing, drug abuse, labor protection, and the advent of the aging of our population, the incidence of malignant blood diseases has risen sharply. In a few years, the admissions of acute and chronic leukemia, myelodysplastic syndrome, myeloma and lymphoma to the hematology departments of various tertiary hospitals have almost doubled.
As we know, once suffering from the above mentioned hematological tumor diseases, patients in most cases will have symptoms or signs such as fever, anemia, bleeding, bone pain, enlarged liver and spleen lymph nodes, etc. There will be obvious abnormalities of white blood cells (elevated or decreased number, a few normal), anemia and platelet abnormalities when checking blood. However, in a few cases, if the disease is in the early stage or these symptoms are covered up by other disease symptoms, then the above symptoms and signs of patients will not be obvious, and the white blood cells, red blood cells and platelets may only be mildly elevated or reduced during blood examination, which is difficult to attract our attention. Together with the fact that the incidence of hematologic tumors is not as high as common diseases, these mild symptoms, signs and blood test abnormalities are often ignored by clinicians or patients, who subjectively think that these manifestations may not be related to hematologic tumor diseases.
In fact, in clinical practice, we often encounter the following situations: (1) Patients have actually had mild blood abnormalities for a period of time before the diagnosis of the above diseases (e.g. physical examination blood test, usual blood test blood cell abnormalities), only that they did not pay attention to them at that time and failed to improve peripheral blood cell classification and bone marrow examination.
(2) Mild anemia in patients is often thought to be malnutrition, heavy menstruation, bleeding hemorrhoids, liver disease, kidney disease, etc., without performing bone marrow and other related examinations to exclude hematologic neoplastic diseases.
(3) This is especially true for elderly patients. Patients or their families think that they are too old, don’t toss the patient, don’t recognize the importance of bone marrow examination, and often reject bone marrow examination. (4) In Guangdong area, the masses think that bone marrow is valuable and cannot be examined casually. In fact, there is no scientific basis for this. Each of us has a large amount of bone marrow, and a bone marrow aspiration smear can be done in as little as 0.3 ml, which is not likely to damage the body.
In addition, in China, as the onset of myelodysplastic syndrome and myeloma tends to be younger, it is important to pay attention to bone marrow aspiration examination for screening the cause of unknown blood cell reduction and to exclude the above hematologic neoplastic diseases to avoid misdiagnosis and missed diagnosis. Xiping Dai, Department of Hematology, Guangdong Provincial Hospital of Traditional Chinese Medicine