Marrow transplantation: from sinusitis to leukemia – 02/02/2023 – Equilíbrio

In 2019, the 27-year-old writer Duda Riedel worked as a salesperson at a clothing store in São Paulo. The constant tiredness and pain in her legs that she felt, she attributed to the hours she spent on her feet at work.

Days after feeling excessive tiredness, the writer was startled to wake up and see blood marks on her pillow. Upon identifying that they had come out of her gum, she looked for a dentist.

“The professional said I needed to clean my teeth. I did, he said everything was fine and I went home”, he recalls.

However, the symptoms did not stop there. Then, the writer began to feel headaches and have nasal congestion and discharge – which, according to the doctors told her, indicated that she had sinusitis. With increasingly intense pain, she twice sought the emergency room at the hospital that attended her medical insurance.

“At the hospital, the doctor said I had sinusitis, prescribed a syrup and I returned home. That’s how it was both times: they indicated a medication and discharged me. I was never asked for a blood test.”

From sinusitis to leukemia

Diagnosed with sinusitis, Duda followed the treatment indicated by the doctor with syrups and returned to her routine, including going out with friends. A few weeks later, a bruise on her leg caught the writer’s attention, as she didn’t remember bumping into it anywhere.

Two days later, alone in her apartment, the writer began to feel sick and had to rush to the hospital.

“Then the terror began, because I vomited blood and that scared me so much. So much so that I ran to the hospital, where they put me on a drip and asked for a blood test. When the doctor saw that I was alone, she got scared, she said that I I was sick, but they still didn’t know what it was and asked me to call someone to accompany me”, reports Duda.

With the family living in Fortaleza, the writer asked a friend to go to the hospital in the capital of São Paulo and stay as a companion. The doctors’ first suspicion was that Duda might have internal bleeding, since her examination had indicated that she had only 45,000 platelets, a number well below what is considered normal (150 to 400,000 per microliter of blood).

The doctors then requested that an endoscopy be performed, but the result was negative for the suspicion of hemorrhage.

“They put me in a room and left me there. But since I was already feeling well, I wanted to leave, I was tired of staying in the hospital, and I started to remove the IVs that were in my hand. That’s when a nurse saw it and said: ‘be careful, girl, leukemia kills’. I panicked, because until then no doctor had talked about leukemia with me”, recalls Duda.

Confused by the supposed diagnosis of leukemia and the doctors’ lack of information, Duda left the hospital and went home. Hours later, she sought care at another hospital in the city, where she was admitted immediately. The next morning, her family was already in São Paulo to accompany her to the hospital to treat what was diagnosed as blood cancer.

Bone marrow transplant

Initially, Duda underwent three cycles of chemotherapy, but due to the severity of the disease, acute myeloid leukemia, the doctors said a bone marrow transplant was necessary.

No family member of the writer was 100% compatible with her – the brothers were only 50%. Therefore, it was necessary to look for a donor at Redome – National Registry of Bone Marrow Donors.

“It took six months of searching, waiting and a lot of anxiety until we found a compatible donor. In November 2019, I had my long-awaited transplant and was reborn. Today I celebrate two birthdays, the one of my birth and the one of my transplant.”

Cured of the disease, Duda undergoes annual medical follow-up with a multidisciplinary team to make sure that everything is fine with her health.

What is leukemia and what are the symptoms?

Leukemia is the name given to the malignant disease that affects leukocytes – blood and bone marrow cells responsible for defending our body. These diseased cells accumulate in the bone marrow, replacing healthy cells.

There are several types of leukemia: lymphoid or myeloid, acute or chronic. And there are four main types: acute myeloid leukemias (AML), acute lymphocytic leukemias (ALL), chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL).

“Leukemic cells can be very immature, as a result of blocking cell differentiation (a process that transforms and specializes the cell in a function), and in this case the cells cannot perform any of the functions of normal blood cells. In this case, we call leukemias of acute diseases”, explains Eduardo Rego, coordinating physician of the Acute Leukemia Service at Icesp (Cancer Institute of the State of São Paulo).

“When some genetic alterations only partially block differentiation and the leukemic cells maintain the aspect and some functions of normal blood cells, we call it chronic leukemias.”

With the “wrong” functioning of the cells, some symptoms begin to appear. They are due mainly to the replacement of normal bone marrow by leukemic cells, leading to a decrease in red blood cells.

“The main symptoms of leukemia are anemia, pallor, fatigue, palpitations, decreased immunity and greater predisposition to infections, with fever, malaise, decreased platelets, increasing the chance of bleeding and the appearance of purple spots on the body. The accumulation of diseased cells can also lead to an enlarged spleen”, explains Iara Zapparoli Gonçalves, deputy coordinator of the hematology department at Hospital de Amor de Barretos.

Treatment for leukemia depends on the type and at what stage the disease is discovered. It may involve chemotherapy, immunotherapy, radiotherapy, bone marrow transplantation or a combination of different treatments.

According to the Atlas of Cancer Mortality, 6,738 people died from leukemia in Brazil in 2020 (date of the last survey released), with 3,703 men and 3,035 women.

Estimates by the National Cancer Institute (INCA) point out that, for 2022, 11,540 new records of the disease were expected, the majority, around 6,000, in men.

This text was originally published here