Haematology and Immunology, Myeloproliferative Disorders - Essay Example

?MYELOPROLIFEFERATIVE DISORDER Nam College Myeloproliferative disorders (MPDs) refer to a category of conditions that occur when red blood cells, platelets and white blood cells develop abnormally in the bone marrow and spread to the rest of the blood tissue. They are also known as myeloproliferative neoplasms (MPNs) and include a number of diseases like: Essential thrombocytosis It occurs when platelets in the blood tissue are produced in large numbers than normal and cause the blood to thicken. The blood flow then slows and could be harmful to health as it could lead to stroke and cardiac arrest. The blood in people with this condition clots abnormally since the number of platelets produced is higher than normal and exposes them to more risk to heart attacks and stroke. Chronic melogenous leukemia It happens when there is a higher production of granulocytes, a type of white blood cells in the bone marrow (Gold, 1970). Polycythemia Vera It translates when the bone marrow produces too much of red blood cells and leads to swelling of the spleen as the extra blood cells gather in the spleen. Its symptoms include itching of the body and pain on the left side of the abdomen where the spleen is located. Primary or Idiopathic myelofibrosis It happens when the bone marrow produces too much of collagen tissue which is a fibrous tissue that affects the formation of red blood cells leading to anemia in patients. In primary myelofibrosis there is a deficiency in the production of red blood cells. Very low count of red blood cells is risky to health since red blood cells are useful in distribution of oxygen around the body. Lack of oxygen in vital organs of the body could lead to death of tissue in those organs posing harm to the entire body (Green, 1998). Chronic neutrophilic leukemia. If occurs when there are too many neutrophils which are a type of white blood cells are being produced. Diagnosis of myeloproliferative disorders Myeloproliferative disorders (MPDs) are caused more by an overproduction of blood cells in the blood tissue than underproduction of these cells except in primary myelofibrosis . The initial cause of the malproduction however is not defined. Studies have it that too much exposure to chemicals and certain types of radiation are major contributions. Genetics on the other hand has developed a mutation theory on an abnormal gene called the Philadelphia gene. Many MPDs are related to the mutation of JAK2, a protein that aids in the regulation of cell production. These mutations occur during growth and people are not born with them rather they develop in during the process of growth (Tefferi, & Vardiman 2007). Acute MPDs can lead to chronic leukemia when the white blood cells formed are too many. They are risky ailments and which have no absolute cure but which can be managed for long periods of time with treatment of their symptoms. These treatments include diagnosis processes which involve blood tests. Total Blood Count (TBC) tests are important in keeping check of the counts of different cells in the blood peripheral and bone marrow. TBC takes the actual number of each kind of cell in the blood tissue and their shapes and the content of hemoglobin in the blood. Bone marrow biopsy is another relevant step in diagnosis and involves analyzing a sample of the bone marrow, this test proves or disapproves the presence of cancer in the marrow and the number of white and red blood cells produced and the type of the cells produced. The treatment process involves physical examination and records being compared from previous treatments. It includes cytogenetic analysis, which is a laboratory analysis on chromosomal changes in tissues. The symptoms of MPDs are not generalized and vary with the cell type in question whether it is a red blood cell or a white or a platelet and the specific kind of disorder. A common symptom in most of the patients with any MPDs however is an inflammation of the spleen which causes a feeling of bloating of the stomach and pain on the right side of the abdomen where the spleen is located. This is because other than the bone marrow, the blood cells synthesis also takes place in the spleen. The enlarged spleen is felt during the physical examination process. The symptoms include of myeloproferative disorder Polycythemia Vera Mostly revolves around stomachaches and presence of blood in the urine or constant nose bleeding. At times it could be high blood pressure and blocked blood vessels that could lead to death of organs like feet and arms due to gangrene, a situation of dead tissue. It also involves headaches and vision problems, exhaustion and breathing problems, paleness and itching of the skin (Silver, & Teferi, 2008). Essential Thrombocytosis The main symptoms include; a pale complexion, gastrointestinal bleeding and blood in the urine, persistent headaches and throbbing pain in the hands and feet and at times cardiac arrest and stroke are glaring threats. Primary Myelofibrosis. Its symptoms include abnormal bleeding, loss of weight and nausea and fatigue, anemia, fever and sweating during the night. This is because of lack of sufficient red blood cells to transport oxygen around the body which ultimately causes exhaustion and nausea (Leaman, 1992). Chronic myelogenous leukemia The signs include loss of weight, bone and joint pain, loss of appetite and weight loss, sweating during the night and strokes are likely to happen along with heart attack and pale complexion. Myeloproliferative disorders can lead to more complicated cancerous situations like juvenile myelomonotic leukemia, myelogenous leukemia and chronic myelomonotonic leukemia. MPDs have no cure, they are lifestyle disease that are managed by controlling the symptoms. Their ways of management is delicately variable in each one of them and includes (Murugesan ET ALL, 2006). Polycathemia Vera Lowering the red blood cells count by removing some of them, the process is called phlebotomy, while the same process of lowering the red blood cell count using medication is called myelosuppressive therapy. Most of the medication prescribed includes hydroxyurea or angrelide which is administered to reduce the number of thrombocytes and regulating them. Low dose aspirin reduces the reddening and burning of the skin while antihistamines reduce the itching (Tefferi, & Barbuit, 2005). Essential Thrombocytosis It focuses on the symptoms when they happen and uses medication, low dose of aspirin to reduce itching of the skin and curb the headaches. It also utilizes hydroxyera to reduce the number of cells being produced and aminocaproic acid to reduce on bleeding. Aminocaproic acid is useful before surgeries to prevent too much loss of blood (Kuby, 1997). Primary myelofibrosis This condition can be suppressed with medications to treat symptoms as they happen as well as blood transfusions. Its medications include thalidomide and lenalidomide to reduce anemia and suppress symptoms. It also requires hydroxyurea to reduce the number of cells produced and contain the enlargements of the spleen and the liver. Hydroxyurea is useful in improving anemia (Mughal, 2008). Chronic myelogenous leukemia Chronic myelogenous leukemia has a variety of treatments which include, chemotherapy, targeted therapy, high dose chemotherapy that could involve stem cell transplant, operative surgeries and infusion of lymphocytes. The options have increased and one can receive lymphocytes from a donor. Blood cells are produced in the bone marrow, the spleen and the liver, when MPDs happen they lead to interference in both the spleen and the liver and their enlargements could be very painful. In primary myelofibrosis, CML and Polycythemia Vera, the liver and spleen can both be removed by surgery (Kuby, 2001). Stem cell transplants involve obtaining new stem cells by surgery. Stem cells are part of the bone marrow that synthesis blood cells, new stem cells are transplanted onto the patient and left to develop and produce healthy blood cells. A bone marrow transplant basically works the same way as a stem cell transplant. Both operations are risky, they have been successful in occasions all the same and continue to be used. Phlebotomy involves removing some blood from the body and lowers the risk of strokes in people with polycythemia vera and is the basic the fundamental therapy in its treatment. Aspirin lowers blood clotting when prescribed on a low dose. People with anemia as well resolve to operations like blood transfusion (LEUKAEMIA FOUNDATION, 2008). The chances of these conditions developing or getting more delicate increase with age; they are most likely to happen in people who are above 60 years of age. Life style, the exposure of someone to radiation and the gender of those persons, MPDs occur in males more than they do in females apart from Essential thrombocytosis whose chances are 1.5 higher for women than men. A lot of exposure to chemotherapy can as well make the situation more dire than better. MPDs are lifestyle conditions, even when the actual cause is not known, lifestyle is the main aspect in managing these disorders are in the patients way of living. Treatment plans should include a healthy diet along with the conventional cancer treatments. Diet plans are recommended to eat less of red meats and more of lean types and to avoid caffeine, alcohol and tobacco. Use of more healthy oils like olive oil and exercise eating vegetables and antioxidants and taking enough water. Bibliography GOLD, E. R., & PEACOCK, D. B. (1970). Basic immunology. Bristol, J. Wright. http://www.optometry.co.uk/uploads/articles/976f2dd6af2042a7ec6326f4b524b41c_heath20020208.pdf GREEN, A. R., & PEARSON, T. C. (1998). Myeloproliferative disorders. London, Bailliere Tindall. http://www.leukaemia.org.nz/uploads/file/efafe7d81932b00d5959dd0b850bff7f.pdf KUBY, J. (1997). Immunology. New York, W.H. Freeman. http://www.who.int/immunization/documents/Elsevier_Vaccine_immunology.pdf KUBY, J. (2001). Immunology. New York, W.H. Freeman. http://www.who.int/immunization/documents/Elsevier_Vaccine_immunology.pdf LEAMAN, T. L. (1992). Healing the anxiety diseases. New York, Plenum Press. http://bloodjournal.hematologylibrary.org/content/112/2/231.full.pdf LEUKAEMIA FOUNDATION (AUSTRALIA). (2008). Understanding myeloproliferative disorders: a guide for patients and families. [Sydney, N.S.W.], Leukaemia Foundation. http://www.leukaemia.com/fileadmin/dl-docs/booklets/2008_booklet_understanding_MPD.pdf MUGHAL, T. I., & GOLDMAN, J. M. (2008). Chronic myeloproliferative disorders. London, Informa Healthcare. https://mywebspace.wisc.edu/lbjohnson2/Journal%20Club%20Website/Articles/myeloproliferative%20disorders.pdf MURUGESAN G, ABOUDOLA S, SZPURKA H, VERBIC MA, MACIEJEWSKI JP, TUBBS RR, & HSI ED. (2006). Identification of the JAK2 V617F mutation in chronic myeloproliferative disorders using FRET probes and melting curve analysis. American Journal of Clinical Pathology. 125, 625-33. http://ajcp.ascpjournals.org/content/125/4/625.full.pdf SILVER, R. T., & TEFFERI, A. (2008). Myeloproliferative disorders: biology and management. New York, N.Y., Informa Healthcare. http://ajcp.ascpjournals.org/content/132/2/261.full.pdf TEFFERI A, & VARDIMAN JW. (2007). The diagnostic interface between histology and molecular tests in myeloproliferative disorders. Current Opinion in Hematology. 14, 115-22. http://linaswish.org/wp-content/uploads/2011/10/Tefferi-and-Vardiman-Diagnostic-Interface1.pdf TEFFERI A, & BARBUI T. (2005). bcr/abl-negative, classic myeloproliferative disorders: diagnosis and treatment. Mayo Clinic Proceedings. Mayo Clinic. 80, 1220-32. http://www.medicine.wisc.edu/~williams/mpdmayo.pdf Read More