All the physicians in our practice have a hematology (blood disease) sub-specialty and our practice has full access to all of the most advanced blood testing available including cytogenetics (cell DNA), flow cytometry, and also the study of chromosomes and their abnormalities which may influence the specific type of leukemia you have. Bone marrow tests are also frequently used. In addition, it is important to enlist the aid of a pathologist known as a hematopathologist, who studies only blood, and this will be done in each case as well.

Once the diagnosis is clearly defined, an outline of therapy and a treatment proposal will be presented to you along with other options that may be available. The availability of clinical trials for specific individuals will be discussed in full and, wherever necessary, consultations with the other subspecialists, namely the bone marrow transplant team and the radiation therapist, will be conducted.

On the right you will find the links to organizations such as The Leukemia And Lymphoma Society, which can more fully discuss this complex disease group and its various subtypes. Our team has extensive experience in treating this variety of hematologic disorders and in the past we have participated in clinical trials of drugs and treatment modalities which have later become the standard of care.

© Lynn Herbert Ratner MD

Leukemia Basics disclaimer

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You may have just been diagnosed with the general term of leukemia or given a more specific term and you are probably confronting some very powerful emotions along with many questions: What is this disease? How did I get it? Can it be treated and how? What is going to happen to me? Am I going to die? What about my family?

Despite these fears and questions, it is helpful to take a deep breath and start to learn about this new reality in your life. In our practice we see this educational process as essential so that, together, you and we can make the best decisions about your treatment.

Leukemia is a generic term which encompasses a wide variety of diseases of the blood. There are many types because different blood cells are affected in different ways. There are four major types of leukemia, often referred to by initials. These four types include: acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL). There are also other less common types including hairy cell leukemia, chronic myelomonocytic leukemia and juvenile myelomonocytic leukemia.

This may all sound very confusing but it is because the ability to accurately define specific types of leukemia has advanced significantly in recent years. There have also been significant advances in treating the leukemias. Following diagnosis and treatment, patients often live with good quality of life for many years; and indeed there are signs that some types of leukemia such as chronic myeloid leukemia (CML) can be cured by taking a simple pill, a drug known as Gleevec (R), which has revolutionized treatment of that particular form of leukemia.

As mentioned, there are distinct cell types as well as differing progressions of the disease. Appropriate treatment can include drug therapy (including chemotherapy, monoclonal antibody therapy and stem cell transplantation) and in certain instances radiation therapy.

The signs and symptoms of the disease vary with each type of leukemia. The chronic leukemias (CLL and CML) are characterized by cells which crowd the bone marrow and can produce signs of bleeding in the skin with petechiae (blood spots) as well as fatigue, fever and night sweats. In some cases, blood cell counts may be low or they may be high.

Since leukemia is a disease of the blood cells, there are many blood tests that will be used to first determine your specific disease, then to select the best therapy for your disease and then even more tests to manage your treatment and monitor your progress.

Valuable Leukemia Resources

The National Cancer Institute information for patients about leukemia

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The National Library of Medicine
X-Plain teaching module for patients about leukemia

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The Leukemia-Lymphoma Society information for patients about leukemias

Lynn H Ratner MD
Paul A C Greenberg MD

112 East 83rd Street
New York City, NY 10028
tel: 1-212-396-0400 fax: 1-212-396-9800

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Doctors Ratner and Greenberg

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