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Li Fang Fang
Hematology
About me
After graduation, I have been working in the Hematology Department at Kaifeng Central Hospital, engaging in clinical work. I have gained certain clinical experience in common diseases in the field of hematology, and have also assisted other clinical departments in auxiliary treatments.
Proficient in diseases
Specializes in common diseases of hematology, such as leukemia, hemophilia, anemia, lymphoma, thrombocytopenia, tetanus, hypoglycemia, aplastic anemia, neonatal hemorrhage, vitamin deficiencies, and other autoimmune diseases.
Voices
What are the harms of thalassemia?
The harm caused by thalassemia mainly comes from two aspects: one is the damage caused by anemia itself; the other aspect is that thalassemia is a hereditary disease, which can pass the pathogenic genes to the next generation. The damage from anemia can affect the nervous system, manifesting as dizziness, headache, brain fog, and tinnitus; in severe cases, it can lead to acute cerebral infarction. The cardiovascular system can be affected by reduced exercise tolerance, chest tightness and shortness of breath after activity, palpitations, and inability to lie flat at night; in severe cases, it can even cause acute myocardial infarction. The inheritance of thalassemia to the next generation depends on how many pathogenic genes are passed from both parents. The more pathogenic genes inherited, the more severe the thalassemia. Severe cases of thalassemia often result in death shortly after birth.
How long can one live with aplastic anemia?
The lifespan of patients with aplastic anemia depends on the type and the effectiveness of the treatment. Aplastic anemia is classified into acute aplastic anemia and chronic aplastic anemia. In cases of acute aplastic anemia, cure is possible through intensified immunotherapy or hematopoietic stem cell transplantation; however, without aggressive treatment, the survival period is relatively short, generally not exceeding one year. Chronic aplastic anemia, on the other hand, has a longer medical history, and patients can often live for ten to twenty years or more. However, throughout this period, ongoing transfusions of red blood cells and platelets are required to support treatment.
How is anemia treated?
For any type of anemia, if the anemia is severe, there is a need for active transfusion of red blood cells to correct the anemia. However, anemia can reoccur after transfusion of red blood cells, and it is not a long-term solution. Therefore, after correcting anemia with red blood cell transfusion, it is still necessary to diagnose the specific cause of the anemia and treat it accordingly. For example, patients with iron deficiency anemia need iron supplementation, those with megaloblastic anemia need to be supplemented with folic acid and vitamin B12, and patients with acute blood loss anemia need to find the source of bleeding and receive hemostatic treatment. Anemia caused by malignant hematological disorders like acute leukemia or myelodysplastic syndromes requires anti-tumor treatment.
The Difference Between Acute Leukemia and Chronic Leukemia
The difference between acute and chronic leukemia lies in the maturity stage of the leukemia cells. Acute leukemia is characterized by more immature leukemia cells, while chronic leukemia cells tend to be more mature. Acute leukemia is further divided into acute myeloid leukemia and acute lymphoblastic leukemia. Among them, acute myeloid leukemia is subdivided into eight types, from M0 to M7. Chronic leukemia is divided into two main categories: chronic lymphocytic leukemia and chronic myeloid leukemia. As the name suggests, acute leukemia has a rapid onset and a shorter survival period, whereas chronic leukemia develops more slowly and has a longer life expectancy.
The etiology of aplastic anemia
The etiology of aplastic anemia currently has no absolute cause, but the more supported theories concerning its etiology include the soil, pest, and seed theories. The soil theory refers to abnormalities in the microenvironment within the bone marrow, which causes an abnormal growth environment for hematopoietic stem cells, consequently limiting their growth. The seed theory indicates a decrease in the number and quality of hematopoietic stem cells in the bone marrow, leading to bone marrow regeneration failure. The pest theory refers to immunological factors, which play a significant role in aplastic anemia, suggesting a disorder in the patient's immune function that leads to bone marrow regeneration failure.
The main cause of aplastic anemia is.
The causes of aplastic anemia are considered to be of three types: abnormalities in hematopoietic stem cells, abnormalities in the bone marrow microenvironment, and abnormalities in immune factors. Among these, abnormalities in immune factors play a dominant role. Therefore, most patients with aplastic anemia see some improvement after receiving immunosuppressive therapy clinically. However, there is a small subset of patients with aplastic anemia for whom immunosuppressive therapy is not effective, and the causes of the disease in these patients are not well understood and may be congenital, such as congenital dyskeratosis.
What causes aplastic anemia?
Aplastic anemia's exact causes are still not completely clear. Clinically, it is believed that immune dysfunction is a significant factor associated with aplastic anemia. Most cases of aplastic anemia can achieve good therapeutic outcomes through immunosuppressive treatment, which indirectly supports this view. However, some scholars believe that in aplastic anemia, there are patients for whom immunosuppressive treatment is ineffective. This suggests that other factors might exist, such as congenital anomalies in hematopoietic stem and progenitor cells, or abnormalities in the hematopoietic microenvironment, which may also play a role in the development of aplastic anemia.
What are the symptoms of aplastic anemia?
The symptoms of aplastic anemia include three main symptoms: firstly, infections; secondly, anemia; and thirdly, bleeding. Infections occur due to a decrease in white blood cells, especially neutrophils, resulting in poor resistance in patients making them susceptible to subsequent infections, including infections of the lungs, digestive system, urinary system, and skin and mucous membranes. Anemia occurs due to a reduction in red blood cells, causing symptoms such as dizziness, headaches, fatigue, reduced tolerance to physical activity, and poor appetite. A reduction in platelets significantly increases the risk of bleeding, especially when platelets are less than 20 times 10 to the ninth power per liter, which can lead to bleeding in the skin, mucous membranes, organs, and even cerebral hemorrhage.
Which is more severe, aplastic anemia or leukemia?
Aplastic anemia is not leukemia. Leukemia is characterized by more than 20% primary cells in the bone marrow being classified as leukemia. Aplastic anemia, on the other hand, is a bone marrow failure disease, characterized by a reduction in hematopoietic cells in the bone marrow, leading to a decrease in all blood cells. Aplastic anemia can be divided into acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia has a rapid onset, severe condition, and high mortality rate, while chronic aplastic anemia has a slow onset, longer disease history, and lower mortality rate. Treatment for acute aplastic anemia requires intensified immunotherapy or syngeneic complete match transplantation, whereas treatment for chronic aplastic anemia mainly involves promotive hematopoietic therapy.
Can anemia cause fever?
Patients with severe anemia may exhibit low-grade fever due to the severity of the anemia, where the fever generally does not exceed 38 degrees Celsius, mostly hovering around 37.5 degrees Celsius. Besides, if a patient with anemia develops high fever above 38 degrees Celsius, even reaching around 39 degrees Celsius, it is crucial to be vigilant about a possible secondary infection due to poor resistance from anemia. It is important to actively search for the source of infection, complete tests such as inflammatory markers, CT scans, and ultrasound imaging, and, once an infectious fever is suspected, to initiate aggressive anti-infection treatment.