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Zhang Xiao Le
Hematology
About me
Associate Chief Physician, obtained a master's degree from Shandong University in 2009, and has been working at Liaocheng People's Hospital. In 2012, went to Peking University People's Hospital for further training in hematopoietic stem cell transplantation.
Proficient in diseases
Familiar with common blood system diseases such as acute leukemia, lymphoma, multiple myeloma, aplastic anemia, myelodysplastic syndromes, various anemia diseases, and platelet disorders; skilled in using hematopoietic stem cell transplantation technology to treat various blood system diseases, with over 200 cases of involvement in hematopoietic stem cell transplantation.
Voices
Is a body temperature of 37.3 and feeling tired indicative of leukemia?
More than half of patients with acute leukemia present with fever as an early symptom, which can be low-grade or as high as 39~40°C or even higher. At the same time, some patients may experience fatigue due to anemia, but the presence of low-grade fever and fatigue does not necessarily indicate leukemia. If leukemia is suspected, further tests such as a complete blood count and peripheral blood smear examination are necessary. If the patient has abnormal white blood cells, combined with anemia and a reduction in platelets, and a large number of blast or early immature granulocytes are seen on the peripheral blood smear, leukemia should be highly suspected, and a further bone marrow biopsy examination is needed for a clear diagnosis. If the complete blood count and peripheral blood smear show no significant abnormalities, leukemia can generally be ruled out.
What to do about vomiting from iron deficiency anemia?
Patients with iron deficiency anemia experiencing vomiting might have the following possible causes: Firstly, iron deficiency can lead to systemic hypoxia, including in the gastrointestinal tract, manifesting as reduced appetite and poor digestion. Severe cases may present with nausea and vomiting. This situation can be addressed by transfusing red blood cells and implementing aggressive iron supplementation to correct the anemia. Once the anemia is corrected, symptoms of nausea and vomiting should disappear. Concurrently, temporary use of anti-emetic medications such as metoclopramide can be considered to help control the vomiting. Secondly, some patients with iron deficiency anemia may have underlying gastric diseases that cause chronic bleeding, including gastric ulcers, gastric mucosal erosion, or even gastric cancer. These gastric diseases themselves can also lead to vomiting, necessitating further investigations like gastroscopy to establish a clear diagnosis and provide targeted treatment.
What are the dangers of leukopenia?
The risks associated with leukopenia mainly relate to the degree of leukopenia and the diseases causing the decrease. Mild leukopenia generally does not show significant symptoms. Moderate leukopenia can manifest as fatigue, while a sharp decrease in white blood cells primarily carries a risk of infection, with symptoms including fever. This is because white blood cells are the main cells for combating infection in the body, and a significant reduction can markedly weaken the immune response, making infections more likely to occur at various sites. Besides the degree of leukopenia, the risks brought about by the underlying causes of leukopenia also vary. For example, leukopenia caused by aplastic anemia carries a risk of bleeding, while leukopenia resulting from rheumatic autoimmune diseases can lead to joint damage and erythema.
What should I do about thalassemia?
Thalassemia is a hereditary hemolytic anemia. Currently, there is no specific cure for thalassemia, and treatment mainly involves symptomatic management based on the type and severity of the disease. This includes red blood cell transfusions, prevention of secondary hemosiderosis, and splenectomy, along with targeted prevention and treatment of factors that induce hemolysis, such as infections. Splenectomy is appropriate for patients whose transfusion needs are increasing, accompanied by splenic hyperfunction and significant compression symptoms. For patients with a suitable HLA-matched donor, allogeneic hematopoietic stem cell transplantation can be performed, which is currently the only effective treatment capable of curing thalassemia. Although mild thalassemia cannot be cured, prenatal genetic diagnosis is crucial for eugenics, effectively preventing the birth of fetuses with thalassemia and playing an important role in genetic health care.
Can aplastic anemia patients eat peanuts and red dates?
Aplastic anemia patients can eat peanuts and red dates, but peanuts and red dates do not have a therapeutic effect on aplastic anemia. Aplastic anemia is a type of bone marrow failure disease, hence patients with aplastic anemia may have symptoms such as anemia, decreased white blood cells, and reduced platelets. The mechanism of the disease is mainly due to abnormal immune functions, and treatment primarily involves the use of immunosuppressants. Although peanuts and red dates are traditionally considered to have blood-enriching effects, this belief is not scientifically based. Many people think red dates can enrich blood, yet they only contain a small amount of iron, which might help patients with iron-deficiency anemia to some extent, but they are ineffective for aplastic anemia.
How to use diet to supplement after surgery anemia?
Postoperative anemia is mostly hemorrhagic anemia. Apart from promptly stopping bleeding and administering blood transfusions, dietary supplementation can also promote the rapid recovery of red blood cells and improve anemia. Therefore, it is possible to include blood-enriching foods such as lean meat, pork liver, pig's blood, and iron-rich vegetables like black fungus, spinach, and rapeseed, as iron is a crucial raw material for synthesizing hemoglobin. Additionally, it is necessary to consume more fresh vegetables and fruits, which are rich in folic acid and vitamin B12, also essential raw materials for the recovery of red blood cell production. Therefore, these nutrients can be appropriately supplemented in daily diet.
Is it good to transfuse platelets for aplastic anemia with low platelets?
Aplastic anemia is a type of bone marrow failure syndrome, with patients often experiencing a decrease in all blood cells in the peripheral blood. As a result, patients typically face a higher risk of infections and bleeding. Treatment for aplastic anemia is a long-term process, and hematopoiesis often cannot be restored quickly. Therefore, especially in severe cases of aplastic anemia, patients' blood cells remain at relatively low levels for an extended period, placing them at severe risk of infections and bleeding. If platelets fall below 20*10^9/L, it is necessary to administer platelet transfusions to prevent severe bleeding.
Mediterranean anemia has symptoms such as fatigue, paleness, delayed growth, and facial bone deformities.
Thalassemia is a hereditary hemolytic anemia, and the symptoms of patients with thalassemia are related to their specific types. Thalassemia can be divided into mild, intermediate, and severe types. Mild thalassemia clinically may have no symptoms or only mild anemia, sometimes accompanied by mild splenomegaly; Intermediate thalassemia can present with moderate anemia, noticeable fatigue, and splenomegaly, with a few cases experiencing mild skeletal changes and delayed sexual development; Severe thalassemia in children manifests within the first half-year after birth with pallor, progressively worsening anemia, jaundice, hepatosplenomegaly, delayed growth and development, and distinctive facial features such as frontal bossing, a depressed nasal bridge, and increased distance between the eyes.
What is the fastest way to treat iron deficiency anemia?
The treatment of iron deficiency anemia mainly includes two aspects: one is iron supplementation, and the other is identifying and correcting the underlying cause of the anemia. Iron supplementation for patients with iron deficiency anemia can be administered orally or via intravenous infusion, the latter of which tends to be faster. Generally, hemoglobin begins to rise about a week after treatment starts, and returns to normal levels within two to three weeks. Even after hemoglobin levels normalize, iron supplementation should continue for three to six months. It is more important to identify and treat the underlying causes of anemia. Common causes of iron deficiency anemia include chronic blood loss, such as from gastrointestinal ulcers or tumors. Therefore, patients with iron deficiency anemia typically need to undergo gastrointestinal endoscopy to identify the specific cause of the iron deficiency.
The difference between chronic granulocytic leukemia and leukemia
Chronic granulocytic leukemia is a type of leukemia, which itself is a group of malignant clonal disorders of hematopoietic stem cells. In leukemia, the leukemic cells exhibit enhanced self-renewal, uncontrolled proliferation, and obstructed apoptosis, causing a halt at various stages of cell development. Leukemia is divided into acute leukemia and chronic leukemia. Acute leukemia includes acute lymphoblastic leukemia and acute myeloid leukemia, while chronic leukemia includes chronic lymphocytic leukemia and chronic granulocytic leukemia. The primary difference between acute and chronic leukemia is that the leukemic cells in acute leukemia mainly stall at the primitive and immature stages, whereas in chronic leukemia, the cells primarily remain at the mid-immature and late-immature stages.