

Li Fang Fang

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

Is aplastic anemia contagious?
Aplastic anemia is not contagious and has a minor hereditary factor, meaning that if a family member has aplastic anemia, it is generally not inherited by the next generation. The cause of aplastic anemia is still unclear, but possible reasons include: 1. Damage to hematopoietic stem cells. After the hematopoietic stem cells are damaged, it leads to limited stem cell proliferation and reduced hematopoiesis. 2. Damage to the hematopoietic microenvironment. Damage to the hematopoietic microenvironment can lead to changes that disrupt the regeneration of hematopoietic stem cells. 3. Immune factors. Immune factors can cause immune damage, directly damaging hematopoietic stem cells, thereby causing bone marrow regeneration disorders.

Does leukemia cause fever?
Leukemia patients do experience fever, which can be categorized into two main types: infectious fever and tumor fever. Infectious fever occurs due to the compromised resistance and lowered immunity of leukemia patients, potentially leading to various types of infections such as pulmonary infections, skin and mucous membrane infections, digestive system infections, urinary system infections, etc. Tumor fever, on the other hand, occurs in the late stages of leukemia and is caused by the abnormal proliferation of leukemia cells, leading to tumor-related fever. Typically, the temperature in tumor fever does not exceed 38 degrees Celsius, with early-stage fevers responding well to treatment, but late-stage fevers showing poorer responsiveness.

How is leukemia diagnosed?
When a routine blood test suggests the possibility of leukemia, further diagnostic tests such as bone marrow aspiration, biopsy, and immunophenotyping are required to confirm the diagnosis. Leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia includes acute myeloid leukemia and acute lymphoblastic leukemia. Acute myeloid leukemia is further categorized into eight types, from M0 to M7. Acute lymphoblastic leukemia is divided into three subtypes: L1 to L3. Chronic leukemia can be divided into chronic myeloid leukemia and chronic lymphocytic leukemia.

What medicine is used for aplastic anemia?
Aplastic anemia, whether acute or chronic, primarily uses immunosuppressive agents and hematopoietic stimulants for treatment. Cyclosporine is commonly used clinically among immunosuppressants, while the medicines stimulating bone marrow hematopoiesis mainly include androgens such as danazol and stanozolol. These medications all have associated adverse reactions: immunosuppressants can lead to hypertension, hyperglycemia, impaired liver and kidney function, and gum hypertrophy, while the main adverse reactions of hematopoietic androgens are liver damage. (Please use medications under the guidance of a doctor.)

Can aplastic anemia be cured?
Aplastic anemia is divided into acute aplastic anemia and chronic aplastic anemia. Acute aplastic anemia can be cured by intensive immunotherapy or syngeneic hematopoietic stem cell transplantation. However, not all cases of acute aplastic anemia can be cured by these two treatments, with the cure rate being approximately 60%-70%. For chronic aplastic anemia, the main treatment currently is oral immunosuppressive therapy, which usually cannot cure the condition unless allogeneic hematopoietic stem cell transplantation is performed. However, if patients with chronic aplastic anemia are on oral immunosuppressive therapy, they can maintain a relatively good condition and typically do not opt for allogeneic hematopoietic stem cell transplantation.

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.