My Dear Doctor ,my sister's husband has a blood disease (Age :50 years old, Sex :Male ), and his blood picture shows marked thrombocytopenia and leucocytosis with relative monocytosis and increase blast cells ,the details is:-
RED CELLS : 4,710,000 / cmm
HAEMOGLOBIN : 11.0 gm/dl
HAEMATOCRIT (PCV): 36.2 %
LEUCICYTIC COUNT : 65,000 /cmm
DIFFERINTIAL PICTURE :
Basophils : 00 %
Eosinopils : 02 %
Neutrophils staff : 01 %
Neutrophils seg. : 08 %
Lymphocytes : 15%
Monocytes : 44%
Blast cells: 17%
Promonocytes : 13%
PLATELETS COUNT : 62,000 /cmm
MCHC : 30.5 gm/dl
MCV : 79.9 FL
Absolute No. of Neutrophils : 5.85 cmm
Absolute No. of Lymphocytes : 9.75 per cmm
And the CLINICAL CHEMISTRY:
Fasting blood sugar : 199 mg %
Sugar in urine fasting : (+)
The BLOOD CHEMISTRY :
S.G.P.T : 38 U/1 (Normal)
S.G.O.T : 29 U/1 (Normal)
The Heamatology (Sedemination rate):
First hour : 45 mm
Second hour : 74 mm
The HEPATITIS MARKERS:
HCV Ab 4th generation by Elisa : 0.201 index (negative)
HBS Ag. : (Negative)
And so, the doctor recommended to do bone marrow aspiration to confirm the above results.
So he made the bone marrow aspiration after 3 days and the dignosis is :
A case of Acute Monoblastic Leuckemia with differentiation(M5b).
CD 14 : positive
CD 13 : positive
CD 33 : positive
CD 2,CD 10,CD 34 ,CD 7,CD 19 : Negative.
N.B : He was suffer from blood sugar from long time (about 15 years).
After that he went to hospital to take a Chemical treatment for about 4 days and his case bcame good ,but after that he suffer a lot from the side effects from the chemical treatment and became in a very bad conditions and the doctors want to contiou that treatment for another 3 days .
So I ask you what is your advise to him and what about the chemical treatment ? and what about his chance to be survival?
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