Frequently Asked Questions
Rapid Assessment Clinic
Why do I need my bone marrow repeated?
You need to repeat your bone marrow test to have your bone marrow reviewed at Princess Margaret as it is a specialized hematology/blood centre. To ensure all the appropriate & often highly specialized tests are completed on your pathology.
What caused my leukemia?
The causes of leukemia are not clear. Sometimes, leukemia can evolve from an underlying hematological condition. It can also be related to an exposure to chemotherapy/radiation or particular chemicals such as benzene.
Is leukemia hereditary?
Very rarely. Most leukemias are not considered hereditary. There is a very rare form of familial leukemia but it is uncommon.
What is my prognosis?
Prognosis is most accurately determined based on the results of your cytogenetic testing. Cytogenetics is the study of chromosome pattern which is often changed in the setting of a new acute leukemia diagnosis. These patterns will place your prognosis into 1 of 3 categories: Favourable, intermediate or unfavourable.
Will all the blood you are drawing for investigations impact my hemoglobin?
No, the blood drawn for investigations will not impact your hemoglobin.
The blood taken will not be the cause of your next transfusion requirement.
Can you cure leukemia?
There is a subset of acute leukemia that can be cured. Your response to therapy will be best determined once all of your diagnostic tests have been completed.
What is the difference between chronic and acute leukemia?
Acute Leukemia is more aggressive while Chronic Leukemia can be easier to control. Chronic Leukemia can transform into an Acute Leukemia.
Why do I need to be in hospital for a whole month?
You will be receiving high doses of chemotherapy that will have a very strong effect on your bone marrow, causing you to have lower red blood cells, white blood cells and platelets. As a result you will need very close monitoring for blood transfusions, bleeding and possible transfusion of platelets as well as monitoring and therapy for infection.
Should I get a second opinion in the United States?
Princess Margaret is the largest leukemia centre in Canada and the second largest leukemia centre in North America. As a result, we are leaders in leukemia care and our therapy planning is consistent with the therapy regimens that are offered in the United States.
Why can't I be treated closer to home? Why do I need to be treated specifically at Princess Margaret?
Acute Leukemia requires very specialized therapy that can only be delivered in certain hospitals. The major leukemia centres in the province of Ontario are: Princess Margaret, Hamilton, Ottawa, and London. It is best to receive your care in a specialized centre if you are requiring intensive therapy.
We can connect you to our Outreach Program so that any supportive components of your management can possibly be arranged at a hospital close to your home.
What can I eat to make this better?
There is nothing you can eat that can improve your leukemia.
There are foods that we would recommend avoiding as they could lead to infectious complications. These foods are: raw meats and fruits and vegetables that you are not able to peel.
How do I avoid infection?
- Avoid crowded places (subway at rush hour, shopping malls)
- Avoid buffet restaurants or restaurants where you are unsure about appropriate food handling
- Avoid sick contacts
- Avoid changing cat litter/ handling pet litter
- Avoid particular house hold chores (cleaning basements, carpets, garages, eaves troughs)
- Practice good hand-hygiene
Would naturopathy help?
There is no scientific evidence to support naturopathy having any significant impact on the status of your leukemia.
Why do I need to be here all day?
The Rapid Assessment visit takes all day as there are multiple tests that need to be completed in order to provide a thorough diagnosis and screening for complications. Investigations include: Detailed health history, comprehensive physical examination, blood work, bone marrow aspirate and biopsy, low dose CT chest, ECG (heart tracing), and dental screening.
We must also review the diagnosis with your assigned hematologist.
We must take some time to review with you your various therapy options.
Why do I have to wait so long?
There are many steps to having your blood counts checked. You have to “check-in” to clinic and have your blood taken (from either your central line or from your vein). Your blood then has to go to the lab to be analyzed, which can take about 1 hour. After your results are entered into the computer, the nurse will need to see your results before calling you into the unit. If you need to have a blood or platelet transfusion, the lab has to be notified and prepare the blood/platelets, which can also take about 1 hour.
What are my blood counts?
Your nurse will review your blood counts with you. You can request a printed copy of your blood count results and are encouraged to keep your own record of your blood counts.
When will I get to see my (staff) doctor?
Generally your doctor will not see you while you are being monitored in the transfusion unit. You will be scheduled to see your doctor in the clinic once your blood counts have recovered after chemotherapy.