Leukemia Clinic

• CD or DVD of your imaging studies.
  Your referring doctor may give you a CD or DVD of imaging studies you may have had done such as x-rays,   CT scans,   MRIs or   ultrasounds. If so, it is very important to bring this CD or DVD with you.
• All medications you are currently taking in their original packaging.
  This includes prescription medications, over-the-counter medications, vitamin or mineral supplements and herbal remedies.   See also: My First Appointment at UHN »
• Medications that you need to take.
  Appointments can take several hours. Bring with you any medications you normally take during the day.
• Record of any changes.
  Make notes about any changes in your condition that you’ve noticed since your last visit, and bring these notes to show your doctor. Also bring any medical equipment you use, such as your colostomy bag, if you have one.
• A trusted friend or family member.
  A friend or family member can give you emotional support and can help you make good choices. They can also help you gather information, take notes and ask questions.
• Questions to ask.
  Bring a list of questions to your appointment to help you remember everything you want to ask.   See also: Treatment Decision-Making and Questions to Ask »

Learn more about what to bring to your appointment »

The first person you meet at the Leukemia Clinic is the Patient Flow Coordinator. To sign in with the Patient Flow Coordinator you will need your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID (such as a driver's license, passport, or other provincial health card).

Before each clinic appointment (in-person or virtual), you will be asked to answer questions about your health and wellbeing. Use eCheck-In to report your symptoms and concerns to your healthcare team. You will still need to check in with the front desk staff, eCheck-I​n does not replace checking in in-person. Learn more about eCheck-In »

Your appointments can take 3 hours or more. This is because your appointments will likely include various tests.

For your follow-up visits, you will usually need to have blood work done before you see the doctor. It is best to arrive 1 hour before your appointment so that you can have the blood work done before you check in at the Leukemia Clinic.

We do our best to stay on time. Unfortunately, your appointment may be delayed by unforeseen circumstances. We recommend that you come prepared for delays. For example, make sure your arrangements for things like babysitting, elder care and parking can accommodate a longer than usual appointment.

Go to the Diagnostic Test Centre/Blood Collection Lab on the Main Floor to have your blood work done.

At the end of your first appointment, the nurse or doctor will give you a contact list for your health care team. If you don’t get a contact list, feel free to ask for it.

After every appointment, the nurse will tell you about your next visit. Be sure you understand what is going to happen next. For example, know the time and place of your next visit or if someone will call you with this information.

If you are unsure about what your next steps are, don’t be afraid to ask a member of your team. We are there to help you.

Other resources that you may find helpful:

• The Cancer Journey Resources include a personal guidebook and planner. These resources are available to all new patients at the Princess Margaret. You can pick up a free copy from your clinic or at the Princess Margaret Patient & Family Library. The Cancer Journey Guide Book and Planner are also available online or on the Princess Margaret Journey App.   Learn more about the Cancer Journey Resources  »
  • See also: Princess Margaret Patient & Family Library ​
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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.

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.

Very rarely. Most leukemias are not considered hereditary. There is a very rare form of familial leukemia but it is uncommon.

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.

No, the blood drawn for investigations will not impact your hemoglobin.

The blood taken will not be the cause of your next transfusion requirement.

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.

Acute Leukemia is more aggressive while Chronic Leukemia can be easier to control. Chronic Leukemia can transform into an Acute Leukemia.

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.

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.

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.

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.

• 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

There is no scientific evidence to support naturopathy having any significant impact on the status of your leukemia.

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.

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.

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.

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.