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Chronic Myelomonocytic Leukaemia (CMML)

Chronic Myelomonocytic Leukaemia (CMML) unfolds as a distinctive type of leukemia, marked by elevated levels of monocytes in the blood and bone marrow. Despite its nomenclature, CMML is a hybrid entity, as per the World Health Organization (WHO), falling under the category of ‘mixed myelodysplastic (MDS) myeloproliferative neoplasm (MPN).’

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    Occurrence and Demographics:

    CMML is a relatively infrequent occurrence, impacting 2 in 100,000 individuals annually in Australia. It primarily affects older adults, with a prevalent diagnosis in those over 70 years, and exhibits a higher incidence in men than in women. Symptoms typically manifest in forms related to anaemia, infections, bleeding issues, or the enlargement of the liver and spleen.

    Root Causes of CMML:

    While the precise cause remains elusive, some instances of CMML are associated with specific gene mutations, such as TET 2 and RAS. These mutations might be triggered by factors like aging, cytotoxic chemotherapy, or radiation exposure. Importantly, CMML is non-infectious and does not transmit from one person to another.

    Diagnostic Process for CMML:

    Diagnosing CMML often occurs serendipitously during routine blood tests for unrelated health concerns. Upon discovering abnormal monocyte levels, further diagnostic steps include additional blood tests, a bone marrow biopsy, and cytogenetic tests to confirm the diagnosis.

    Classifying CMML Types:

    CMML is categorized into two types based on the percentage of blast cells. Type 1, with less than 5% blasts, and Type 2, with 5-20% blasts. This classification aids in tailoring treatment strategies, given that around 20% of CMML cases may progress to acute myeloid leukaemia (AML) with more than 20% blast cells in the bone marrow.

    Diverse Treatment Approaches:

    No one-size-fits-all treatment exists for CMML, with the approach contingent on variables like disease stage, age, symptoms, and overall health. A ‘watch and wait’ tactic is often employed, intervening only if symptoms advance. Supportive care, involving therapies to ease symptoms or manage treatment side effects, is commonplace.

    Supportive Care Modalities:

    Blood and Platelet Transfusions: Administered for symptom relief and overall health improvement.

    Antibiotics: Employed to prevent severe infections in individuals with a compromised immune system.

    Chemotherapy: Azacitidine, a chemotherapy drug, is occasionally utilized to manage CMML.

    Through Stem Cell Transplantation:

    For a select group, a stem cell transplant remains the sole known cure for CMML. However, eligibility for this option hinges on associated risks. Treatment decisions are collaborative, involving the patient, their loved ones, and healthcare providers, considering individual health and preferences.

    Conclusion:

    Chronic Myelomonocytic Leukaemia emerges as a nuanced blood disorder, blending characteristics of myelodysplastic and myeloproliferative neoplasms. Grasping the intricacies of the disease, its diagnostic journey, and available treatment avenues empowers individuals and healthcare professionals to navigate a tailored approach suited to each patient’s distinctive circumstances.

    FAQS

    1. What distinguishes Chronic Myelomonocytic Leukaemia (CMML) from other forms of leukaemia?

    Answer: CMML is unique for its combination of characteristics from myelodysplastic and myeloproliferative neoplasms. It is characterized by elevated monocytes in the blood and bone marrow, differentiating it from other leukaemias.

    1. How common is CMML, and who does it predominantly affect?

    Answer: CMML affects 2 in 100,000 people annually in Australia. It primarily impacts older adults, with most diagnoses occurring in individuals over the age of 70. Men are more commonly affected than women.

    1. What are the potential causes of CMML?

    Answer: The exact cause of CMML is unknown. However, some cases are associated with gene mutations, including TET 2 and RAS. Aging, cytotoxic chemotherapy, and radiation exposure are potential triggers for these mutations.

    1. How is CMML diagnosed?

    Answer: CMML is often diagnosed incidentally during blood tests for other health concerns. Confirmation involves further tests, including blood tests, bone marrow biopsy, and cytogenetic tests.

    1. Are there different types of CMML, and how does the classification impact treatment?

    Answer: Yes, CMML is classified into two types based on blast cell percentage. Type 1 has less than 5% blasts, and Type 2 has 5-20% blasts. This classification helps tailor treatment strategies, as approximately 20% of cases may progress to acute myeloid leukaemia (AML).

    1. What treatment options are available for CMML, and is there a cure?

    Answer: There is no standardized treatment for CMML. Treatment approaches vary based on factors such as disease stage, age, and overall health. Supportive care, including blood transfusions, antibiotics, and chemotherapy, is common. For select individuals, a stem cell transplant is the only known cure, but eligibility is determined based on associated risks and individual health factors.

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      BLK_Super_Specialty_Hospital

      BLK-Max Hospital

      Number of beds: 700
      ICU Beds:               175
      Airport Distance: 13 Km

      About Hospital:

      • BLK Super Speciality Hospital was established by Dr. B.L. Kapur  in 1959. It was inaugurated by the then Prime Minister of India, Pandit Jawahar Lal Nehru.
      • BLK Super Speciality Hospital was established by Dr. B.L. Kapur  in 1959. It was inaugurated by the then Prime Minister of India, Pandit Jawahar Lal Nehru.
      • BLK has a unique combination of the best in class technology, put to use by the best names in the professional circles to ensure world-class health care to all patients.

      Max Hospital Saket

      Max Hospital Saket

      Number of beds:   500
      ICU Beds:                 267
      Airport Distance: 13 KM

      About Hospital:

      • Max Super Speciality Hospital at Saket is one of the topmost healthcare service
      • Providers in India. The multi-super speciality hospital has a capacity of over 500 beds, 250 functional beds. It is equipped with state-of-the-art facilities, advanced technologies.
      • With the help of over 300 leading specialist Doctors, strong nursing staff, and state-of-the-art innovative medical tools.

      indraprastha apollo hospital

      Indraprastha Apollo Hospital

      No. of beds: 900
      ICU Beds:     262
      Airport:        20kms

      Brief About:

      • Indraprastha Apollo Hospital is a flagship hospital of India’s foremost healthcare groups,the Apollo Group. It is a highly renowned multi-speciality facility that offers tertiary and quaternary care services to domestic and international patients.
      • The 900 bedded hospital is outfitted with the most modern technology for diagnostics as well as therapeutic purposes.
      • A team of highly trained medical professionals work under all the 52 specialities at the hospital.

      Artemis Hospital

      Artemis Hospital Gurgaon

      Number of beds:  600
      ICU Beds:                185
      Airport Distance: 19 Km

      Brief About:

      • Artemis Hospital, established in 2007, spread across 9 acres, is a 600plus bed; state-of-the-art multi-speciality hospital located in Gurgaon, India.
      • Artemis Hospital is the first JCI and NABH accredited hospital in Gurgaon.
      • Designed as one of the most advanced hospitals in India, Artemis provides a depth of expertise in the spectrum of advanced medical & surgical interventions, a comprehensive mix of inpatient and outpatient services.

      Medanta-Hospital-Gurgaon

      Medanta The Medicity Hospital

      Number of beds:  1250
      ICU Beds:                300
      Airport Distance: 18 KMs

      Brief About:

      • Medanta – The Medicity is amongst India’s largest and most renowned multi-super speciality healthcare centre with 1250 beds, 29 super speciality units and more than 800 accomplished doctors.
      • Supported by state-of-art infrastructure, all the departments in the hospital are fully equipped with cutting-edge technology, modular Operation Theatre and modernized monitoring systems in ICUs.
      • The panel of doctors from Medanta, headed by A.S.Soin performed the first successful intestinal transplant in India.

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        FMRI

        Fortis Memorial Research Institute

        Number of beds:    1000
        ICU Beds:                  298
        Airport Distance:  17 KMs

        Brief About:

        • Fortis Memorial Research Institute was established in 2001.
        • It is an outstanding multi-speciality quaternary care hospital,having the top-notch infrastructure, advanced equipment, highly qualified and experienced medical professionals and super sub-specialists.
        • Fortis Hosptial Gurgaon is an advanced centre of excellence in Robotic Surgery, Neurosciences, Oncology, Renal Sciences, BMT, Organ Transplants, Orthopaedics, Cardiac Sciences and Obstetrics & Gynaecology.

        Sanar International Hospital Gurugram, Delhi NCR

        Sanar International Hospital

        Number of beds:   130
        ICU Beds:                  35
        Airport Distance:  20 Km

        About Hospital:

        • Sanar International Hospital was established in 2018.
        • Sanar International Hospital founded by Mr. Naresh Kapoor.
        • Sanar International Hospital offers comprehensive advanced surgical care in specialties like Cancer, Heart, Blood and Marrow Transplant, Lung, Liver, and Neurosciences along with other major departments with advanced state-of-the-art facilities.

        W Pratiksha Hospital

        W Pratiksha Hospital

        Number of beds: 110
        ICU Beds:                 31
        Airport Distance: 19 KMs

        About Hospital:

        • Established in 1995, W Pratiksha Hospital is a 110+ bedded flagship hospital of the Pratiksha group.
        • W Pratiksha Hospital in Gurgaon, the flagship hospital of Pratiksha Group is a one-of-its-kind facility in Gurgaon that brings to you 30 years of experience.
        • The hospital has treated more than 25,000 people In 2018.

        Accord Superspeciality Hospital Faridabad Delhi NCR

        Accord Superspeciality Hospital

        Number of beds:   380+
        ICU Beds:                  41
        Airport Distance:  46 Km

        About Hospital:

        • The story of Accord began with the thought of leveraging the new age technology with the healthcare infrastructure to serve the patients, rightly, effectively, and timely.
        • Accord Superspeciality Hospital (A Unit Of SCL Healthcare Pvt. Ltd) is India’s first smart hospital and one of the first of its kind in the world.
        • Accord Superspeciality Hospital aims at providing technologically advanced healthcare services to international patients who are looking out for medical tourism in India.

        aakash hospital

        Aakash Health Care Delhi

        Number of beds:  230
        ICU Beds:                70
        Airport Distance: 10 Km

        About Hospital:

        • Aakash Healthcare Super Speciality Hospital is a tertiary care facility, with 15 Dialysis, and 70 Critical care beds for treating the most complex cases in the National Capital Region (NCR) of Delhi, Dwarka.
        • The hospital is equipped with state of the art infrastructure, latest technology, competent clinicians and compassionate staff.
        • Aakash Healthcare Super Specialty Hospital is known for its leading care in Orthopaedic and Joint replacement surgery.

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          We offers these Services

          • Providing a doctor’s opinion and proper quotation
          • Selecting the best hospital and doctor as per your case
          • Arranging a call with the doctor (if the case required)
          • Visa assistance, Providing Visa Invitation Letter (VIL)
          • Providing full guidance how to get Visa from your country
          • Providing total cost including treatment, air tickets, accommodation, and food
          • Assitance to book flight ticket from your country
          • Arranging airport pick up/ drop
          • Providing professional language interpreter
          • Booking accommodation and guest house as per your budget/ prefrence
          • Providing help in money exchanging
          • Providing local sim card
          • Arranging video consultation with specialist doctor if case requires
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