Bone marrow transplant: ‘How my diagnosis went from sinusitis to leukemia’

It took writer Duda Riedel, 27, a while to find a diagnosis of the disease; she today she is healed.

In 2019, 27-year-old writer Duda Riedel worked as a saleswoman in a clothing store in São Paulo. The constant tiredness and pain in her legs that she felt, she attributed to hours spent standing at work.

Days after feeling excessive fatigue, the writer was surprised to wake up to see blood marks on her pillow. After identifying that they had come out of her gum, she sought out a dentist.

“The pro said I had to brush my teeth. I did, he said everything was fine, and I went home,” she recalls.

However, the symptoms didn’t stop there. Then the writer began to experience headaches and have nasal congestion and discharge—which doctors told her indicated that she had sinusitis. In increasingly intense pain, she sought out the hospital emergency department twice, which handled her medical insurance.

“At the hospital the doctor said I had sinusitis, he prescribed me a syrup and I went home. Both times it was like this: they indicated me a drug and discharged me. I was never asked for a blood test “.

From sinusitis to leukemia

Diagnosed with sinusitis, Duda followed the treatment indicated by the doctor with syrups and returned to her routine, including outings with friends. A few weeks later, a bruise on her leg caught the writer’s attention, as she did not remember bumping into any part of her.

Two days later, alone in her apartment, the writer began to feel ill and had to rush to the hospital.

“Then the terror started, because I vomited blood and it scared me so much. So much so that I ran to the hospital, where they put me on an IV and asked me for a blood test. When the doctor saw that I was alone, yes she was scared, she said I was sick, but they still didn’t know what it was and asked me to call someone to accompany me,” reports Duda.

With his family living in Fortaleza, the writer asked a friend to go to the hospital in the capital São Paulo and stay as a companion. The doctors’ first suspicion was that Duda might be bleeding internally, since his examination indicated he had only 45,000 platelets, a number well below what is considered normal (150 to 400,000 per microliter of blood). ).

The doctors then asked to perform an endoscopy, but the result was negative due to the suspicion of haemorrhage.

“They put me in a room and left me there. But since I was already fine, I wanted to leave, I was tired of being in the hospital, and I started taking out the IVs I was holding. It was then that a nurse l ‘he saw and said: ‘be careful, girl, leukemia kills.’ I panicked, because until then no doctor had spoken to me about leukemia,” recalls Duda.

Confused by the presumed diagnosis of leukemia and the lack of information from the doctors, Duda left the hospital and went home. Hours later, she sought assistance at another hospital in the city, where she was immediately admitted. The next morning, her family was already in São Paulo to take her to the hospital to treat what she had been diagnosed with blood cancer.

Bone marrow transplant

Initially, Duda underwent three rounds of chemotherapy, but due to the severity of the disease, acute myeloid leukemia, doctors said a bone marrow transplant was needed.

No member of the writer’s family was 100% compatible with her: siblings were only 50%. Therefore, it was necessary to look for a donor at Redome – National Bone Marrow Donor Registry.

“It took six months of searching, waiting and a lot of anxiety before finding a compatible donor. In November 2019 I had the long-awaited transplant and I was reborn. Today I celebrate two birthdays, that of my birth and that of my transplant”.

Recovered from her illness, Duda undergoes an annual medical checkup with a multidisciplinary team to make sure everything is fine with her health.

What is leukemia and what are the symptoms?

Leukemia is the name given to the malignant disease that affects leukocytes, blood and bone marrow cells responsible for defending our body. These diseased cells build up in the bone marrow, replacing healthy cells.

There are different types of leukemia: lymphoid or myeloid, acute or chronic. And there are four main types: acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL).

“Leukemia cells can be very immature, due to blockage of cell differentiation (a process that transforms and specializes the cell into a function), and in this case the cells cannot perform any of the functions of normal blood cells. In this case, we call leukemias of acute diseases”, explains Eduardo Rego, medical coordinator of the acute leukemia service of Icesp (Cancer Institute of the State of São Paulo).

“When certain genetic alterations only partially block differentiation and the leukemia cells maintain the appearance and some functions of normal blood cells, we speak of chronic leukaemias.”

With the “wrong” functioning of cells, certain symptoms begin to appear. They are mainly due to the replacement of normal bone marrow with leukemia cells, which leads to a decrease in red blood cells.

“The main symptoms of leukemia are anemia, paleness, fatigue, palpitations, decreased immunity and increased susceptibility to infections, with fever, malaise, decreased platelets, increased chance of bleeding and appearance of purple spots on the body. The accumulation of diseased cells can also lead to an enlarged spleen,” explains Iara Zapparoli Gonçalves, deputy coordinator of the hematology department at the Hospital de Amor de Barretos.

Treatment for leukemia depends on the type and stage at which the disease is discovered. It may involve chemotherapy, immunotherapy, radiation therapy, bone marrow transplant, or a combination of several treatments.

According to the Atlas of Cancer Mortality, 6,738 people died of leukemia in Brazil in 2020 (date of the last published survey), with 3,703 men and 3,035 women.

Estimates by the National Cancer Institute (INCA) underline that 11,540 new reports of the disease were expected by 2022, the majority, about 6,000, in men.

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