So essentially in AML, right, this is a cancer of your bone marrow, or really your factory for making cells. So one of those cells are your red blood cells or your hemoglobin. So when the factory is not working or is filled up of workers that may look funny, they just don't do what they're supposed to do and ultimately you're left with a lower hemoglobin or what we call anemia. This translates to symptoms like fatigue, shortness of breath, not able to do your normal activities. Everybody's a little bit different, so some patients may feel more symptoms at a certain level than others, so it's not a one size fits all. But let's say you're less than seven grams per deciliter, then essentially you need a blood transfusion regardless. There's sort of a gray range between seven and eight grams per deciliter. What is considered a low hemoglobin level for someone with AML? How would I feel if my hemoglobin was low? The hemoglobin is important because the hemoglobin carries your oxygen. And when you have AML, those blasts or those leukemic cells in the bone marrow crowd out your bone marrow's ability to make your other cells. And the critical hemoglobin is usually seven grams or less where you will need a transfusion. And you may notice symptoms that go along with that if you're not checking your labs all the time, which some people get really fixated on that. But you can't check your labs every day unless you're in a hospital setting. So a hemoglobin less than seven, you will normally have some shortness of breath, increased fatigue. Some patients tell me that they have difficulty sleeping at night when their hemoglobin is low or they wake up several times. I think that's the body's natural way of trying to say, hey, take a deep breath. Like your oxygen might be dropping into those dangerous levels. So just being aware of how your symptoms line up with your values, then you can kind of self-monitor when you think you might need a transfusion and call if it's not time for you to go in. So a hemoglobin varies for every patient with a patient with AML. Typically on treatment, hemoglobin may dip down to seven or below seven. Typically that's our transfusion requirement level. So when it becomes less than seven, it's a level of severe anemia where we will do transfusions. But for a lot of patients, it's really a trend. So an exact number, being at that normal 14 or 15 isn't what we typically need for someone with AML. So of course, the major way would be to get treatment. And ideally, treatment that works quicker will get your hemoglobin levels up fast. That can happen as quickly as one month, although dependent on the therapy can take several months to at least get to the point that you no longer need blood transfusions or at least to where the frequency of transfusions is less frequent. Of course, the whole time, your physician and your medical team will help support you. So again, you will need transfusions almost always when you're getting initial therapy for acute myeloid leukemia. But again, over time, if the treatment is working, then ideally those will decrease. And many patients can go even back to a normal hemoglobin.
HealthTree • May 11, 2023
