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Hospital Universitario La Zarzuela Madrid

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Oncohaematology Department

WHAT IS ONCOHAEMATOLOGY ?

Oncohaematology is the part of haematology that treats oncological processes (tumours) that appear in the organs responsible for creating blood and in the lymph nodes (the lumps that appear in your neck when, for example, you have an infection in your throat, or an infected tooth). The doctors that treat these problems are called 'haematologists' (blood doctors), and are different from the more well-known oncologists who treat other types of tumours (breast cancer, colon cancer, lung cancer, etc.).

Haematologists treat a very different process called leukaemia (acute or chronic) and others including lymphomas, myeloma, myelodysplastic syndromes and myeloproliferative syndromes.

It is important to recognise that oncohaematology has made giant steps forward, with recovery rates unheard of in other types tumours. One obvious example are the advances that have been made in treating leukaemia ('cancer of the blood'), which by definition are disseminated processes (extending throughout the body) when they are diagnosed. Thus, for example, the most common acute leukaemia occurring in infants is cured in 90% of cases, and some types of acute leukaemia in adults have recovery rates of 80%. Chronic myelogenous leukaemia, the most common type of chronic myeloid leukaemia (which affects a type of blood cells), is treated with oral medications that are very well tolerated (a few pills per day), and which are computer-designed to inhibit leukaemic cells (tumour cells), the biochemical abnormality that causes the disease. In other processes the success rate is lower, as is the case with lymphomas, approximately half of the patients recover, although this rate may vary considerably depending on the case.

WHO GETS TREATED IN THE ONCOHAEMATOLOGY UNIT?

The oncohaematology processes mentioned above affect people of all ages-- from children to senior citizens. Children are treated by paediatric oncohaematologists, who specialise in their age group. Adults are treated by haematologists.

To treat these conditions, oncohaematologists use a very different type of medication, which can very generally be called 'chemotherapy' (treating with chemical products/medication). On some occasions radiotherapy is necessary (treating with radiation), and some cases involve haematopoietic stem cell transplants (commonly known as bone marrow transplants), as will be explained below. Depending on the case, haemoderivatives may be necessary (i.e., a transfusion of the blood components which are not properly producing cells such as red cells or platelets).

Chemotherapeutic agents are medications that are administered either orally or intravenously. Some may also be administered subcutaneously (under the skin, like how insulin is administered). Some of these drugs are administered in groups in a special way that is repeated from time to time. These are what are called 'chemotherapy cycles.' This may be every month, or every 15 days, depending on the case.

Haematopoietic stem cell transplantation (HSCT) is a type of non-surgical medical transplant in which after a special type of treatment (known as 'conditioning treatment') cells are administered intravenously that will trigger blood production. These cells are called haematopoietic progenitors. HSCT is a complex procedure, and patients are placed in special rooms, with a hospital stay that may last a month or longer. This type transplant is only performed in certain cases. Check with your doctor to see if your condition may this type of treatment.

Any treatment, from chemotherapy to transplants, must be administered in the facilities of the UCCO.

WHERE IS THE TREATMENT ADMINISTERED?

Some oncohaematological diseases are treated on an out-patient basis, while others more complex treatment that s a hospital stay. The out-patient treatments can either be administered at your home or in the 'Day Hospital,' depending on your case. The Day Hospital is a doctor's office with consultation rooms like any other medical centre, and with 'treatment boxes,' which are private rooms the necessary intravenous medicine can be administered. You may have someone accompany you for your entire stay at the Day Hospital. All of the boxes are individual, and have ample lighting and a television.

If you will need to stay at the hospital for treatment, you will be given a normal private room, or if necessary for your case, a room especially prepared with a special air filtration system that provides sterile air free of micro-organisms. These are the recently built rooms equipped with HEPA filters (High-Efficiency Particulate Air filters) with positive air pressure.

WHO WILL BE TAKING CARE OF ME?

Your oncohaematological problem will be treated be a haematologist specialised in these types of processes, and by specialist nurses. You will also be supported by additional staff including a psychologist, a nutritionist, secretaries and clinical adjuncts, together with other professionals who can offer you help and advice on the various aspects of your illness. An important part of this whole process will be your family and social surroundings, who will also be given special attention, so that your treatment will be as satisfactory as possible at every level, and not only in its medical aspects.

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