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Published on: Jul 14, 2021
1 minute read
By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.

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Types of Blood Cancer: Understanding Leukemia, Lymphoma, and Myeloma

Blood cancer is a serious group of diseases that affect how blood cells are formed and function. Unlike solid tumors, blood cancers usually begin in the bone marrow or lymphatic system, where blood cells are produced. These cancers interfere with the body’s ability to fight infections, carry oxygen and control bleeding.

Understanding the types of blood cancer is essential for early detection, appropriate treatment and improved survival outcomes.

What Is Blood Cancer?

Blood cancer develops when abnormal blood cells grow uncontrollably, preventing healthy blood cells from functioning normally. These cancers affect:

red blood cells
white blood cells
platelets

According to Indian cancer registries and ICMR data, blood cancers account for a significant proportion of cancer diagnoses across age groups.

Why Blood Cancer Is Increasing

Several factors contribute to rising blood cancer diagnoses:

improved diagnostic methods
ageing population
environmental exposure
genetic susceptibility

Early detection remains critical for effective treatment.

Main Types of Blood Cancer

Blood cancers are broadly classified into three major categories.

1. Leukemia

Leukemia is a cancer of the bone marrow and blood, primarily affecting white blood cells.

ALL is more common in children; CLL/CML more common in adults.

In Lymphoma section,

Non-Hodgkin Lymphoma is more common than Hodgkin Lymphoma.

Multiple Myeloma hallmark features (CRAB):

Calcium ?, Renal issues, Anemia, Bone lesions

Types of Leukemia

Leukemia is classified based on:

speed of progression (acute or chronic)
type of white blood cell involved (lymphocytic or myeloid)

Acute Leukemia

Acute leukemia progresses rapidly and requires immediate treatment.

Includes:

Acute Lymphoblastic Leukemia (ALL)
Acute Myeloid Leukemia (AML)

Common in children and adults.

Chronic Leukemia

Chronic leukemia progresses more slowly and may remain stable for years.

Includes:

Chronic Lymphocytic Leukemia (CLL)
Chronic Myeloid Leukemia (CML)

Often diagnosed in adults.

Symptoms of Leukemia

persistent fatigue
frequent infections
easy bruising or bleeding
fever
bone pain

2. Lymphoma

Lymphoma is a cancer of the lymphatic system, which is part of the immune system.

Types of Lymphoma

Hodgkin Lymphoma

Characterised by the presence of Reed-Sternberg cells.

Features:

high treatment success rates
common in young adults

Non-Hodgkin Lymphoma

A diverse group of lymphatic cancers.

Includes:

B-cell lymphomas
T-cell lymphomas

More common than Hodgkin lymphoma.

Symptoms of Lymphoma

painless swelling of lymph nodes
night sweats
unexplained weight loss
fever
fatigue

3. Multiple Myeloma

Multiple myeloma affects plasma cells in the bone marrow.

How Myeloma Affects the Body

weakens bones
reduces immunity
causes anemia
affects kidney function

Symptoms of Multiple Myeloma

bone pain, especially in the back
frequent infections
fatigue
kidney problems
high calcium levels

Other Rare Blood Cancers

Less common blood cancers include:

myelodysplastic syndromes
myeloproliferative disorders

These conditions may progress to leukemia if untreated.

Causes and Risk Factors of Blood Cancer

Risk factors may include:

genetic mutations
family history
radiation exposure
chemical exposure
immune system disorders

Many cases have no identifiable cause.

How Blood Cancer Is Diagnosed

Diagnosis may involve:

complete blood count (CBC)
peripheral blood smear
bone marrow biopsy
imaging tests
genetic and molecular testing

Early diagnosis improves treatment outcomes.

Importance of Early Detection

Early detection:

allows timely treatment
improves survival rates
reduces complications

According to Lancet Oncology studies, early-stage diagnosis significantly improves prognosis.

Treatment Options for Blood Cancer

Treatment depends on cancer type and stage and may include:

chemotherapy
targeted therapy
immunotherapy
bone marrow or stem cell transplant

Treatment plans are personalised.

Living with Blood Cancer

With modern advances:

many patients live long-term
quality of life has improved
supportive care plays a vital role

Ongoing monitoring is essential.

When to Seek Medical Advice

Consult a doctor if experiencing:

persistent fatigue
frequent infections
unexplained bruising
swollen lymph nodes

Early evaluation can be life-saving.

Conclusion

Blood cancer includes a diverse group of diseases that affect blood and immune cells. The main types of blood cancer—leukemia, lymphoma and multiple myeloma—differ in their origin, progression and treatment. Awareness of symptoms and early diagnosis play a crucial role in improving outcomes. With advances in medical science, many blood cancers are now manageable, especially when detected early. Understanding the types of blood cancer empowers individuals to seek timely care and make informed health decisions.

References

Indian Council of Medical Research (ICMR) – National Cancer Registry Programme
World Health Organization (WHO) – Classification of Blood Cancers
National Cancer Institute – Leukemia, Lymphoma and Myeloma Guidelines
Lancet Oncology – Global Blood Cancer Survival Studies
NFHS and National Health Data – Cancer Burden in India
Statista – Global Blood Cancer Statistics

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