Most leukemia patients discover they have the disease in the evening. A pilot program at Rambam—in its third year—has used this knowledge to develop a new way to quickly diagnose and treat leukemia.
Acute leukemia is form of cancer that develops quickly. Tragically, patients may succumb to this disease within days of being diagnosed. According to Rambam’s Department of Hematology, which treats most of the leukemia patients in Northern Israel, approximately 100 new cases are diagnosed annually—one fifth of all cases in the country.
Clearly, an emergency room visit is less than ideal—it takes time until the needed treatment can be administered. Dr. Yishai Ofran, Director, Leukemia Service, Head, Laboratory of Genetics and Immunology of Leukemia at Rambam explains, “A person visits their doctor and complains of a headache, fever, weakness and other symptoms. They are likely to receive conventional treatment. If the doctor orders a blood test, the lab results point to a problem and the doctor calls the patient and instructs them to go to the emergency room…. But it takes time until the patient receives the appropriate treatment.”
This situation was also the rationale for a new protocol that was set up at Rambam to fast-track diagnosis and treatment of acute leukemia. “When we realized there was a trend and that acute leukemia patients were paying a price, we decided to deal with the matter,” said Dr. Ofran.
The hematology team developed a methodology to determine what type of leukemia was involved and the optimal treatment for it. If an emergency room visit is not necessary, but next-day treatment is needed, patients are told advised that they have unusual findings in their tests that need to be checked out. They are given an appointment in the Hematology Clinic for the next day, rather than forced to spend the night in the emergency room.
A senior hematologist then examines the patient’s bone marrow, enabling same day diagnosis and receipt of a treatment plan. Chemotherapy can often be started the very next day and they even work with the patient to help arrange payment via the patient’s HMO.
“All of our patients are happy with about this,” Dr. Ofran shares.
Results of this pilot program, which has been operating for three years, prove that this protocol is safe and effective. The findings are scheduled to be published shortly in a medical journal.
Dr. Ofran concludes, “The reality is crowded hospitals. These patients now have a better alternative—more effective for them and the hospital, and most important, more respectful.”