Living healthy is the only wish of all of us. But no matter what we do, sometimes luck may not be on our side, and we may have to face situations that we cannot avoid. Unfortunately, we often meet with cancers that have shown an intense explosion in recent years and have become the fearful dream of our age. Therefore, in our interview today, we discussed leukemia, which is a very important type of cancer.

Turkey Medicals Co-ordinator at Antalya MedicalPark Hospital Center, “We asked the questions, Head of Transplant Department Prof. Dr. Demirbas answers to be an interpreter for those who are experiencing this problem.” was said.

1- What is leukemia, how is its course in the body?

Leukemia is the name given to cancer of white blood cells, that is, white blood cells (as it is called in medicine, leukocytes). In a child with leukemia, a large number of leukocytes are produced in the bone marrow and released into the bloodstream. But these leukocytes cannot perform their functions of fighting infections. Initially, leukocyte dysfunction and, accordingly, the ability to cope with infections decreased, while as leukemia progresses, abnormal leukocytes also disrupt the functions of other blood cells. These other cells are red blood cells and platelets (clotting cells). A decrease in the function and number of red blood cells causes anemia, while a disorder in platelets also results in bleeding. Initially, leukemia is accompanied by an excessive number of cells in the bone marrow and blood vessels, while over time these cells accumulate in organs such as the liver, spleen, lymph nodes, brain and testicles, preventing these organs from functioning as well.

2- Are there types of leukemia, if any, what are they?

Leukemias are examined in two classes according to their cruising speed:

a- Acute leukemias: Rapid-course leukemias, and 98% of childhood leukemias are in this group.

b- Chronic Leukemia: These are slow-progressing types of leukemia. It is extremely rare in childhood.

In addition, childhood acute leukemia is also divided into acute lymphoblastic leukemia (ALL) or acute non-lymphoblastic leukemia (ANLL), depending on whether they are related to a type of white blood cell called lymphocytes (ANLL is also called acute myeloblastic leukemia: AML).

Leukemias account for ¼ of childhood cancers. 60% of acute leukemias are ALL, 40% are AML. CML, which has a slow course, is extremely rare in childhood.

3- At what ages does leukemia occur in childhood, does it differ between races and genders, how is the risk in twins?

ALL is usually seen in children between the ages of 2-8 (the most common age is 4). It occurs more frequently in whites than in negroes, in boys than in girls. While AML can be seen in the first months of life, the frequency and risk of AML gradually decreases towards adolescence.

If ALL or AML occurs in twins in identical twins, the probability of developing leukemia in the other twin before the age of 6 is 20-25%. In fraternal twins, this probability is less, but it is 4 times higher than the general risk of leukemia in society.

4- In what situations is the disk factor more?

In some genetic diseases, the risk of leukemia is also much higher than usual. For example, in Down syndrome, a chromosomal disease called ataxia-telangiectasia, neurofibromatosis, a genetic type of anemia called Fanconi anemia, the risk of leukemia is much higher. In addition, because an organ transplant has been performed, the risk of developing leukemia is also higher in those who take immunosuppressive (immunosuppressive) drugs than their healthy peers in society.

There is also an increased risk of leukemia in those who have previously received radiation therapy or chemotherapy due to other types of cancer, especially more in the 8 years following treatment.

5- Can the factors that trigger leukemia be controlled?

Neither parents nor children can control the factors that trigger leukemia. Most leukemias have gene changes in the genes of blood cells that are not inherited, but only occur with a mutation in the sick person. These gene disorders occur randomly and cannot be predicted or predicted beforehand, remind your doctor that you are pregnant if you need to have a movie during pregnancy, as exposure to X-rays during pregnancy may increase the risk of ALL in the future, especially in the child who will be born, if you need to have a movie during pregnancy.

6- What are the Symptoms of Leukemia?

Since there will be a loss of number and function in infection-fighting leukocytes, the number and frequency of febrile infections increase.Anemia also occurs because leukemia also disrupts the production of red blood cells that carry oxygen in the bone marrow. These patients are extremely pale and get tired quickly and out of breath.Because the construction of blood cells called platelets, which control clotting and bleeding in the bone marrow, is also disrupted, large bruises, prolonged nosebleeds, etc. occur in small bumps. In addition, side effects such as bone and joint pain, lymph nodes growing in the neck, groin or other areas, rapid fatigue, loss of appetite, weight loss and weakness are also observed

7- How is leukemia diagnosed?

The diagnosis of leukemia is sometimes not as easy as it is thought. If your doctor notices a suspicious finding in a blood count performed on a child with the above symptoms, he will refer you to a pediatric hematology specialist. Here, in addition to various blood tests, bone marrow will be taken from your child and stained with various chemical dyes and examined under a microscope. If blood cancer cells called blast are seen, their type will be determined. Later, ultrasonography, scintigraphy, tomography may be required to detect the spread of leukemia in the body, and “cerebrospinal fluid removal” from the waist may be required to detect brain involvement. At the end of all these procedures, the type and stage of leukemia are determined, and the treatment protocol is decided.

8- How is leukemia treated, how long does the treatment process involve?

The main treatment method of leukemia is chemotherapy. Chemotherapy is performed by oral and intravenous administration of more than one cancer drug and high doses of cortisone. In addition, it is tried to kill cancer cells that jump into the cerebrospinal fluid by taking fluid from the waist and giving cancer drugs instead. Treatment is carried out in the form of cures. According to various protocols, treatment courses last 3-6 weeks and the total treatment period can extend up to 1-2 years.

9- What is the percentage success rate of chemotherapy treatment?

With the developments in chemotherapy, very serious distances have been gained in the treatment of leukemia. In this way, treatment success can reach up to 70 – 80%, especially in some types of leukemia diagnosed early.

10- Are there any harmful aspects of chemotherapy, if any, what kind of side effects are seen?

The undesirable side effects of chemotherapy are too many: hair loss, stomach bleeding due to destruction of the digestive system, nausea and vomiting, as well as mouth sores; serious weakening of the immune system due to a decrease in intact cells in the bone marrow, and a tendency to infections are the main ones of these side effects.



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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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