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Fertility and Pregnancy

Patients of childbearing age, as well as the parents of children with cancer, should ask their healthcare team to explain how treatment may affect fertility (the ability to have children). Patients with CML who will be taking TKIs should discuss fertility preservation with their doctors before starting TKI therapy.

Growing numbers of CML patients of childbearing age are living in stable remissions and are considering having children while being treated for CML. There is no risk that parents will pass the Ph chromosome onto their children.

Diagnosis

Diagnosing chronic myelomonocytic leukemia (CMML) usually involves a series of repeated tests, including blood and bone marrow tests. Your doctor usually can't confirm a diagnosis of CMML with one lab test result that shows abnormal blood counts. Instead, he or she will monitor you over a period of time with repeated lab tests that show abnormal blood counts. This is done to rule out other diagnoses.

Bone marrow testing involves two steps usually done at the same time in a doctor's office or a hospital:

Treatment

It's important that your doctor is experienced in treating patients with myeloma or works in consultation with a myeloma specialist. This type of specialist is usually called a hematologist oncologist.

Your treatment may include one or more of the following therapies:

The International Prognostic Scoring System

Specific factors may affect the prognosis (likely outcome) of MDS, and help doctors determine when to start treatment and how intensive the treatment should be. These factors include:

Your Treatment Team

Oncologists and hematologists are specialists who treat persons with leukemia, lymphoma, myeloma, myelodysplastic syndromes and myeloproliferative diseases. Pediatric hematologist oncologists treat children, adolescents and some young adults who have blood cancers. The oncologist or hematologist-oncologist coordinates a treatment and follow-up plan that involves other doctors as well as nurses, social workers, case managers and nutritionists.

Talking with Family, Friends and Children

Many people find it best to be honest with family and friends. By confiding in loved ones, you give them the chance to offer their support. It's true that some of your relatives or friends may not know what to say or do. But most do want to be supportive.

Consider "appointing" a willing family member or friend to be your "press secretary." He or she can be responsible for regularly letting others know your health status so you can focus on your treatment and recovery.

Possible Treatment Effects

Sperm is made and stored in the testes. Sperm production begins at the onset of puberty and continues throughout the person’s life, although the amount and quality of sperm can naturally decrease with age. Cancer treatment can cause:

Fertility

People in the YA age group can be in many different stages of life. You may have children; you may want children in the future; you may not want children now, but may change your mind; or you may not have given it much thought at all. Cancer treatment can affect fertility in both women and men making it difficult to conceive a child in the future. A cancer diagnosis may require you to think seriously about children.

Not all cancer treatments affect fertility. Your risk depends on several factors, including

Childhood Blood Cancer

Hearing that your child has cancer is terrifying. Today, however, most childhood blood cancer patients can expect to have full and productive lives. Thanks to new and improved therapies, survival rates for childhood blood cancer have improved significantly over the past several decades. In addition, doctors, nurses and researchers continue to search for the causes of childhood leukemia and lymphoma to develop even better treatments and tailor therapies to decrease toxic side effects.

Targeted Therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells with less harm to normal cells. Not all cancers have the same targets. Each type of targeted therapy works a little bit differently, but they all interfere with the growth and survival of cancer cells. To find the most effective treatment, your doctor may run tests to identify the genes, proteins and other factors in your cancer cells. This helps the doctor choose the most effective treatment for you based on the specific factors of your disease.

Disease Complications

In medicine, a complication is a medical problem that occurs during the course of a disease or after a procedure or treatment. Possible complications of PV include:

Jamie

After he was diagnosed with blood cancer in 2013, Jamie was told by doctors that he’d never walk again, let alone ride a bike. Despite those predictions, he finished a 540-mile ride in June 2019 to raise money for The Leukemia & Lymphoma Society (LLS).

Ira

In August 2014, at age 48, I was literally in the best shape of my life. I was an avid cyclist, averaging more than 150 miles per week, leading groups of riders for my cycling club, and completing multiple 100-mile century rides in a single season. Over the course of just a few days, while cycling, I noticed a sudden setback in my performance. Virtually overnight I lost stamina, speed, and endurance. Roads or hills I had ridden countless times before instantly became unmanageable. Thinking I was battling the flu or a virus, I visited my doctor. Blood tests revealed an abnormality.

Alicia

You never think it will happen to you until it does. Hearing the idea that you might have cancer was one of the darkest moments of my life. I was diagnosed with acute promyelocytic leukemia (APL) in February 2023 at only 27 years old. I am a mom, a wife, a sister, a daughter, and a pediatric ICU nurse. I am used to taking care of patients on their worst days, but becoming a patient made a huge impact on me and made me a better nurse and advocate for patients/family/friends. 

Anne

My story with leukemia began in July 2016 when I was diagnosed with chronic myeloid leukemia (CML). It was four months and 13 days after my wedding to my husband Eddie, and one month to the day after our vow renewal ceremony. What we didn’t realize at the time was that my body had likely been fighting for months. I thought my exhaustion was from wedding planning and running my writing business.

Caroline

In November of 2004, I was in the very best shape of my life. A few months prior, I had run my fastest marathon in San Diego, beating out all of my previous six finishing times in Austin, Nashville, Dallas, New York, and Boston. One month prior, I had completed the Los Angeles triathlon, finishing in the top bracket in my age division. I was even in the process of training to climb Mount Kilimanjaro with my brother. Then my entire world was turned upside down.

Heather

My name is Heather and I was diagnosed with acute myeloid leukemia (AML) +FLT3/ITD on December 14th, 2017. That morning I noticed I was extremely pale and I had large bruises over my body. My doctor ran blood work STAT and within an hour I knew my platelets were below 20 and I needed to rush to the ER. I was pretty near death at that time. I was in Disseminated Intravascular Coagulation (DIC), which has a pretty high mortality rate.

Andrew

When I write about the fact that I have cancer, it is not my intention to suggest that I am in any way unique. Although when I was first diagnosed with non-Hodgkin's lymphoma in 2010, I did feel special, and not in a good way. At first, I thought I had a hernia. But the surgeon said no. It took almost two months for the biopsy of the lymph node that he extracted from my body to be definitively identified. They sent it to Bethesda for further analysis. Still no answer. I then had a second biopsy.

Doug

I have always been a builder. Professionally, I am an architect.  ​You could say that I’ve spent my life building spaces where people could grow. I never imagined, however, that I would someday have to rebuild my own. In February 2015, after experiencing months of excruciating and debilitating back pain that doctors mistakenly attributed to deteriorating lower lumbar discs, I had an MRI that revealed multiple vertebral compressed fractures.

Douglas

My story begins almost 24 years ago in 1996, when I was diagnosed with cancer, chronic lymphocytic leukemia (CLL). Back then, there was no cure for CLL except for a bone marrow transplant (BMT), but that procedure only had a survival rate of 50%, not very attractive odds. My prognosis was I had anywhere from six to 15 years without a BMT.

Heather

The Leukemia & Lymphoma Society’s Light The Night Walk serves as an inspiring, empowering and comforting event, made possible by those who share, remember, and advocate for the fight against cancer. Each year, we here at LLS are graced with countless stories that demonstrate and display the spirit of this event. Heather Lee’s story is one of them.

Spencer

I am a 27-year-old transgender man who won a hard-fought battle with stage 3 Hodgkin lymphoma just after graduating from college. My story begins with a good friend. One night, we were hanging out around the house and they caught a glimpse of my neck under a particular light and said, “Hey, come here for a second, your neck looks pretty swollen.” We both looked in the mirror and noticed something protruding from the space where the left side of my neck met my clavicle. I called my doctor’s office and made an appointment for the next day. 

Jesus E.

My grandpa was diagnosed with non-Hodgkins lymphoma (NHL) in 2007. It turned our world upside-down. You always hear these stories of families going through the motions of this disease but never personalize it until it actually happens to someone you love.

Jaleah

In April 2018, our lives were forever changed when we found out that our sweet Jaleah, full of life and personality, had cancer. Sometimes life is unfair — to sit there helpless and scared and then hear the doctor say, “Your child has cancer,” was pure devastation and the worst day of our lives! These words should never be heard by any parents.

We got transferred the next day to Duke Children’s Hospital, and I was still in disbelief. How could my sweet snuggly baby, who has a history of good health, loves to eat, and bury her head into my shoulder, have cancer?

Sarah

I was diagnosed with B-cell acute lymphoblastic leukemia (B-cell ALL) in October 2020 at the age of 38. It was a shocking diagnosis. I started feeling bad in September with extreme fatigue and some body aches, nothing terribly alarming. I'm a busy wife and mom of two young kids (ages 2 and 8 at the time of diagnosis) with a full-time job and two new puppies. I figured I was just worn out from everything. I had routine bloodwork scheduled for my annual physical. When my primary care doctor received the results, he called and asked me to go to the emergency room.