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關於 leukemia diagnosis ，我們在網路上蒐集到這些相關的討論、資訊與評價

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在leukemia diagnosis這個產品中，有4篇Facebook貼文，粉絲數超過2萬的網紅畢明，也在其Facebook貼文中提到， //Francisco Garcia, 21, A Spanish youth team coach has died after it was revealed he had the coronavirus and a previously unknown diagnosis of leukemi...
　同時也有1部Youtube影片，追蹤數超過15萬的網紅pennyccw，也在其Youtube影片中提到，During his latest interview with Turner Sports sideline reporter Craig Sager, Philadelphia 76ers legend Allen Iverson took a moment to give his interv...

leukemia diagnosis 在 畢明 Facebook 的最讚貼文

畢明 By 畢明

2020-03-17 11:55:42 有 95 人按讚
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//Francisco Garcia, 21, A Spanish youth team coach has died after it was revealed he had the coronavirus and a previously unknown diagnosis of leukemia.//

你可以話佢同時打緊leukemia，但醫生朋友講明，話一般
leukemia病人中流感，都唔會死。

所以！唔好再當武漢肺炎係一般流感。尤其外國人！

Doctor friend said It's not because he was also battling leukemia that he died, leukemia patient won't get a flu and die. So please, take the Wuhan Coronavirus seriously. It is NOT just a flu.

#21歲
#唔好以為後生就好老定
#NotJustAFlu
#WearAFuckingMask
#CanDieYoungToo
#WuhanCoronavirus

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leukemia diagnosis 在 賴叔閱事 Facebook 的最佳解答

賴叔閱事 By 賴叔閱事

2020-03-13 18:45:13 有 29 人按讚
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恐慌嘅時候，更需要睇清楚啲。

肥人知道呢篇文真係寫得遲，本來我乜都唔想寫，依家見到個勢係全世界順水推舟圍堵中共就更加唔想寫，但係姣婆係好難守寡既，尤其是呢排成日俾班極度恐慌既人trigger… 我決定代肥控制員寫，因為我呢邊收視率高過佢。

好，開波！
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“We had better learn to doubt our inflated fears before they destroy us. Valid fear have their place; they cue us to danger. False and overdrawn fears only cause hardship. Even concerns about real dangers, when blown out of proportion, do demonstrable harm.” – Barry Glassner, American sociologist, author of The Culture of Fear.

網絡世界千奇百趣，好多網上既意見同評論，如果同傳媒製造既輿論結合（不論有心定無意），係會對社會有非常深切既影響。例如以前有政權會向群眾灌輸恐懼，挑起群眾之間既仇恨，或令群眾不知所措，進而控制群眾。呢種手法，不論以前納粹德國、現存或者已覆亡既共產國家、甚至自命民主自由既開放社會如美國都有出現。當政者及其黨羽，就係利用群眾既錯誤認知，以感性因素去扭曲大家既認知同決策能力，咁就可以達到佢地既政治目的啦。咩政治目的？好多種既，下至失敗政府要掩飾施政失誤，上至衝出國際統治全世界都有。

所以唔好話咁樣係「誇張」、「陰謀論」、同「乜都拉埋政治來講」呀，因為人類歷史就係充滿呢種叫 fearmongering既手段－用有目的地散播同誇大一樣不愉快既事情既手法，去引起大家既恐懼來控制群眾。現今世界，庸碌無能之輩當政比比皆是，唔識控制群眾既情緒，點樣遮掩政府既無能同做錯事既後果？不過肥人今次唔講法律，我學下一般既KOL咁「跨界別評論」先，所以呢篇文我講生物醫學，particularly 係將近來我係周遭聽聽埋埋既恐慌言論歸納一齊，逐點解釋。
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首先，等肥人我同大家重溫一下近來有關武漢肺炎既新聞標題：

信報報導「河南超長潛伏期病例疑94天確診」
HK01就話「逾5000疫廈元朗區最多　衛生署拒回應真偽」
Business Focus既報導就恐怖啦，話「肺炎突變新冠腦炎?　北京醫院首證病毒能侵襲中樞神經系統　感染肺炎併發腦炎北京醫院：患者意識曾陷入混亂」
CCTVB報導「私家醫生可收患者呼吸道樣本交政府陳肇始稱可及早減低傳播」

仲有零零星星報導例如：

「伊朗新冠肺炎疫情增至145死55歲國會議員不治」
「伊朗新型冠狀肺炎疫情失控，再有一位高級官員病逝。」
「【新冠肺炎・伊朗】數名官員先後染病身亡　23國會議員確診」
「新型冠狀病毒南韓確診個案累計增至逾7千宗死亡人數維持在44人。」
「【新冠肺炎．最新疫情】意大利確診個案逾萬　美國突破千宗」
上面堆報導實在睇到好多人好恐慌，尤其是本來對科學／病毒／醫療／疾病無咩認知既人，呢兩個月睇新聞就好似睇恐怖熱線咁。於是搞到好多心理質素差，表面受過教育既人墮入恐慌之中。

然後，我聽到身邊好多人竭斯底理咁驚叫：

「個肺花！個肺花！個肺花！個肺花呀！」
「呢個唔係流感呀！唔好再錯誤同流感比較啦！」
「潛伏期變長呀！無病徵既隱形病人都會傳染人架！」
（隔離果個choke到，咳兩聲）「我以後唔同你坐埋一齊呀！我唔想死呀！」
「如果唔係香港人衛生意識好，堅持戴口罩，香港一早淪陷啦！依家已經無新病例！你睇鬼佬幾污糟！又唔戴口罩，病又話唔使入醫院，返屋企休息，依家美國同意大利都爆發啦！」
「呢D廢老唔戴口罩，鬼唔望佢地中招死全家！政府應該強制人戴口罩！」

以上說話我全部聽過人講，最後一句我最撚火滾，你自己恐慌就好啦，咒人死仲要政府好 draconian 咁立法同執法？俾個民主自由既國會你仲可以普選，你都會選班人渣出來，然後大比數通過立法強制抽血抽組織，強制所有人有無問題都要戴口罩，仲可能要將人tag完再限制人出入自由。1984呀！

我日日做mon post狗睇網上既post，好多share出來又會令人恐懼既post，大部份都係有好多空間令人胡思亂想，如果你對科學尤其是 research methods, medical science, microbiology, virology等等唔認識的話，你鐵定會誤讀誤解再誤判… oh wait，睇返上面「利用群眾既錯誤認知，以感性因素去扭曲大家既認知同決策能力」，BINGO! 咁就搞掂你啦。為咩事要搞掂你？唔講啦，因為你會用陰毛論、陳雲信徒、唔好乜都政治化來駁我。

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依家太多post講呢個新型冠狀病毒，例如Facebook有個印度人既 Infographics on Covid-19，好詳盡，但咁又點呢？大家對病毒以致肺炎、流感、醫療系統等等都毫無認識，講到咁深入你地都會誤解或者一頭霧水。咁樣樣，好多人因為無足夠既basic knowledge，又先入為主咁因為自己既恐慌情緒相信左錯既資訊，要同佢地「解毒」，就好似同藍絲講咩叫法治一樣困難，真係太監洞房無撚用。

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好，依家開始【法網肥人講病毒】！

1. 眾所鳩知，武漢肺炎係由新型既冠狀病毒 Covid-19引起。Covid-19係冠狀病毒科 Coronaviridae裡面其中一種，佢係屬於 positive-sense, singled stranded RNA virus (正鏈單股核醣核酸病毒) 。RNA病毒有好高突變率，因為病毒既RNA polymerases缺乏 DNA polymerase 既proofreading能力，所以佢地好難有 nearly identical既 sequence。仲有一點好重要，病毒同病菌唔同，病毒係需要靠 host cell (宿主細胞)先可以生存，離開 host cell 佢地不能複製，不能運作，只有死路一條。所以一開始就話新病毒同SARS個sequence有幾多幾多 percent 相似，我即刻叮左一下，然後好多人傳話新病毒點點點可以生存好耐，我更加叮多兩下…. 邊個放呢D料出來既？

2. 另外，呢隻病毒並非 retrovirus (逆轉錄病毒, class VI single-stranded RNA-Reverse Transcriptase)，唔會將自己既RNA用 reverse transcriptase (逆轉錄酶)塞入host cell既基因裡面，然後適時復發。咩係retrovirus呢? 例如會引起 T Cell Leukemia 既 Human T-cell lymphotropic virus type 1 (HTLV-1)，或者引起愛滋病既 Human Immunodeficiency Virus (HIV)。呢個病毒，亦唔係好似肝病毒科乙型肝炎咁，唔係 retrovirus 但會有reverse transcriptase去將 viral genome incorporate 入host cell，所以就算不幸中左，都唔會話咩病者會成世帶住個病。所以我每一次聽到人講「就算中左都一世帶病呀」就會好抆，冠狀病毒變愛滋，黐L線！

3. 冠狀病毒既結構好簡單：一個 viral envelope，外面有protein spike，裡面有RNA，that’s it。佢地個replication mechanism (複製機制) 就係病毒接觸host cell後進入 host cell，然後係host cell個細胞核nucleus裡面複製。複製完之後就由host cell cytoplasm (細胞質)裡面製造既 necleocapsid (核蛋白衣) 加埋細胞核既 endoplasmic reticulum (內質網) 既phospholipid membrane (磷脂層)包住病毒RNA，經由host cell 既Golgi apparatus (高氏體)帶出host cell 繼續傳染人。呢個複製過程，當然會破壞甚至殺死 host cell啦。咁知道呢點有咩用？Phospholipid membrane係lipid bilayer (脂質雙分子層)，lipid bilayer係怕番梘soap既！咁勤D用番梘洗手就得啦，使撚用甲醇咩屌你，你嫌命長？

4. 有人話：「咁基因突變都得架嘛！個病毒咪做到所有野囉！」喔，係咩？如果咁簡單，呢個世界既大學就唔需要有生物系，而且達爾文應該無人理。首先，病毒點解會有基因變異？簡單講就係 replication 之中，有polymerases 抄錯條 sequence，例如本來係 ATCG 既，抄成 ATTG，跟住無 proofread 就掉出去。又有一種變異，就好似屬於Orthomyxoviridae 既influenza A virus咁，裡面有八條 RNA segments，可以係 replication既時候洗牌。呢種 replication 既錯誤或者洗牌，積埋積埋，小則變成 genetic drift/antigenic drift，大則變成 genetic shift/antigenic shift。前者可能將某一個半個 surface protein 結構變左少少，整體來講人體免疫系統仲認得出，變異後既病毒殺傷力有限。後者可能將原有病毒變成新既 subtype，大部份人既免疫系統都認唔出而死傷無數。假設，新既冠狀病毒係由舊有冠狀病毒（包括 SARS）天然 antigenic shift 變出來既，咁點可能係短短兩三個月再次 antigenic shift 呢？如果基因突變去到呢個地步，肯定顛覆生物學界既認知。但好多本來就無讀過生物既人會唔認同，佢地會搏命咁話基因變異點能夠預測！肥人話你知，唔係預測，而係不符合現實同暫時無人能夠推翻既理論。如果新病毒可以係短時間內變成 retrovirus，可以無任何條件下生存好耐，隨意改變 latent period潛伏期，隨意改變傳染力同殺傷力的話，科學家應該點 classify 佢呢？簡單講，長頸鹿頸長先叫做長頸鹿，如果長頸鹿變成 Mike Tyson 條頸咁短，咁我地應該叫佢做 Mike Tyson 定長頸鹿？如果新冠狀病毒有 HTLV-1既retrovirus能力，有hepatitis B 既 reverse transcriptase，有 flu A 可以 shuffle RNA 既能力，又有 HIV 既超長 latent period，你會叫佢做 coronavirus 定 super virus?

5. 講基因變異，要一個變異既病毒基因可以流傳，病毒本身必須要不斷繁衍，宿主傳宿主咁一代傳一代，病毒先可以續存。呢個就係進化論，survival of the fittest。古代有好多生物不能續存，就係因為被環境淘汰，例如有理論認為三葉蟲因為蛻變機制 (instar and molting) 有問題，結果難以生存，最後被大自然淘汰。如果病毒勁到咩人都可以一野就殺死佢的話，佢點傳播？宿主死左，無人帶佢地去傳染其他人嘛！病毒唔係病菌，可以係環境種生存好耐，病毒只要離開宿主好快就會死，就算有飛沫帶住，我地環境中既太陽紫外光、oxidizing agents、濕度與氣溫等等會令佢地好快收皮。病毒唔係倪匡衛斯理《藍血人》裡面隻「獲殼依毒間」，可以變成游離電波周圍飄。大家明白進化論，就會明白病毒學101既常識，從而 debunk 左一個不斷流傳既流言：「隻病毒好勁，好多人死架，傳播得又快！」傳播得快，不等如勁，而太勁既病毒，難以傳播。係呢度，傳播得快，同隻病毒之間並無關係。病毒殺傷力勁，傳播範圍就會窄，傳播速度都會慢；病毒殺傷力一般如普通流感的話，傳播範圍先會闊，傳播速度先會快。如果新聞瘋狂報導好多人死就等如勁，咁非洲同中東都有好多基督徒男女老幼被人大規模屠殺，你會唔會覺得信耶穌係死路一條？

6. 又有人話：「呢隻病毒唔同流感呀！唔好再同流感比啦！呢隻病毒會死人架！呢隻病毒無藥醫架！」首先，除左冠狀病毒同流感病毒，仲有 Respiratory Synctical Virus (人類呼吸道合胞病毒) 同 Rhinovirus (鼻病毒) 都會引起呼吸道感染疾病，隻隻都係病毒，病毒一向未必有有效既藥物醫治，隻隻都會死人。你地以為流感有得醫？用 Tamiflu 都未必得架，而且有可能有嚴重副作用。咁冠狀病毒同流感病毒有咩唔同? 有人話death rate高，無vaccine，latent period又長又短，病人無病徵，但呢堆因素唔係用來分別病毒勁唔勁囉。Death rate 高低由咩決定，點計？Vaccine有咩用，target 咩？latent period 點解會長短不一？有無病徵同嚴重性有咩關係，係咪好似異形咁，你怕有人無病徵但會 sudden death？你地睇得太多 WhatsApp D人無啦啦訓低既片段啦，你又知人地係武漢肺炎死？New England Journal of Medicine 有篇叫 First Case of 2019 Novel Coronavirus in the United States既文，提到美國華盛頓州有個病人1月19日入廠，20日確診，一直都係 supportive care，直到染病第11日，即係入廠第7日，醫生先用 IV 俾 remdesivir (瑞德西韋)，然後佢就退燒，其他症狀都消失或者減輕。咁又點解會係無得醫？大家記住remdesivir (瑞德西韋)，遲下會再講。

7. 仲有，我最憎既「個肺花！個肺花！個肺花！個肺花呀！」呢句，我想同講呢句既人講，肺花，係因為照 X-ray 既時候個肺有 consolidation/infiltration，呢個問題唔單止係肺炎，肺癆甚至cancer都會肺花。你怕咩肺花？流感去到嚴重的話，都可能肺花，因為你有 pulmonary consolidation or infiltration。肺花係因為你個肺 filled with liquid, exudate, pus 甚至 blood from hemorrhage。理性少少，冷靜D，肺花講一次就得，repeat 幾次無幫助。

8. 孤勿論點，呢隻病毒都只係一隻呼吸道感染既病毒，一隻真病毒，一隻同流感一樣會令人病，亦會令人死既病毒，只係流感令人鼻塞，但一樣有機會令人肺炎。呢個新病毒佢所有既威力都係傳媒、WhatsApp片段、社交媒體既報導俾佢，就好似有D 人，你聽佢大名如雷灌耳，一見到真人原來係柒碌又無料到一樣（我懷疑我自己都係咁）。其實有無人真正去了解上面我所講既野？無人話你聽你可以當呢隻病毒無到，話之佢死，但係一開始就進入恐慌狀態，咁你係咪俾人耍緊呢？

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講完上面既病毒既基本知識，不如講多少少基本病毒檢測既知識。好，依家開始【法網肥人化身肥控制員】！

外面成日有人話：「哎呀，個病人21日後先確診呀！」「哎呀，佢隻狗弱陽性呀！」「哎呀，本來係陰性依家係陽性呀！」「哎呀，南韓同意大利爆發，突然好多人確診呀！」Now TV 更報導「鑽石公主號在日確診香港人　康復回港後再檢測呈陽性」

究竟，呢堆確診數字信唔信得過？我意思唔係話邊個國家信唔信得過，而係呢個 test method 同個 protocol 信唔信得過，會唔會有 uncertainty 或者error? 一開始，我地可以睇下 Journal of the American Medical Association 3月9日既文章，Diagnostic Testing for the Novel Coronavirus，裡面有講到 false positive/false negative 既問題，仲有病毒測試既regulation，測試既 guideline等等。文中有提到，開初發展出來既病毒測試有 false negative，顯示出呢個測試既設計應該係有問題。另外，FDA，CDC與美國各州政府之間都有分歧，州政府當然想為居民檢驗啦，但因為個測試係新開發，有大量問題同 uncertainy，所以FDA “made clear that laboratories were encouraged to develop tests but could not use them for clinical diagnosis without FDA’s “approval, clearance, or authorization during an emergency declaration.” 咁 what does that means? 如果你讀 law 的話，我expect你可以 read between the lines。

講返個測試，檢驗新病毒一般都係會用 RT-PCR (Reverse transcriptase-polymerase chain reaction 逆轉錄聚合酶鏈式反應)。好多人，包括肥人好多行家與同事甚至客仔，一聽到咩DNA測試，就以為呢個 test 無L敵啦，一定準確啦。Oh Sorry，no! 撇除所有「中國的會爆炸」同「中國有咩係真」呢兩個因素，一個test既結果是否可信係建基於樣本收集同檢驗方法，無論你係美國，意大利，南韓，日本定中國，樣本收集同檢驗方法先係 main point！

檢驗呼吸道感染疾病，你地話收集咩樣本好呀？Saliva? Sputum? Nasopharyngeal aspirate (NPA)? Bronchial lavage? 如果係上呼吸道病毒，咁 NPA都足夠既，sputum 都可以，但saliva 就應該要reject。但有時呢類既樣本都未必有足夠既病毒樣本去驗，病毒深入氣管去到肺氣泡(alveoli)，樣本可能要係bronchial lavage先夠做。仲有，收集樣本既手法，部位，儲存方式，收集時間與檢驗時間既差距，樣樣都會影響結果。支棉花棒「了」得唔好，你或者都會無 result。

好啦，到講 RT-PCR啦。RT-PCR係需要 medical scientist 去砌一段 primer 出來開始做test。為左檢驗結果既可靠性，scientist通常會係新病毒入面抽一段比較穩定既 RNA segment 出來做 primer。可惜，有好多情況下，RT-PCR會俾個錯既答案你。

第一，primer 既設計好影響結果，上面都話段 primer 要係抽病毒一段比較穩定既 RNA segment 出來做，咁如果你抽錯左呢？第二，樣本既 DNA/RNA sequence 既integrity好差，甩頭甩骨咁，結果就會受影響。即係上面所講既樣本收集出現問題呀！第三，樣本純度低，或者份量少，又即係上面所講既樣本收集出現問題呀！咁個 tech 或者 scientist 要係咁加 PCR cycle去 amplify 個 sample，咁 amplify 出來既樣本就有好大機會係 false positive，呢點會影響所謂確診既可信度，亦係咁肥人我見到漁護處話瑞士花園個阿婆患者隻狗呈現弱陽性反應，我當下笑 L97 左出來。大佬呀，你是咪無足夠 sample 就鳩 amplify，然後個 result 根本有問題你都聽長官意志，鳩簽個名話係弱陽性呀？陽就陽，陰就陰。Result 唔 significant 或者 inconclusive，你出咩報告jack? Invalid 啦！仲有呀，病毒係 host specific 架，會傳染人既病毒，又點會無啦啦傳染狗? 眾所鳩知冠狀病毒係靠人類細胞上既 ACE2 (Angiotensin-converting enzyme 2，血管收縮素轉化酶2)來進入人體細胞啦，狗 ACE2既同人既一樣？

寫下寫下，喂，原來未寫數據演繹同政策問題，太長啦，下次再續！

#跨界別吹水
#本來要免於恐懼唔跟隨共匪起舞
#依家又俾共匪睇穿你班人既心理
#個勢變啦全世界同共匪切割了

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leukemia diagnosis 在 吳鈞鴻-犬貓腫瘤科醫師-豆漿醬油小馬爸 Facebook 的最佳貼文

吳鈞鴻-犬貓腫瘤科醫師-豆漿醬油小馬爸 By 吳鈞鴻-犬貓腫瘤科醫師-豆漿醬油小馬爸

2019-06-25 23:47:38 有 64 人按讚
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【淋巴相關的腫瘤（主要是淋巴瘤）不同次分型，存活時間中位數】
（預估可以活多久？）

這也是昨天在廣播的時候，
楊醫師要求要加碼的部分(淋巴瘤)XD
其中我提到診斷淋巴瘤，
還是希望可以有採樣做病理！

很重要的原因就是不同的次分型(subtype)，
可能有截然不同的存活時間！
這張圖可以很清楚的看到這件事情
（不是B細胞就一定好，T細胞就絕對差）

#採樣還是很重要
#狗/ #淋巴瘤/ #淋巴癌/ #化療/ #存活時間

-
來源：Fourth Meeting of the European Canine Lymphoma Group
https://www.facebook.com/348359251917466/posts/2309202892499749?s=741488888&sfns=mo

-
備註
BL – Burkitt’s
（勃氏淋巴瘤，通常是很惡性的B細胞型）
AL – acute leukemia
（急性白血病）
TCLEB – T cell leukemia of English bulldogs (provisional diagnosis)
（英鬥T細胞型白血病，暫時的名稱）
HS – hepatosplenic lymphoma
（肝臟脾臟型）
CEL – cutaneous epitheliotrophic lymphoma
（皮膚親上皮型）
DSBCL – diffuse small B cell lymphoma (provisional diagnosis)
（瀰漫性小型B 細胞，暫時的名稱）
PTCL – peripheral T cell lymphoma
（周邊T細胞型）
nMZL – nodal marginal zone lymphoma
（結節邊緣區型）
DLBCL – diffuse large B cell lymphoma
（瀰漫性大型B 細胞）
LGL – large granular lymphocytic leukemia
（大顆粒性淋巴球性白血病）
B-CLL – B cell chronic lymphocytic leukemia
（慢性淋巴B細胞型白血病）
MCL – mantle cell lymphoma
（被套細胞型，B細胞）
TZL – T zone lymphoma
（T區型）
sMZL – splenic marginal zone lymphoma
（脾臟邊緣區型）
FL – follicular lymphoma
（濾泡型）

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吳鈞鴻-犬貓腫瘤科醫師-豆漿醬油小馬爸

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leukemia diagnosis 在 pennyccw Youtube 的最佳貼文

pennyccw By pennyccw

2016-04-08 00:08:18 有 76,725 人看過 有 217 人喜歡
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During his latest interview with Turner Sports sideline reporter Craig Sager, Philadelphia 76ers legend Allen Iverson took a moment to give his interviewer a heartfelt message.

Fight. Just fight.

Sager revealed late last month on HBO's Real Sports that he is no longer in remission, and that he was told by doctors he might have three to six months to live, as his leukemia has returned. While some may not be able to handle tough news like that, the 64-year-old reporter decided he wanted to be one of those who lives well past the initial medical timetable.

There has been an outpouring of support throughout the sports world since Sager shared his diagnosis, with Iverson's being the latest. While Sager has to deal with the situation himself, seeing all of the love he has gotten has to help him push through the tough times and continue to fight.

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All about Allen Iverson !!
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Often health care professionals conduct a variety of blood tests to determine if someone has leukemia. Leukemia patients often have ... ... <看更多>

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Just Diagnosed In Treatment After Treatment Diagnosing Acute Lymphoblastic Leukemia (ALL) To diagnose leukemia, doctors perform a number of tests.

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NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ® ) are posted with the latest update date and version number. Acute Lymphoblastic Leukemia.

#95. Leukemia Tests & Cancer Diagnosis | Banner MD Anderson

Leukemia Tests, Diagnosis, Prognosis and Stages · Are there Screening Tests for Leukemia? · What Tests Are Used to Diagnose Leukemia? · What Is the Prognosis of a ...