“Lifesaving” Plumping Procedure: Bad Reaction From Lip Filler Leads to 36-Year-Old Nurse’s Leukemia Diagnosis

“Not many people can say that lip fillers saved their life — but I can,” Edita said in an interview for SWNS news agency picked up by DailyMail.com.

The dental nurse from outside of London had also been losing weight, which she admittedly didn’t mind so much (as she was “about to go on holiday” at the time), but in hindsight, the signs started making sense. “I had no idea about the signs and symptoms of leukemia.”

Edita had also been drinking a lot of energy drinks, which “may have disguised my tiredness.”

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“If the bruising hadn’t happened and I hadn’t been encouraged to see the GP [doctor] because of it then I may well have put it off again and again which could have then meant the leukemia may have progressed and been much harder to treat.”

After her lip reaction, Edita disclosed that she had been bruising more easily in other areas of her body prior to receiving the injection, which is a reminder to always disclose anything you’ve noticed, no matter how minor, to your medical team for any medical or cosmetic appointments.

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Edita, who is now thankfully in remission, had received oral chemotherapy treatment and said she will also be on medication for the rest of her life to help keep the cancer from coming back.

“There definitely needs to be more general awareness of leukemia and what to look out for so more people can be diagnosed in time for treatment to be effective, like I was.”

What is Chronic Myeloid Leukemia (CML) and How is it Diagnosed?

Leukemia is a type of cancer that begins in blood or in blood forming tissues. There are several different kinds of leukemia. In CML, blast cells (or immature white blood cells) form and uncontrollably multiply and divide. This change in cells creates an abnormal gene called BCR-ABL, which is responsible for turning healthy cells into CML cells.

As the disease progresses, CML cells crowd out healthy cells and eventually build up and spill over into the blood. CML cells can also land in other areas of the body, among them the spleen, intestinal tract, kidneys and lungs. Although CML usually grows fairly slowly, it can also turn into a faster-growing acute leukemia. When this happens, CML may become more difficult to treat.

“What happens with CML is there is a cross of your chromosomes, so there is a cross between chromosome 9 and chromosome 22,” Dr. Eric Winer, clinical director of adult leukemia at Dana-Farber Cancer Institute, previously told SurvivorNet. This cross leads to the creation of a gene called BRC-ABL, which eventually causes the overproduction of cells seen in CML.

Learning about CML

But with early diagnosis and treatment, there’s good news. “It is important for patients diagnosed with CML to understand that their prognosis is quite favorable,” Dr. Jay Yang, hematologist, medical oncologist, and leader of the Hematology Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute in Detroit, added in a prior interview with SurvivorNet. “With modern treatments, most patients will go on to live healthy and productive lives with a normal life expectancy.”

CML patients are commonly asymptomatic.

When they do have symptoms, they usually present with:

• Night sweats
• A full feeling on the left side of their stomach, below their ribs
• Unintentional weight loss

Who Gets CML?

“That’s a very interesting question,” said Dr. Frances Arena, Medical Director at NYU Langone Arena Oncology and Integration, when discussing the topic with SurvivorNet. “Our only known reason for getting CML is exposure to radiation such as the event at Chernobyl. We know high dose radiation exposure may lead to CML but that people generally do not get CML from low dose exposures such as sunlight or X-Rays. Outside of radiation exposure, we know it’s primarily a disease of older people and that means people in their sixth and seventh decade.”

However, this is not always the case.

“I have a patient with CML in her 30s,” Dr. Arena added. “Also, men are slightly more likely to get the disease, although in my practice on Long Island, New York, “It’s about equal between men and women.”

According to the American Cancer Society:

• There will be about 8,860 new diagnoses of CML in the United States in 2022 (an estimated 5,120 men and 3,740 women)
• It is estimated that approximately 1,220 people will die of the disease (an estimated 670 men and 550 women) however while that number is always changing it is likely that the majority of patients may have had long time from diagnosis to end of life.

Dr. Yang reiterates that risk factors for CML are not clear like they are with some other forms of cancer. “We don’t know exactly why some people get CML,” said Dr. Yang. “It’s not a cancer that’s strongly associated with environmental exposures and it’s not thought to be hereditary.”

How Are You Screened for CML?

“Way back when I was chief resident and later on, as the assistant chairman of medicine at Memorial Sloan Kettering in NYC, when we saw a patient with CML, they were usually very ill,” Dr. Arena recalled. The reason? “We didn’t pick up the disease as quickly as we now do. These days, every person who comes in for a routine physical or for some type of checkup gets a blood count.”

“I can’t tell you how many times a week someone is referred to me because their white blood cell count is elevated.”

How is CML Diagnosed Without Obvious Symptoms?

When a blood test is suspicious, further screening is advised, which would include a Complete Blood Count (CBC). In fact, most patients with a high white count do not have CML.

Complete Blood Count (CBC)

Before symptoms develop, as Dr. Arena said, most people who have CML find out by having a routine blood test called a CBC or complete blood count. A CBC sees how many different kinds of cells are in your blood: red blood cells, white blood cells, and platelets (which are pieces of very large cells in the bone marrow called megakaryocytes). People with CML often have low numbers of red blood cells or blood platelets. If your blood test results show a high number of white blood cells it’s an indication that you might have CML.

From there, other screening tests will be recommended by your healthcare provider. This may include bone marrow samples or genetic tests.

What Are the Treatment Options?

Targeted therapies, which go after specific proteins that control how cancer cells grow, divide, and spread, (as opposed to chemotherapy which may also kill healthy cells) have become a mainstay in treating CML.

“CML to me, has been the poster child for targeted medicines,” Dr. Arena said. “Back in the day, we only had medicines like hydroxyurea, which was a blatant type of oral chemotherapy, that could keep the blood counts down but could have severe side effects. Also, the old chemotherapies didn’t go after the molecular signature of the disease — the BCR-ABL gene — the way new targeted treatments do.”

Dr. Arena pointed out that for the first time we have medicines that go ahead and really attack where this disease lives and what causes it. “It’s not a chemotherapy,” he said

“These days there are plenty of treatment options available for patients and physicians. Patients with CML are treated with a class of drugs called tyrosine kinase inhibitors (TKIs),” explained Dr. Yang. “These targeted oral medications (pills) are specifically designed to kill the leukemia cells.”

RELATED: Tyrosine Kinase Inhibitor (TKI) Therapy for Chronic Myeloid Leukemia (CML): The Basics

Several TKIs are currently approved for the treatment of newly diagnosed CML. These drugs work by blocking the protein made by the BCR-ABL gene. They include:

• Imatinib (Gleevec) — Imatinib was the first targeted therapy approved by the U.S Food and Drug Administration (FDA) for CML in 2001
• Dasatinib (Sprycel)
• Nilotinib (Tasigna)
• Bosutinib (Bosulif)
• Ponatinib (Iclusig)
• Asciminib is a new therapeutic option in chronic-phase CML with treatment failure

“Most of my patients are not getting sick from the CM: medications,” says Dr. Arena. “There can be some side effects, such as fluid retention, but as we look at our different generations of medication, we find that even some of these kinds of side effects have become less and less.”

The Future of CML Treatment

“The biggest advance in CML in the past five years is not a treatment per se, but a lack of treatment,” said Dr. Yang. “We had previously thought all patients with CML needed to stay in treatment for the rest of their lives. We now know that a portion of patients with CML who have responded well to treatment and who have achieved a deep remission can potentially stop their treatment and stay in remission long-term. Unfortunately, this situation does not apply to all patients and should only be done under the careful supervision of their treating physician.”

Dr. Arena added: “I can say to some of my patients: Let’s stop the medicine!” And in greater than 50% of patients, their CML will not recur.” Researchers are currently investigating new strategies that may allow more patients to discontinue their treatment.

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