Bethesda Comprehensive Cancer Center

Bethesda Comprehensive Cancer Center

Leukemia Lessons

Survivor Erika Medina



In July 2011, Erika Medina, 36, of Boynton Beach was having stomach problems. When routine blood work showed a dangerously low white blood cell count, she was sent to Bethesda Hospital East's Emergency Room.

There, Board Certified medical oncologist Felix A. Rodriguez-Pinero, M.D., of Hematology and Medical Oncology of Southern Palm Beach County, was asked to evaluate Medina’s condition. After a few more days of medical testing and pathology reports, Dr. Rodriguez made his diagnosis: Medina had acute leukemia—specifically, acute promyelocytic leukemia.

“Leukemia is a cancer of the blood,” explains Dr. Rodriguez. “Acute leukemia develops quickly and generally needs immediate treatment.”

Acute myeloid leukemia (AML) begins when normal blood cells change and grow uncontrollably. It is usually found in the blood and bone marrow. In normal cell processes, neutrophils, a type of white blood cell, are produced and are used by the body to fight bacterial infections. Mature neutrophils develop from immature white blood cells in a process called differentiation.

In AML, damaged DNA causes an interruption in the differentiation process, creating many immature cells called blasts. The large number of blasts reduces the production of healthy red blood cells and platelets. Therefore, people with AML are usually anemic because they do not have enough red blood cells; they are more likely to get infections because they do not have enough mature neutrophils; and they are prone to bruise or bleed easily because of a low level of platelets.

“Promyelocytic leukemia (APL) is a less common ‘subtype’ of AML. It requires a unique treatment regimen, as the cancer cells are at a different stage of development,” continues Dr. Rodriguez.

“I tried to stay positive and I see the glass as half full, or even three-quarters full,” says Medina.

During her six-week hospital stay, Medina underwent several rounds of chemotherapy that severely weakened her immune system. Strict precautions were taken to protect her from infections. She also needed several blood and platelet transfusions during this time.

“I was blessed with support from my family and friends,” she adds. “I had cards and pictures on every wall in my room. The nurses and staff on the oncology unit were phenomenal.”

Once Medina was released from Bethesda, she underwent another five weeks of outpatient chemotherapy. Medina’s last bone marrow biopsy showed no traces of the cancer. As part of her continued treatment, Medina has weekly blood tests to determine the level of her white blood cells and her ability to fight infection. If her counts are too low, she must stay inside and be extra cautious.

“It has been found that patients with APL benefit from the long-term (one to two years) use of continued chemotherapy to make sure the leukemia does not return,” adds Dr. Rodriguez.

Currently under the care of Dr. Rodriguez’s partner, Board Certified hematologist oncologist Jacy Villa, Jr., M.D., Medina is looking forward to returning to her active lifestyle. She is eager to return to work, take dance classes and go to the gym.

“I can’t wait to go kayaking. The trip I had planned last summer was postponed when I became ill.”

Dr. Rodriguez adds, “Fortunately for Ms. Medina, she has a highly treatable AML with a high chance of complete and sustained remission.”