Leukemia is a collective name for several different cancers in the bone marrow where the blood is formed. The treatment you will receive and how it will go depends, among other things, on your leukemia. More and more people who have leukemia can receive treatment that removes the disease or that makes it possible to live a good life for a long time.<\/p>\n\n\n\n
Leukemia is cancer in the cells that are to become different blood cells. The leukemias are divided into lymphatic and myeloid leukemias, depending on the cells that are diseased.<\/p>\n\n\n\n
Leukemia is also divided into acute and chronic leukemias depending on how quickly the disease develops.\u00a0Chronic leukemia<\/strong> is more common than acute leukemia.\u00a0But overall, leukemia is quite uncommon.<\/p>\n\n\n\n There are some other leukemias that do not fit into any of the divisions. They are not described in this text.<\/p>\n\n\n\n Acute lymphatic leukemia, ALL, is more common in children.\u00a0Acute myeloid leukemia, AML, is more common in adults.\u00a0The younger you are, the greater the chance of getting rid of acute leukemia.\u00a0Most effective is the treatment for children with ALL.\u00a0Over 85 percent of all children with ALL get rid of the disease after treatment.\u00a0The chance of getting rid of the disease is less in adults and decreases with age.\u00a0One reason is that the diseased cells then have a character that makes them more difficult to treat.<\/p>\n\n\n\n It is important to get treatment quickly if you have acute leukemia.<\/p>\n\n\n\n The most common leukemia<\/em> form in adults is chronic lymphocytic leukemia, KLL.\u00a0Disease is also a form of\u00a0lymph node cancer.\u00a0The disease is often detected without any symptoms, for example in connection with a health check.\u00a0The disease is mostly life-long.\u00a0You get treatment when you have a problem.\u00a0You go on regular checks when you are without the hassle.<\/p>\n\n\n\n Chronic myeloid leukemia, KML, usually develops slowly. The goal of the treatment is to prevent the disease from passing into more acute phases. The disease is mostly life-long. Often you can live as usual, despite the illness and the treatment.<\/p>\n\n\n\n You may have one or more of these problems if you have leukemia:<\/p>\n\n\n\n The problems often come quickly if you have acute leukemia and more slowly if you have chronic leukemia. The symptoms can also be due to many things other than leukemia.<\/p>\n\n\n\n If\u00a0you think you have leukemia,\u00a0contact a\u00a0health care\u00a0provider.\u00a0You can contact many receptions by\u00a0logging in.<\/p>\n\n\n\n First, you have to tell the doctor how you feel.\u00a0Then the doctor looks and feels on the body to detect symptoms that may indicate leukemia.\u00a0You also submit\u00a0blood tests.\u00a0The test answers usually come within a day and are often enough to tell if there is a suspicion that you have leukemia.<\/p>\n\n\n\n You may come to a specialist clinic if your doctor suspects you have leukemia.\u00a0The specialist clinic is called a hematology clinic or medical clinic.\u00a0Some leukemias<\/span> need to be investigated and treated quickly while there is less urgency in other forms of the disease.<\/p>\n\n\n\n At the specialist clinic, you will be given more blood tests.\u00a0Here are examples of other samples that may be needed:<\/p>\n\n\n\n A\u00a0bone marrow test\u00a0can confirm if you have leukemia and provide more detailed information about the disease.\u00a0It is common for the sample to be taken on the back of the hip bone.\u00a0You get\u00a0local anesthesia.\u00a0Then a few milliliters of bone marrow is drawn from the hip with a needle.\u00a0It may feel uncomfortable but goes over quickly.<\/p>\n\n\n\n Sampling usually does not cause any problems afterward.<\/p>\n\n\n\n A\u00a0spinal fluid test can show if the disease is also present in the nervous system.\u00a0The sample is taken between two vertebrae in the lower back with a thin needle.\u00a0It may feel like a light pressure but usually doesn’t hurt.\u00a0You can get local anesthesia if you want.\u00a0After sampling, you will receive a small dose of\u00a0cytostatic drugs.\u00a0It is a drug that prevents sampling from spreading leukemia cells.<\/p>\n\n\n\n The sampling itself takes one to five minutes.\u00a0Afterward, you get to rest for half an hour and two hours.\u00a0You may have headaches after the examination, but it is unusual.<\/p>\n\n\n\n Sometimes the doctor will need to take samples from one or more lymph nodes. Then they use a needle to extract some tissue that can be analyzed in the laboratory. The sampling itself goes pretty fast. The entire survey takes a few minutes. Sampling can feel uncomfortable but usually does not hurt. You can get local anesthesia.<\/p>\n\n\n\n Sometimes a piece of the lymph node needs to be removed to be examined.\u00a0The operation is usually done in an operating department.\u00a0You usually get local anesthesia but sometimes you may need to be\u00a0anesthetized.<\/p>\n\n\n\n You will be examined according to a standardized course of care if your doctor suspects you have any of the following leukemia diseases:<\/p>\n\n\n\n Standardized care is a way of organizing the investigation so that it goes as quickly as possible.<\/p>\n\n\n\n The doctor will arrange a referral and tell you why you should be examined, what it means and when you can be told if you have cancer or not.<\/p>\n\n\n\n It is often quick to get calls for examinations in a standardized course of care.\u00a0It is good if you are clear about how the health care personnel most safely reach you so that you do not miss any time.<\/p>\n\n\n\n The goal of the treatment is to remove all leukemia cells and reduce the risk of relapse. The treatment is given in several parts that together can take between three months and 2.5 years. How long it takes depends, among other things, on the type of acute leukemia you have.<\/p>\n\n\n\n Sometimes the treatment needs to start before there is an answer to all samples. Then the treatment is adjusted when the answers are clear.<\/p>\n\n\n\n Before treatment can begin, some preparation is required.\u00a0For example, you need either a\u00a0\u00a0subcutaneous venous port or a\u00a0\u00a0central venous catheter, CVK.\u00a0They make it easier to submit samples and receive treatment.\u00a0They are operated under the skin of the chest and then go into a large blood vessel.<\/p>\n\n\n\n Your heart and lungs are examined to see that you have no infection and to be able to customize the treatment you should receive. Teeth may also need to be examined to reduce the risk of infection.<\/p>\n\n\n\n It is common for the treatment to start with high doses of cytostatic drugs, which are a form of the cell-inhibitory drug.\u00a0The cytostatics you get in repeated cures.\u00a0A cure is given as a drip for several days.\u00a0Then you need to be taken to hospital waiting for the healthy bone marrow to recover.<\/p>\n\n\n\n It is common to have to be in the hospital for about four to five weeks but it can vary.\u00a0Then a new bone marrow test is taken which can show if the treatment has removed the leukemia cells and the blood can again be formed properly.\u00a0It is possible that you can be discharged from the hospital for a short time while waiting for the test answer.<\/p>\n\n\n\n Treatment usually needs to continue even if all signs of the disease are gone.\u00a0The purpose is to reduce the risk of relapse.\u00a0You get more cytostatic drugs in cures.\u00a0The cures are interrupted with a pause in the treatment.\u00a0This part of the treatment can last from a few months to over two years.\u00a0The most common thing is that you are in the hospital while a cure is in progress.\u00a0In between, you can be home but you need to be admitted to the hospital if you get an infection.<\/p>\n\n\n\n You need supportive treatment to cope with the intensive treatment with cytostatic drugs. Here are some examples of such supportive treatment:<\/p>\n\n\n\n The weeks after the first, intensive treatment can feel laborious. You may need blood transfusions almost every day. You may need care in isolation rooms to protect against infections.<\/p>\n\n\n\n You who are close relatives or friends can greet you even if the sick person is cared for in isolation rooms.\u00a0The visits can make it easier for those who are ill to cope with the hospital stay.\u00a0It is important that you who greet you to follow the special routines that apply at the hospital for, among other things, hand hygiene and food.\u00a0Wait with the visit if you are cold or have any other infection.<\/p>\n\n\n\n You may need a\u00a0\u00a0stem cell transplant if the risk is high that you will have a relapse.\u00a0The treatment usually takes four to five weeks.\u00a0During that time, you are hospitalized.\u00a0The body must be strong enough to withstand the strain of a stem cell transplant.\u00a0There is also a great risk of complications, both during hospital time and in the coming months after stem cell transplantation.\u00a0Therefore, you may not be able to receive the treatment.<\/p>\n\n\n\n You may be treated again if you have relapses. Relapse means that the disease returns. What treatment you can receive depends, among other things, on what type of leukemia you have, what treatment you have received before and how much your body can handle.<\/p>\n\n\n\n The only thing that can cure acute leukemia is an intensive treatment.\u00a0Sometimes there is too much risk with such treatment.\u00a0It depends on how you feel and whether your body is able to cope.\u00a0For some, it may be better to refrain from the very demanding treatment and instead receive treatment that reduces the symptoms of leukemia<\/strong>, even if you cannot get rid of the disease.\u00a0It is called palliative care.\u00a0Then you can, for example, get cytostatic drugs in lower doses, blood transfusions, and treatment for infections.<\/p>\n\n\n\n Chronic lymphocytic leukemia, KLL, can be expressed in various ways. Some people already have symptoms when the disease is discovered. Then treatment is needed immediately.<\/p>\n\n\n\n Many are without symptoms. Then no treatment is needed but you may go for regular checks and blood tests a few times a year. In this way, the doctor can monitor how the disease develops and determine when you need to start receiving treatment.<\/p>\n\n\n\n There are many different medicines for KLL.\u00a0It is common for\u00a0cytostatic drugs to be combined with drugs called monoclonal antibodies.\u00a0It is a form of the targeted drug.\u00a0This means that they look up and attach themselves to cancer cells so that the cancer cells break down and die.<\/p>\n\n\n\n You can get monoclonal antibodies as a drip or as syringes.\u00a0The treatment does not remove the disease but can make you trouble-free for several years.<\/p>\n\n\n\n At the beginning of the treatment with monoclonal antibodies, you may get a little fever, chills, muscle aches or palpitations. Cytostatic drugs can, among other things, make you feel sick. There are medicines that can help you avoid side effects.<\/p>\n\n\n\n You may get infections after treatment with cytostatics and monoclonal antibodies, but it is quite uncommon and treatment is available.<\/p>\n\n\n\n There are drugs that contain small molecules. They block the signaling pathways of the cancer cells. The treatment can be used as an alternative to cytostatic drugs. Small molecules can be obtained as a single treatment or in combination with, for example, monoclonal antibodies.<\/p>\n\n\n\n You may be treated again if the symptoms return. Contact a doctor as soon as possible if you experience any problems that you think may be related to leukemia. This applies both if the treatment is completed and if it is still ongoing.<\/p>\n\n\n\n Contact a health care center if the inconvenience comes after a long time after the treatment and the contact with a special doctor or contact nurse is over.<\/p>\n\n\n\n The goal of the treatment is to greatly reduce the number of leukemia cells and to prevent the disease from moving into a more severe form, which may be reminiscent of acute leukemia.\u00a0You usually need treatment for the rest of your life.<\/p>\n\n\n\n Chronic myeloid leukemia, KML, means that there has been a special change in cells in the bone marrow.\u00a0The change is found in the nuclei of the cells and is called the Philadelphia chromosome.\u00a0The chromosome contains the code for a protein that allows leukemia cells to form.\u00a0The protein is called tyrosine kinase.\u00a0It can be blocked with drugs called tyrosine kinase inhibitors, TKI.\u00a0There are various tyrosine kinase inhibitors.\u00a0You take them as tablets every day.<\/p>\n\n\n\n You may need preparatory treatment before taking tyrosine kinase inhibitors.\u00a0For example, you may get tablets with mild\u00a0cytostatic drugs if you have very white blood cells in your blood.<\/p>\n\n\n\n For most people, the treatment with tyrosine kinase inhibitors means that they can live almost as usual without the inconvenience of the disease or treatment. But you can usually not stop treatment because the disease can be exacerbated then.<\/p>\n\n\n\n Tyrosine kinase inhibitors can cause you to have lowered blood levels, swelling or feeling unwell. There are several different types of tyrosine kinase inhibitors and you can therefore usually get a variety that works well for you.<\/p>\n\n\n\n It is rare, but sometimes tyrosine kinase inhibitors do not help.\u00a0Then you may need a\u00a0stem cell transplant.\u00a0It can make you get rid of cancer altogether.\u00a0The treatment usually takes four to five weeks.\u00a0During that time, you are hospitalized.<\/p>\n\n\n\n The body must be strong enough to withstand the strain of a stem cell transplant. There is also a great risk of complications, both during hospital time and in the coming months after stem cell transplantation.<\/p>\n\n\n\n For some, it may be better to refrain from the demanding treatment and instead receive treatment that relieves the symptoms.\u00a0It is called\u00a0palliative care.\u00a0For example, you may receive cytostatics at lower doses,\u00a0blood transfusions,\u00a0and treatment for infections.<\/p>\n\n\n\n The treatment can affect fertility, for example, if you have had cytostatic drugs or if you have had a stem cell transplant.\u00a0Talk to your doctor before treatment if you want to freeze sperm or meet a gynecologist to discuss what other options may be available to get pregnant.<\/p>\n\n\n\n Protect yourself from pregnancy while receiving treatment for cancer<\/strong>.\u00a0You can be fertile even though fertility is usually impaired.\u00a0Cancer treatment can be harmful to a fetus.<\/p>\n\n\n\n Wait a while to get pregnant after completing cancer treatment. Talk to your doctor.<\/p>\n\n\n\n You need to stop treatment if you have KML and want to get pregnant. Then you have to go on tighter medical examinations and start the treatment again as soon as appropriate. Sometimes it is possible to use other medicines in the meantime.<\/p>\n\n\n\n Talk to your doctor if you have KML and want to use your sperm in a pregnancy. It can go without you having to stop treatment. It depends on what treatment you receive.<\/p>\n\n\n\n Also, talk to your doctor if you have leukemia and want to breastfeed.<\/p>\n\n\n\n Getting leukemia usually means that life is affected in different ways.\u00a0How much the disease changes every day depends, among other things, on the type of leukemia you have and what treatment you receive.<\/p>\n\n\n\n Life is greatly affected if you are treated for acute leukemia.\u00a0During the first part of the treatment, you need to be\u00a0on sick leave if you are entitled to it.<\/p>\n\n\n\n For some, it may work, for example, to start working or studying again part-time, while the latter parts of the treatment are still ongoing. But it varies from person to person.<\/p>\n\n\n\n It is common to be tired, have decreased fitness and increased susceptibility to infections. Then you need time for recovery.<\/p>\n\n\n\n Often, you can start living as usual again a few months after treatment, with for example family, work or school.<\/p>\n\n\n\n Sometimes the recovery takes longer, for example, if you have had a stem cell transplant.<\/p>\n\n\n\n You go on regular checks, maybe every month for the first time. Then you can walk less often. The checks continue for a long time. This depends, among other things, on the type of treatment you have received.<\/p>\n\n\n\n It is important that you exercise energy and fitness.\u00a0One suggestion is to start with walks and things you do every day.\u00a0As you get stronger you can continue with more intense physical exercise.\u00a0Do what you like and do yourself.<\/p>\n\n\n\n Chronic leukemia can cause symptoms or side effects that make you less able to cope.\u00a0Then you may need to be\u00a0on sick leave if you are entitled to it.\u00a0But it varies from person to person.\u00a0Some may live as usual despite leukemia.\u00a0You need to go for regular life checks.<\/p>\n\n\n\n Leukemia means that cancer has arisen in cells that will become different blood cells.<\/p>\n\n\n\n The blood cells are formed in the red bone marrow.\u00a0Redbone marrow is found in various parts of the skeleton, for example in the upper leg, sternum, vertebrae, pelvic bone and femur.\u00a0Every second, millions of new blood cells are ready to be sent out into the bloodstream.<\/p>\n\n\n\n There are three different types of blood cells, which have different tasks:<\/p>\n\n\n\n The blood cells develop from cells called stem cells. From the beginning, a stem cell has the ability to form all types of blood cells. Gradually, the blood cells mature and become more specialized, until they are ready to enter the bloodstream.<\/p>\n\n\n\n The stem cell gradually develops into blood cells that are either myeloid or lymphatic.<\/p>\n\n\n\n The myeloid origin cells should mature into different types of white blood cells that are important for, for example, the defense against bacteria. They should also turn into red blood cells and platelets.<\/p>\n\n\n\n The lymphatic origin cells should mature into the white blood cells called lymphocytes. They are found both in the lymph nodes and in the blood and can, among other things, form antibodies that prevent viruses from attacking the body.<\/p>\n\n\n\n Leukemia prevents the blood from forming properly.\u00a0Some of the cells that are to mature into blood cells stop in development and become cancer cells.\u00a0They are called leukemia cells.\u00a0Most often, it is white blood cells that develop into leukemia cells instead.\u00a0They take over space in the bone marrow so that there is a lack of all kinds of blood cells.\u00a0Leukemia cells can then enter the bloodstream, and also reach different organs such as the lymph nodes, the spleen, and the liver.<\/p>\n\n\n\n The causes of leukemia are unknown. Some things seem to increase the risk of getting leukemia, such as ionizing radiation. Some blood disorders or congenital gene changes may also involve an increased risk of leukemia.<\/p>\n\n\n\n It is rare for leukemia to be hereditary. Most people with leukemia have the disease without a relative.<\/p>\n\n\n\n You can respond in many ways to a cancer message. It is common to need a lot of time to talk to your doctor and other healthcare professionals about what the message means. If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.<\/p>\n\n\n\n Many hospitals have special nurses known as contact nurses.\u00a0They are particularly accessible to the sick and related.\u00a0The contact nurse can provide support and also help with various practical things.\u00a0<\/p>\n\n\n\n You can also contact for example the Cancer Foundation or Cancer Counseling.\u00a0Here you will find contact information and can read more about how you can get different types of\u00a0help and support in cancer.<\/p>\n\n\n\n A minor child has the right to receive information and support based on his or her own needs if a relative is ill.\u00a0You can get help with what you have to say if you want to and can tell the child yourself.\u00a0Often it is good to make children as involved as possible, no matter how old they are.\u00a0But you may need to customize the information and not have to tell everything.\u00a0It may be good to start with the child’s own questions.<\/p>\n\n\n\n You have the right to be involved in your care as far as possible. The healthcare staff should tell you what treatment options are available. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment. That way, you can help decide which treatment is best for you.<\/p>\n\n\n\n You can make a care plan together with the contact nurse, the doctor and other staff.\u00a0The care plan should contain information that is important to you, such as contact information and how to get the rehabilitation you need.\u00a0Here you can read more about the\u00a0contact nurse and the care plan.<\/p>\n\n\n\n You may get a\u00a0\u00a0new medical assessment from another doctor if you have a life-threatening or particularly serious illness.\u00a0Obtaining another doctor’s assessment can help you, for example, if you are unsure of which treatment or treatment is best for you.\u00a0<\/p>\n\n\n\n It can feel difficult to be close to someone who has a disease. It is common to want to support while you yourself have a strong concern and feel bad.<\/p>\n\n\n\n If you have people close to you, they can be a support. Often it will be easier for them to help you if you tell them how it feels. <\/p>\n\n\n\n You can get relief if you help take care of or support the sick person.\u00a0You can also get support, for example in the form of calls or help with practical things.\u00a0Talk to the contact nurse if you are close and need support.<\/p>\n\n\n\n Through the\u00a0Blood Cancer<\/strong> Association, you can get in touch with others who have experience of being ill or related.<\/p>\n","protected":false},"excerpt":{"rendered":" Leukemia is a collective name for several different cancers in the bone marrow where the blood is formed. The treatment you will receive and how it will go depends, among other things, on your leukemia. More and more people who have leukemia can receive treatment that removes the disease or that makes it possible to live a good life for a long time.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2,22,542],"tags":[44,261,262,150],"class_list":["post-227","post","type-post","status-publish","format-standard","hentry","category-diseases","category-cancer","category-types-of-cancer","tag-cancer","tag-different-forms-of-leukemia","tag-forms-of-leukemia","tag-leukemia"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=227"}],"version-history":[{"count":8,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/227\/revisions"}],"predecessor-version":[{"id":3588,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/227\/revisions\/3588"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=227"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=227"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}Acute leukemias: ALL and AML<\/h3>\n\n\n\n
Chronic Lymphatic Leukemia, KLL<\/h3>\n\n\n\n
Chronic myeloid leukemia, KML<\/h3>\n\n\n\n
Symptoms of Leukemia<\/h2>\n\n\n\n
When and where should I seek care?<\/h2>\n\n\n\n
Investigations<\/h2>\n\n\n\n
Leukemia is being investigated at a specialist clinic<\/h3>\n\n\n\n
You may submit several different tests<\/h3>\n\n\n\n
Bone marrow samples<\/h3>\n\n\n\n
Spinal fluid test – lumbar puncture<\/h3>\n\n\n\n
Lymph node test<\/h3>\n\n\n\n
Standardized care course at ALL, AML and KLL<\/h3>\n\n\n\n
Treatment of acute leukemias: ALL and AML<\/h2>\n\n\n\n
Preparation before treatment starts<\/h3>\n\n\n\n
Drugs remove cancer<\/h3>\n\n\n\n
You need different treatment at the same time<\/h3>\n\n\n\n
Relatives and friends can greet<\/h4>\n\n\n\n
Stem cell transplantation<\/h3>\n\n\n\n
If cancer comes back – relapse<\/h3>\n\n\n\n
Treatment that relieves the symptoms<\/h3>\n\n\n\n
Treatment of Chronic Lymphatic Leukemia, KLL<\/h2>\n\n\n\n
Cytostatic and monoclonal antibodies<\/h3>\n\n\n\n
Other drug treatments<\/h3>\n\n\n\n
If you get symptoms of leukemia again<\/h3>\n\n\n\n
Treatment of chronic myeloid leukemia, KML<\/h2>\n\n\n\n
Tyrosine kinase inhibitors reduce the number of leukemia cells<\/h3>\n\n\n\n
Tyrosine kinase inhibitors can cause side effects – then you can switch<\/h4>\n\n\n\n
Stem cell transplant is sometimes needed<\/h3>\n\n\n\n
Pregnancy and breastfeeding<\/h2>\n\n\n\n
So, life is affected by leukemia<\/h2>\n\n\n\n
After acute leukemia, recovery is needed<\/h3>\n\n\n\n
Important to exercise<\/h4>\n\n\n\n
Chronic leukemia affects life differently<\/h3>\n\n\n\n
What happens in the body?<\/strong><\/h2>\n\n\n\n
The blood cells are formed in the bone marrow<\/h3>\n\n\n\n
The blood cells develop from stem cells<\/h3>\n\n\n\n
Myeloid and lymphatic origin cells<\/h4>\n\n\n\n
Leukemia changes blood formation<\/h3>\n\n\n\n
What is Leukemia?<\/h2>\n\n\n\n
Getting a sick message<\/h2>\n\n\n\n
You can get support from several directions<\/h3>\n\n\n\n
Children also need to know<\/h3>\n\n\n\n
You have to be involved and influence<\/h2>\n\n\n\n
You can get a new medical assessment<\/h3>\n\n\n\n
For those of you who are related<\/h2>\n\n\n\n
Support for those who are ill or related<\/h3>\n\n\n\n