Ask a Haematologist: Dr Daryl Tan from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: HaematologyAsk a Haematologist: Dr Daryl Tan from Mount Elizabeth Novena Hospital Singapore
dr. Daryl Tan asked 3 years ago
I am Dr Daryl Tan, Haematologist based in Mount Elizabeth Novena Hospital Singapore. I graduated from National University of Singapore in 1997 and obtained my membership with the Royal College of Physicians (United Kingdom) in 2002. I received my internal medicine and haematology training at the Singapore General Hospital. In 2007, I was awarded the Singapore Government Human Manpower Development Plan (HMDP) fellowship to pursue postdoctoral training and clinical research in the field of lymphoma at Stanford University, USA. Upon my return, I served as the clinical lead for the lymphoma and myeloma services at the Singapore General Hospital and spearheaded several clinical trials examining novel approaches in treating lymphoma and multiple myeloma. I was Assistant Professor at the Duke-NUS Graduate Medical School and received numerous grants from the National Medical Research Council, Singapore Health Foundation and the Singapore Cancer Syndicate for my research. I joined Raffles Hospital in 2011 to help set up a comprehensive haematology service and became the managing partner of the Raffles Cancer Centre and the Director of Research of Raffles Hospital. I integrated research with clinical practice, availing novel therapeutics for cancer patients failing standards of care. Being the principal investigator of more than 40 investigator-initiated and industry-sponsored clinical studies allowed me to gain early experience with state-of-the art innovations in the treatment of blood cancers. My research has led to several international presentations and more than 100 publications in high impact factor scientific journals including numerous first-authored articles in the Lancet Oncology, Blood and the Annals of Oncology. My expertise in lymphoma and multiple myeloma was recognised by the publication of two lead-author review articles on their respective treatment guidelines in Lancet Oncology in 2014. My work on immunotherapy in NK/T-cell lymphoma has led to its endorsement on the American NCCN cancer treatment guidelines in 2018. I was elected into the International Myeloma Working Group in 2014 and also sit on the advisory panel of the International Myeloma Foundation’s Asia Myeloma Network. As a key opinion leader, I have delivered more than 100 invited lectures on the treatment of lymphoma and multiple myeloma at international and regional conferences and serve as an advisor to many regional and international expert panels on novel drugs development. I am currently a board member of the Chapter of Haematologists and is appointed by the Ministry of Health as an advisor for the Residency Advisory Committee for Haematology training in Singapore. My continued affiliation with the academic hospitals allows me to contribute to post-graduate teaching, and to advise patients on participation in clinical trials for lymphoma and multiple myeloma. Learn more about Mount Elizabeth Novena Hospital here: Learn more about me here: I am excited to be here to discuss Blood Cancers. Ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
12 Answers
LK answered 3 years ago
Doctor, what should I do to treat high levels of leukocytes in my blood, 33000/mm3? What is the cause of this condition?
dr. Daryl Tan replied 3 years ago

There are many causes of high white blood cells. The most common cause is an infection and the condition will resolve with treatment of the infection. If it remains persistently elevated, it has to be investigated.

As there are many different types of white blood cells, it is important to find out which type is elevated. The treatment for them are all different. If the lymphocyte is elevated, it may be due to condition called chronic lymphocytic leukaemia. If the neutrophil and its precursors are elevated , it may be due to chronic myeloid leukaemia. However, if baby cells called 'blasts' are elevated, seek urgent attention as it may be due to acute leukaemia which will need immediate treatment.

Agung Septian answered 3 years ago
Doctor, my cousin has severe anaemia. Almost every month he needs a transfusion, otherwise his condition will deteriorate. Is there any solution for him to get totally cured?
dr. Daryl Tan replied 3 years ago

There are many causes of anaemia. Some can be treated , some need a bone marrow transplant and some like thalassaemia major cannot be cured and the patient may need regular blood transfusions. It is important to find out the cause of the anaemia first to determine if it can be treated.

Julian answered 3 years ago
Doctor, I have hemophilia. I often experience excessive nosebleeds and if I have a wound, it would take a long time to recover. I regularly check in with a doctor and take medication. Is it true that this condition is incurable? What is the best solution?
dr. Daryl Tan replied 3 years ago

It is important to determine the severity of the haemophilia and this will guide the amount of replacement factor to correct the bleeding. It can be cured with a new technique called 'gene therapy' for younger patients. However, this procedure is still not available in Singapore. It may be available in the UK or US now.

Qori Asy-syifa answered 3 years ago
Doctor, what is the key to be cured from lymphoma?
dr. Daryl Tan replied 3 years ago

There are more than 60 subtypes of lymphoma. Some can be cured and some cannot. Some may require a stem cell transplantation to improve the cure rate. Most important first step is to get the diagnosis correct, including the subtype . A dedicated lymphoma pathologist is import in
this regard. Then after, depending on the subtype, get advice from a lymphoma specialist. There have been a lot of recent improvements in the way we treat lymphoma and as such, the cure rates have improve significantly. It is important that the treating doctor is familiar with all these recent advances so he can give the best advice. It is also important that once a chemotherapy regimen is prescribed, the patient stay on course. sometimes patients don't do well because they delay chemo or do not follow the schedules of the chemo.

Rachel answered 3 years ago
Doctor, bruises often appear on my skin although I never had an accident or any kind of impact. I went to a clinic and the doctor there said it is due to obstructed blood flow. What is the solution for this?
dr. Daryl Tan replied 3 years ago

Bruises are not due to 'obstructed blood flow'.There are many causes of easy bruising. Best to get a blood test done to see if the platelet levels are normal and whether the blood is able to clot
properly. If there is any abnormality detected, any treatment is based on the cause of these abnormalities in blood results.

Dimas Waluyo answered 3 years ago
Doctor, my first child is 20 years old. His body is weak and his face and lips are pale. When he was a kid, up until he was 10 years old, he had blood transfusion twice due to anaemia. After that, everything was normal. It is only recently that he's had these symptoms. Is it possible for anaemia to recur?
dr. Daryl Tan replied 3 years ago

If your child is a female, anameia due to lack of iron from heavy menstruation is very common. Important to find out the cause of the anaemia to address it. First of all, do a blood test to check if your child has anaemia indeed.

Devinta answered 3 years ago
Good morning, Doctor. My eldest brother was diagnosed with multiple myeloma. My grandfather had this disease too in his lifetime. Some said this disease is incurable and the patients have to undergo therapy for life - is that true? My brother has had radiotherapy and medications. What is the best treatment we can try? Will bone marrow transplant work for his condition? Am I, his sister, at risk to inherit this cancer?
dr. Daryl Tan replied 3 years ago

The disease is usually not inheritable.Very rarely, it may run in families. There are many ways to treat the condition as there are now many classes of drugs available. Transplant is done for patients less than 65 years old as it may keep patients in remission longer . Overall there is not cure and the disease keeps relapsing. Newer drugs allow patients to enter further remissions nowadays.Unfortunately, many patients will require therapy continuously.

Regita Maulani answered 3 years ago
Doctor, 5 years ago, I was diagnosed with MDS ( Myelodysplastic Syndrome). Now, I feel it is recurring. Is it true that MDS can recur after treatment?
dr. Daryl Tan replied 3 years ago

MDS cannot be cured. Early stages may not cause symptoms, but at more advanced stages, it may cause very low blood counts and the patients becomes very symptomatic. There are medications to improve the condition, but it cannot be cured by medications alone. The only way to cure it is with stem cell transplant.This is done for younger patients less than 65 years old.

Sulastri ningsih. answered 3 years ago
Doctor, my son has had ALL typed leukemia since 3.5 years ago. He had a complete remission, but he had a relapse 7 months ago. Now he is back on chemotherapy. Can leukemia be cured? Can the mutated cell be normal again? What should I do to keep him healthy?
dr. Daryl Tan replied 3 years ago

If he has relapsed ALL, the standard treatment is chemotherapy followed by stem cell transplant from a sibling or a matched unrelated donor. This will ensure the best chance for cure.

Bismo answered 3 years ago
Good afternoon, Doctor. What does "dirty blood" actually mean? After exercising, my calves turn red. People say this is due to “dirty blood”.
dr. Daryl Tan replied 3 years ago

" Dirty blood" is not a scientific term. Calves getting red after exercise may sometimes be due to venous insufficiency. If there is any concern, good to check with your doctor and do a blood test to make sure that everything is alright.

Risna Inayah answered 2 years ago
What is the life expectancy for someone with LMK (Chronic Myeloid Leukemia)?
dr. Daryl Tan replied 2 years ago

Chronic Myeloid Leukemia (CML) is now readily treatable with tyrosine kinase inhibitor such that it is considered a chronic disease and no longer a terminal cancer. The life expectancy now is almost the same as the healthy population.

wilzan answered 2 years ago
Doctor, my lymphocyte level was stagnant at 55. Then I was asked to have an examination of peripheral blood images but my lymphocyte level decreased to 40.5 and the impression of my peripheral blood images is normal. What is the cause of increased lymphocyte levels?

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