Leukemia

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Leukemia


The body is the most unique mechanism ever created. It is composed of many


sructures that bring life. But what’s more interesting is the great-giving source of life, the


blood. And, it could also be the leading cause of death. Leukemia is a cancer of the


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blood. Unlike other cancers, leukemia doesn’t produce a tumor that results in


overproduction of cancerous white blood cells. Leukemia, the term is derived in a Greek


word, leukos, meaning “white”, and haima, meaning “blood”. It is often considered a


disease of children yet it affects far more adults. It is more common in men than women,


and in Caucasians than African-Americans. According to the American Cancer Society,


leukemia is the sixth leading cause of cancer deaths among men and the seventh leading


cause of deaths among women. It accounts for about one-third of all cancer deaths in


children. Over 8,000 new cases of leukemia are diagnosed in the United States each


year.


Leukemia is classified as acute or chronic. Cancer cells in acute leukemia multiply faster before their maturity stage. Chronic leukemia, on the other hand, progresses more slowly, with cancer cells developing to full maturity. The four types of leukemia are acute lymphocytic, acute myelocytic, chronic lymphocytic, and chronic myelocytic. Acute lymphocytic, or lymphoblastic, leukemia (ALL), sometimes called childhood leukemia, is the most common type of cancer in children; acute myelocytic leukemia (AML) is the most common form of leukemia in adults. Without treatment, acute leukemia is usually incurable within months. Treatment effectiveness varies with the type and stage of the disease, but the younger the patient, the greater the chances of healing. Chronic leukemia is likely to affect middle-aged adults. Chronic lymphocytic leukemia (CLL) is the most gentle, slowly progressing type. It can be controlled with medication and may require no treatment in its early stages. Chronic myelocytic leukemia (CML) is more aggressive and could occur at any age.


No one knows exactly what causes leukemia, but physicians have identified known causes of certain types of leukemia. Research suggests that prolonged exposure to radiation, various chemicals in homes and work environments, and low-frequency electromagnetic fields may be connected with leukemia, but there is no definitive proof. Workers exposed to benzene over long periods of time have greater risk of developing acute myelocytic leukemia. Chemotherapy drugs, used to treat other types of cancer, also increase a patient’s risk of later developing acute myelocytic leukemia. Genetic factors may also contribute to the development of leukemia. Some inherited conditions, such as Down syndrome, increase a person’s risk of developing leukemia, and at least one virus in the same family as the human immunodeficiency virus (HIV) has been associated with a rare form of the disease most likely due to an inherited genetic mutation. Environmental factors seem to influence the risk of developing leukemia.


Many types of leukemia produce no obvious symptoms in early stages. Eventually, symptoms may include anemia and related symptoms, such as fatigue, paleness, and a general feeling of illness. A tendency to bruise or bleed easily, including bleeding from the gums or nose, or blood in the stool or urine. A weakness to infections such as sore throat or bronchial pneumonia, which may be accompanied by headache, low-grade fever, mouth sores, or skin rash are the most common signs. Swollen lymph nodes typically in the throat, loss of appetite and weight, and discomfort under the left lower ribs are another. In advanced stages, symptoms may include sudden high fever, confusion, seizures, inability to talk or move limbs, and an altered state of consciousness.


There are three major treatments for leukemia. These are chemotherapy, radiation therapy, surgery and bone marrow transplantation. The most effective treatment for leukemia is chemotherapy, which may involve one or a combination of anticancer drugs that destroy cancer cells. Each type of leukemia is sensitive to different combinations of chemotherapy. Medications and length of treatment vary from person to person. Treatment time is usually from one to two years. Treatment may consist of different chemotherapy drugs and biologic therapies. The short-term goal is for a complete reduction, meaning that no leukemia cells can be found in the blood and bone marrow at that time and the platelets and white blood counts have returned to normal. The long-term goal is for an extended disease-free state and cure. A course or cycle is the period of time from the start of the chemotherapy until either the blood and bone marrow cell counts are back to normal or when they are able to receive further treatment. A specific treatment plan is called a protocol. Letters usually name each protocol with each letter standing for a particular drug. A protocol may be considered either standard or experimental therapy. The common side effects of most chemotherapy drugs include hair loss, nausea and vomiting, decreased blood counts and infections.


In some cases, the leukemia cells are destroyed only from the blood and not from the bone marrow during the first course of chemotherapy. In these cases, a second course of action may be needed. If the leukemia does not respond to one or two courses of treatment, a different drug program may be used to bring on a reduction. A different drug program may also be used if a relapse occurs.


Along with chemotherapy, radiation therapy, also called radiotherapy is being use. It uses high-energy rays to damage cancer cells and stop them from growing. The radiation comes from a large machine. Radiation therapy for leukemia may be given in two ways. For some patients, the doctor may direct the radiation to one specific area of the body where there is a collection of leukemia cells, such as the spleen or testicles. Other patients may receive radiation that is directed to the whole body. Chemotherapy and radiation are designed to destroy all the leukemic cells in a patient’s body. However, this treatment also destroys the blood-forming system in the patient’s bone marrow. For this reason, healthy stem cells, the cells in bone marrow that enable long-term formation of blood, must then be infused into a patient to replenish the blood-forming system. The stem cells must come from an immunologically matched donor, usually a sibling or other close relative. Formerly, stem cells could only be transplanted from the bone marrow of the donor, and the procedure is known as bone marrow transplantation.


Bone marrow transplantation has three stages. These stages are preparation, operation, and recovery. First, the patients cancerous white blood cell count is brought under control usually by chemotherapy but possibly by leukopheresis, a mechanical process that separates cancer cells from the blood. During the operation stage, the patients bone marrow is destroyed by intensive chemotherapy to avoid rejection of new marrow. The patient then receives about one tablespoon of donor marrow. Recovery is the most dangerous stage. Until the donor marrow cells start producing new blood, the patient is left with almost no white blood cells, making death by infection a strong possibility. Once the donor marrow multiplies sufficiently the outlook for long-term reduction and sometimes a complete cure is good. Bone marrow transplantation is still both expensive and risky, but it offers the best chance of reduction and cure for AML and returning cases of ALL.


Having leukemia or any other cancer is scary whether to a child or an adult. It is not necessarily a death sentence but anyone with cancer deserves to live his or her life to the fullest. Encourage friends, family, and others to act normal around them and try helping them live a normal life. Don’t pretend that the disease doesn’t exist. It is better to think positively and don’t ever lose hope. Try to be open-minded and have a good sense of humor.





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