“LEUKEMIA” CANCER OF THE BLOOD INTRODUCTION “You have to realize that every well person is a miracle, it takes billions of cells to make up a person, and it will only take one cell to be bad to destroy the whole person”, this quote is from Barbara Bush from one of her past interviews about a daughter she lost with leukemia (Cunningham, 1988). This quote reminded me five years ago, when my niece was diagnosed with leukemia. She does not only have one bad cell inside her body but she has extra 330,000 counts of white blood cells that are not normal.
It was summer of year 2008 when my niece who is freshmen in high school was diagnosed with leukemia or cancer of the blood. Leukemia is a cancer that starts in the tissue that forms blood and affects the bone marrow (Anonymous A, 2012). Leukemia is found in white blood cells or leukocytes which characterized by an abnormal increase in white blood cells called “blast”, they do not fully form as they should and thereby blocking production of functioning blood cells. Unlike normal blood cells, leukemia cells don’t die when they should. They may crowd out normal white blood cells, red blood cells, and platelets.
This makes it hard for normal blood cells to do their work (Anonymous A 2012). Experiencing this type of cancer in our family makes me realize how a healthy body is truly a blessing that everybody should appreciate and learn how to take care of. Leukemia may not be the worst cancer we have right now, but many people of all ages suffer from this disease. According to the Leukemia and Lymphoma Society (2012), an estimated 274,930 people in the United States are living with or are in remission from Leukemia and an estimated 44,600 new cases of leukemia are expected to be diagnosed in the United States in 2011.
It is also said that leukemia is the most common type of cancer in children and adolescents and is the tenth most frequently occurring type cancer of all races or ethnicities (Leukemia and Lymphoma Society, 2012). Leukemia is a cancer that has a significant effect on our society, it is a non-sexist or ageist cancer that we should be aware of and be educated more on. BODY I. HISTORY OF LEUKEMIA Leukemia was first observed in 1845 by a pathologist named Rudolf Virchow.
He observed an abnormal large number of white blood cells in a blood sample from a patient and called this condition “Leukamie” in German, which he formed from the two Greek words leukos, meaning “white” and aima, meaning “blood”. Ten years after this discovery, another pathologist, Franz Ernst Christian Neumann found that a deceased leukemia patient’s bone marrow was colored “dirty green-yellow” as opposed normal red colored. This finding helped Neumann to conclude that a bone marrow problem was responsible for the abnormal blood leukemia patients.
In 1947 pathologist Sydney Farber believed from past experiments that administering, a folic acid mimic, could potentially cure leukemia for children. In 1962, researchers Emil J. Freireich Jr. and Emil Frei III used combination of chemotherapy to attempt to cure leukemia, the test were successful with some patients surviving long after the tests (Patlak, 1998). II. FOUR TYPES OF LEUKEMIA Leukemia is grouped by how quickly the disease develops (acute or chronic), as well as by the type of blood cells that is affected (lymphocytes or myelocytes) (Anonymous A. 012). Acute leukemia cells increases rapidly and usually worsens quickly than chronic leukemia. There are four main types of leukemia which includes acute lymphocytic leukemia “ALL”, chronic lymphocytic leukemia “CLL”, acute myelocytic leukemia “AML”, and chronic myelocytic leukemia “CML”. * Chronic lymphocytic leukemia “CLL” is the most common type of leukemia (Bazell, 2011). It affects the lymphoid cells and usually grows slowly or gets worst slowly. It is also sometimes referred to as chronic lymphoblast leukemia (Anonymous B, 2012).
Most often, people diagnosed with this type of leukemia are over the age of 55, it almost never affects children and more common in men than women. * Chronic myelogenous leukemia “CML” it is sometimes referred to as chronic myeloid leukemia or chronic granulocytic leukemia. This type of leukemia affects the myeloid cells and usually gets worse slowly. This type of leukemia occurs frequently in adults in their 50’s and is rarely seen in children. CML is also classified into three district phases, the chronic phase, accelerated phase and the blast crisis.
Knowing the CML phase plays a large part in determining the type of treatment a patient will receive (Leukemia and Lymphoma Society, 2012). Each phase describes the CML’s progression which determined by the number of blast cells. * Chronic Phase, this phase is made up of patients with fewer than five percent blast in their blood and bone marrow samples (The Survivors Club Staff, 2012). During this phase, the white cells can still fight infection. Patients in this phase have a very mild symptoms or not noticeable. In most cases, long term drug therapy can control this phase. Accelerated Phase, in this phase, the patients have more than five percent but less than thirty percent blast in their blood and bone marrow samples. Most patients within the accelerated phase suffer from loss of appetite and weight loss and do not respond as well as to traditional treatments. * Blast Crisis Phase or Acute Blast Phase, in this phase the patients has more than thirty percent blast cells and the cancer has spread from the bone marrow to other organs (The Survivor’s Club Staff, 2012). Because of elevated blast in the blood, this means lower than normal number of red blood cells and platelets. Acute Lymphoblastic Leukemia “ALL”, this is most common type of childhood leukemia, which accounts for about 3 out of 4 cases of leukemia in children. It usually occurs in children ages 2 through 5 years. This disease also affects adults especially those ages 65 and older. ALL is the most successful treated type of childhood leukemia (Leukemia and Lymphoma Society, 2012). This type of leukemia usually gets worse quickly and sometimes referred to as acute lymphocytic leukemia. * Acute Myelogenous Leukemia “AML” occurs more commonly in men than women and more with adults than children.
The incidence of AML increases with age. This is a kind of leukemia that gets worse quickly and sometimes referred to as acyte myeloid leukemia, acute myelocytic leukemia and myeloblastic leukemia (Anonymous, 2012). III. SIGNS & SYMPTOMS OF LEUKEMIA Like many other cancer, leukemia usually is diagnosed when it is in the accelerated stage because people usually go to the doctor only when they feel sick, and most often than not the symptoms for leukemia manifest when there is already a large amount of blast in the blood.
People with chronic leukemia may not even have symptoms until it is in the accelerated phase. Because leukemia is characterized by rapid increase in the number of immature blood cells and by the excessive buildup of relative mature, but still abnormal white blood cells. The crowding of blast in the blood makes the bone marrow unable to produce healthy blood cells which results in lack of red blood cells that carries oxygen, lack of platelets which is important in blood clotting process and lack of healthy white blood cells which are important in fighting infections.
When there is lack of platelets in the body this result in easy bruising or bleeding. Lack of red blood cells leads to paleness and fatigue due to anemia. With lack of healthy white blood cells the body is susceptible to infections and this could lead to patient experiencing frequent infection ranging from infected tonsils, sores in the mouth or diarrhea to life threatening infections (Morgan, 2010). Other symptoms of chronic and acute leukemia may include fevers or night sweats, weight loss for no known reason, pain in the bones or joints, swelling or discomfort in the abdomen from a swollen spleen or liver.
Having the symptoms mentioned above does not necessary mean that a person has leukemia. If a person is experiencing more than one of the symptoms it is best to check with their doctor or a health care provider and do some blood test, only then can the doctor tell if a person has leukemia or not. Ignoring warning signs and symptoms can make a treatable condition terminal. The sooner a person checks with their doctor the better chances they have in fighting any disease. III. CAUSE OF LEUKEMIA
The exact cause of leukemia is not known and there is no known way to prevent this disease. Many doctors seldom know why one person gets leukemia and the other doesn’t (Anonymous A, 2012). However, according to the National Cancer Institute (2011), there are researches which show that certain risk factors increase the chance that a person will get leukemia. Some of the risk factors are radiation, smoking, benzene, chemotherapy, down syndrome and certain other inherited diseases, certain other blood disorders and family history of leukemia.
Exposure to a very high level of radiation will make the person much more likely to get AML, CML and ALL. Exposure to radiation can come from atomic bomb explosions, radiation therapy and diagnostics x-rays. Smoking can also increase the risk of AMC. The average smoker is exposed to about 10 times the daily intake of benzene compared to nonsmokers (Leukemia and Lymphoma Society, 2012). Benzene is widely used in the chemical industry and it is also found in cigarette smoke and gasoline, exposure to benzene can increase a person’s risk of getting AMC.
Chemotherapy, down syndrome and other inherited disease, certain blood disorder such as myelodysplastic syndrome and family history of leukemia are all linked with increasing the risk of leukemia. IV. TREATMENT The ability to listen to one’s body is an important first step in finding a problem, so it can be properly diagnosed and treated (Wedro, 2012). The diagnosis of leukemia starts by going to the doctor and having a blood test. If the person is tested positive for leukemia then bone marrow aspiration test might be needed to check for the blood cells that cause leukemia and what type of leukemia it is.
People with leukemia have many treatment options these days. According to the Leukemia and Lymphoma Society (2012), chances in surviving this disease is a lot better today than they were 40 years ago. The overall five-year survival rate for leukemia has nearly quadrupled in the past 50 years. From 1960 to 1963, the five-year relative survival rate among whites with leukemia was 14 percent, then it went up to 34. 4 percent from 1975 to 1977 and from 2001 to 2007, the overall relative survival rate was at 56. 6 percent.
Treatment of this disease also depends on the type of leukemia, the age of the patient and if leukemia cells were found in the cerebrospinal fluid. Treatment for leukemia can be one or combination of chemotherapy, targeted therapy, biological therapy, radiation therapy and stem cell transplant. * Chemotherapy is probably the most common type of treatment for cancer. Chemotherapy uses drugs to destroy leukemia cells. A patient may receive chemotherapy by mouth, which are pills that can be swallowed, by vein or tube inserted into the vein.
Another way to receive the drug is through catheter where a tube is placed in a large vein in the upper chest and drugs will be injected into the catheter rather than directly into veins. The drugs can also be received into the cerebrospinal fluid by injecting drugs directly into the cerebrospinal fluid * Targeted therapy is another treatment for people with chronic myeloid leukemia and some with acute lymphoblast leukemia. This type of therapy use drugs such as Imatinib (Gleevec) tablets that block the growth of leukemia cells, it blocks the action of an abnormal protein that stimulates the rowth of leukemia cells (National Cancer Institute, 2011). * Biological therapy for leukemia is a treatment that improves the body’s natural defenses against the disease. This is a substance that can be injected directly into the muscle or can be given by IV infusion. * Radiation Therapy or radiotherapy is another treatment for leukemia; it uses high energy rays to kill leukemia cells. Some people receive radiation therapy from a large machine that is aimed at the spleen, the brain, or other parts of the body where leukemia cells have collected.
Others may receive radiation that is directly to the whole body. Radiotherapy is a standard treatment for many types of cancer (Anonymous, 2012). * Stem Cell Transplant is the replacement of damaged bone marrow cell with healthy cells. Stem cells that are used for transplants can be taken from bone marrow, from the bloodstream, or from umbilical cord blood. This treatment is used to treat the disease that damage or destroy the bone marrow and to restore the bone marrow after it has been destroyed by high doses of radiation and chemotherapy.
Stem cells may come from the patient, from identical twin, family member and from other donor. People with acute leukemia need treatment right away and the goal of the treatment is to destroy signs of leukemia in the body and make symptoms go away. Many people with acute leukemia can be cured. (National Cancer Institute, 2011). If a person has chronic leukemia without symptoms, they may not need a cancer treatment right away. When treatment for chronic leukemia is needed, it can often control the disease and its symptoms.
Unfortunately, CLL is probably incurable by present treatments as chronic leukemia can seldom be cured with chemotherapy. However, stem cell transplants offer people with chronic leukemia the chance for cure (National Cancer Institute, 2011). With all the technology available to us right now and with all the research and studies being done to find a new and better ways to treat leukemia, I’m hopeful that a cure for all types of leukemia will be discovered soon. CONCLUSION Learning you have leukemia or one of your loved ones have this disease can definitely change your live and the lives of those people around you.
When we learned about my niece’s condition 5 years ago, there was a dramatic change in our family on how we viewed life and the importance of having a healthy body. My niece Shayna has gone through a lot of test, procedures and treatments because of this disease, it is probably her positive outlook in life and prayer that helped her fight this disease. Although Shayna is still taking Gleevec every day to block the growth of leukemia cells, her doctors already considered her to be in remission.
She had normal blood counts for over four years now. In any disease, may it be cancer, diabetes, pneumonia or any life threatening or non-life threatening disease, it is important to listen to your body and do the first step of getting checked by a health care professional. It is also important to take life’s obstacle with a positive outlook and to have faith and hope from your love ones, from your health care provider, from yourself and from God, for all these would help a person deal and survive any disease.
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