LEUKEMIA

CANCER OF THE
BLOOD
Contents
I. Introduction VII. References
II. Causes
III. Symptoms
IV. Types
V. Diagnosis
VI. Treatment
Leukemia: Introduction
Leukemia causes almost one-third of all cancer deaths in children under the age
15.
What is Leukemia?
Leukemia is a type of cancer of
the blood or bone marrow
characterized by an abnormal
increase of immature white
blood cells called "blasts".
Leukemia is a broad term
covering a spectrum of
diseases. In turn, it is part of
the even broader group of
diseases affecting the blood,
bone marrow, and lymphoid A Wright's stained bone marrow
system, which are all known as aspirate smear from a patient
hematological neoplasms. with precursor B-cell acute
lymphoblastic leukemia.
What is Leukemia?
Leukemia is a treatable disease.
Most treatments involve
chemotherapy, medical
radiation therapy, or hormone
treatments. The rate of cure
depends on the type of
leukemia as well as the age of
the patient. Children are more
likely to be permanently cured
than adults. Even when a
complete cure is unlikely, most Dr. Stephen A. Grupp examining Emma,
people with a chronic leukemia recipient of CTL019 therapy.
and many people with an acute
Leukemia: Causes
Experts do not know what causes leukemia. They do not know why some people get it
and others do not. It is likely that the different types of leukemia have different causes.
 Causes of Leukemia
Benzene as a cause of leukemia had
documented since 1928. In 1948, the
American Petroleum Institute officially
reported a link between this solvent used
in many of their industries used and
cases of leukemia in their workers. Their
findings concluded that the only safe
No one knows the exact causes of
leukemia. Doctors can seldom
explain why one person gets
leukemia and another does not.
Studies have found the following
risk
factorswith
Working for leukemia:
certain
chemicals Exposure to high
levels of benzene in the workplace
can cause leukemia. Benzene is
used widely in the chemical
industry. Formaldehyde is also
used by the chemical industry.
Workers exposed to formaldehyde
 Causes of Leukemia
Very high levels of radiation have been
caused by atomic bomb explosions (such
as those in Japan during World War II) and
nuclear power plant accidents (such as
the Chernobyl [also called Chornobyl]
accident in 1986).
No one knows the exact causes of
leukemia. Doctors can seldom
explain why one person gets
leukemia and another does not.
Studies have found the following
risk
Veryfactors
highfor leukemia:
levels of radiation
People exposed to very high levels of
radiation are much more likely than
others to develop leukemia. Medical
treatment that uses radiation can be
another source of high-level
exposure. Radiation used for
diagnosis, however, exposes people
 Causes of Leukemia
For patients treated for Hodgkin
lymphoma (HL), cumulative doses of
alkylating agent (AA) is associated with
the risk of therapy-related acute myeloid
leukemia/myelodysplastic syndrome (t-
AML/MDS), according to a study published
online Jan. 7 in the Journal of Clinical
No one knows the exact causes of
leukemia. Doctors can seldom
explain why one person gets
leukemia and another does not.
Studies have found the following
risk
factors for leukemia:
Chemotherapy Cancer
patients treated with certain
cancer-fighting drugs sometimes
later develop leukemia. For
example, drugs known as
alkylating agents are associated
with the development of leukemia
many years later.
 Causes of Leukemia
SMOKING cigarettes may increase a
person's risk of contracting leukemia by
30 percent and cause up to 3,600 cases
of adult leukemia a year in the United
States. (Published February 3, 1993)
No one knows the exact causes of
leukemia. Doctors can seldom
explain why one person gets
leukemia and another does not.
Studies have found the following
risk
factors for
Smoking leukemia:
Tobacco products are
the single, major avoidable cause
of cancer. Smoking is also causally
associated with cancers of the
pancreas, kidney, bladder,
stomach, and cervix and with
myeloid leukemia.
 Causes of Leukemia
Down syndrome was linked to leukemia for the
first time in a case report published in 1930.
Since then, Down syndrome has been
recognized as one of the most important
leukemia-predisposing syndromes and patients
with Down syndrome and leukemia have unique
clinical features and significant differences in
No one knows the exact causes of
leukemia. Doctors can seldom
explain why one person gets
leukemia and another does not.
Studies have found the following
risk
Downfactors for leukemia:
syndrome and certain
other genetic diseases Some
diseases caused by abnormal
chromosomes may increase the
risk of leukemia.
Leukemia: Symptoms
Over 1 million Americans are living with, or are in remission from, leukemia,
lymphoma or myeloma.
Symptoms
Like all blood cells, leukemia cells
travel through the body. Depending
on the number of abnormal cells and
where these cells collect, patients
with leukemia may have a number of
leukemia symptoms.
Acute leukemia symptoms appear
and get worse quickly. Chronic
leukemia symptoms may not appear
for a long time; when leukemia
symptoms do appear, they generally
are mild at first and get worse
gradually.
Fever, chills, and other flu-like
symptoms
Weakness and fatigue
Frequent infections
Loss of appetite and/or weight
Swollen or tender lymph nodes, liver, or
spleen;
Easy bleeding or bruising
Tiny red spots (called petechiae) under
the skin
Swollen or bleeding gums;
Sweating, especially at night; and/or
Bone or joint pain.
Symptoms
In acute leukemia, the abnormal In chronic leukemia, the
cells may collect in the brain or abnormal blood cells may
spinal cord (also called the central
gradually collect in various
nervous system or CNS). The result
may be headaches, vomiting, parts of the body. Chronic
confusion, loss of muscle control, leukemia may affect the
and seizures. Leukemia cells also skin, central nervous system,
can collect in the testicles and digestive tract, kidneys, and
cause swelling. Also, some patients testicles.
develop sores in the eyes or on the
skin. Leukemia also can affect the
digestive tract, kidneys, lungs, or
other parts of the body.
Leukemia: Types
Leukemia is the 10thmost frequently occurring type of cancer in all races or
ethnicities.
Types
There are several types of by how quickly the
leukemia. The different disease develops
types of leukemia are Chronic
grouped in two ways. One
way is by how quickly the
Acute
disease develops and gets by the type of blood
worse. The other way is by cell that is affected
the type of blood cell that is Lymphoid cells
affected.
Myeloid cells
Types
In chronic leukemia, the
leukemia cells come from
mature, abnormal cells.
The cells thrive for too
long and accumulate. The
cells grow slowly. It is not
unusual in chronic cases
for symptoms to take a
long time to even appear.
Acute leukemia develop
from early cells, called
"blasts". Blasts are young
cells, that divide
frequently. They target
immature cells, causing
symptoms to appear
quickly. In acute leukemia
cells, they don't stop
dividing like their normal
counterparts do.
Types
Lymphocytic
leukemiabegins from
white blood cells called
lymphocytes or immature
types of lymphocytes. It
commonly affects lymph
nodes in the body but can
invade all body tissues.
Myelogenous leukemia
involves the other 3
common types of white
blood cells known as
granulocytes. They are
the neutrophils,
eosinophils, or basophils.
Leukemia: Diagnosis
About 20 percent of adult acute myeloid leukemia cases are
linked to smoking.
Diagnosis
The diagnosis
ofleukemiafrequently occurs
following a routine blood test that
results in an abnormal blood cell
count. If you have symptoms that
suggest leukemia, your doctor will
try to find out what's causing the
problems. Your doctor may ask
about your personal and family
medical history.
You may have one or more of the
following tests:
Blood tests: The lab does
acomplete blood countto
check the number of white
blood cells, red blood cells,
and platelets. Leukemia
causes a very high level of
white blood cells. It may
also cause low levels of
platelets andhemoglobin,
which is found inside red
blood cells.
Diagnosis
The diagnosis
ofleukemiafrequently occurs
following a routine blood test that
results in an abnormal blood cell
count. If you have symptoms that
suggest leukemia, your doctor will
try to find out what's causing the
problems. Your doctor may ask
about your personal and family
medical history.
You may have one or more of the
following tests:
Biopsy: Your doctor removes
tissue to look for cancer cells. A
biopsy is the only sure way to
know Your doctor removes some
bone marrow from your hipbone
or another large bone. A
pathologist uses a microscope to
check the tissue for leukemia
cells.There are two ways your
doctor can obtain bone marrow.
Some people will have both
procedures during the same
visit:
Diagnosis
The diagnosis Biopsy
ofleukemiafrequently occurs
following a routine blood test that Bone marrow
results in an abnormal blood cell aspiration: The doctor
count. If you have symptoms that uses a thick, hollow
suggest leukemia, your doctor will needle to remove
try to find out what's causing the
problems. Your doctor may ask
samples of bone
about your personal and family marrow.
medical history. Bone marrow biopsy:
You may have one or more of the The doctor uses a very
following tests: thick, hollow needle to
remove a small piece of
Diagnosis
The tests that your doctor
orders for you depend on
your symptoms and type
of leukemia. You may
have other tests:
Cytogenetics: The lab looks at the
chromosomes of cells from samples
of blood, bone marrow, or lymph
nodes. If abnormal chromosomes
are found, the test can show what
type of leukemia you have. For
example, people with CML have an
abnormal chromosome called the
Philadelphia chromosome.
Chest x-ray: An x-ray can show
swollen lymph nodes or other
signs of disease in your chest.
Diagnosis
The tests that your doctor
orders for you depend on
your symptoms and type
of leukemia. You may
have other tests:
Spinal tap: Your doctor may
remove some of the cerebrospinal
fluid (the fluid that fills the spaces
in and around the brain and spinal
cord). The doctor uses a long, thin
needle to remove fluid from the
lower spine. The procedure takes
about 30 minutes and is
performed with local anesthesia.
You must lie flat for several hours
afterward to keep from getting
aheadache. The lab checks the
fluid for leukemia cells or other
signs of problems.
Leukemia: Treatment
Hispanic children of all races under the age of 20 years have the highest rate of
leukemia.
Treatment
The goal of treatment for leukemia
is to destroy the leukemia cells
and allow normal cells to form in
your bone marrow. Treatment
decisions are based on the kind of
leukemia you have, its stage, and
your age and general health. Many
times, leukemia is treated with
one or more types of treatment.
Treatment for Acute
Leukemia
Chemotherapy -
Chemotherapy is the use of
drugs that either kill cancer
cells or preventing the cells
from dividing. Chemotherapy
can be given in a variety of
ways, with IV infusion and
pill being more common. The
type of chemotherapy given
depends on the stage and
type of lung cancer.
Treatment
The goal of treatment for leukemia
is to destroy the leukemia cells
and allow normal cells to form in
your bone marrow. Treatment
decisions are based on the kind of
leukemia you have, its stage, and
your age and general health. Many
times, leukemia is treated with
one or more types of treatment.
Treatment for Acute
Leukemia
Some types of acute leukemia
spread to the brain and spinal
cord. Regular chemotherapy
cannot reach those areas,
because your body puts up a
special barrier to protect them. A
different way of giving
chemotherapy, called
intrathecal chemotherapy,
treats these areas by injecting
the drugs directly into your spinal
canal to attack any leukemia
cells there.
Treatment
The goal of treatment for leukemia
is to destroy the leukemia cells
and allow normal cells to form in
your bone marrow. Treatment
decisions are based on the kind of
leukemia you have, its stage, and
your age and general health. Many
times, leukemia is treated with
one or more types of treatment.
Treatment for Acute
Leukemia
Radiation Therapy -
Radiation therapyuses high
doses of radiation, such as X-
rays, to destroy cancer cells.
Radiation is usually given from
a machine outside the body
that directs radiation to the
cancer (external radiation).
Radiation is also used to treat
acute leukemia that has
spread to the brain and spinal
cord.
Treatment
The goal of treatment for leukemia
is to destroy the leukemia cells
and allow normal cells to form in
your bone marrow. Treatment
decisions are based on the kind of
leukemia you have, its stage, and
your age and general health. Many
times, leukemia is treated with
one or more types of treatment.
Treatment for Acute
Leukemia
Stem cell transplantmay be
part of the treatment plan for
people who have high-risk
acuteleukemia. Moststem
celltransplantsfor leukemia
areallogeneic, meaning the stem
cells are donated by someone
else. The goal of a transplant is
to destroy all the cells in your
bone marrow, including the
leukemia cells, and replace them
with new, normal cells.
Treatment
Sometimes leukemia gets worse
in spite of treatments.
Sometimes it gets better, or
"goes into remission." Sometimes
it comes back, or "relapses."
Even when that happens, there
are several treatments that may
help to cure the leukemia or help
you live longer:
Treatment if Acute
Leukemia gets Worse
Stem cell transplant.
Donated cells from a
"matched" donor can rebuild
your supply of
normalbloodcells and
yourimmune system.
Chemotherapy. Sometimes
medicines or doses that are
different from those used
during your initial
chemotherapy can help.
Treatment
Chronic lymphocytic
leukemia is not always
treated right away. It usually
gets worse more slowly than
acute leukemia.
Treatment of Chronic
Leukemia
Chronic Lymphocytic
Leukemia
Watchful waiting - CLL usually gets
worse very slowly, and you may have
no symptoms for some time. You and
your doctor may decide to hold off on
treatment for a while. During this
time your doctor will watch you
carefully.
Radiation therapy -Radiationmay
be used to destroy cancer cells. It
also may be used to shrink swollen
lymph nodes or a swollenspleen.
Sometimes radiation is used on the
whole body to prepare for abone
marrowtransplant.
Treatment
Chronic lymphocytic
leukemia is not always
treated right away. It usually
gets worse more slowly than
acute leukemia.
Treatment of Chronic
Leukemia
Chronic Lymphocytic
Leukemia
Chemotherapy - Chemotherapy is
the use of medicines that attack
cancer cells. Many medicines are
available to fight leukemia and help
you live longer.
Surgery - If thespleenstarts
destroying red blood cells and
platelets, it may need to be removed.
This operation is called asplenectomy.
Targeted therapywith amonoclonal
antibody. These antibodies can kill
cancer cells, stop their growth, or keep
them from spreading.
Treatment
Chronic lymphocytic
leukemia is not always
treated right away. It usually
gets worse more slowly than
acute leukemia.
Treatment of Chronic
Leukemia
Chronic Myelogenous
Leukemia
Targeted therapywith atyrosine
kinase inhibitor, such
asimatinibordasatinib, is the first
treatment used for CML.
Chemotherapy - Chemotherapy is
the use of medicines that attack
cancer cells. Many medicines are
available to fight leukemia and
help you live longer.
Biological therapy - This is the
use of special medicines that
improve your body's natural
defenses against cancer.
 Treatment
Chronic lymphocytic High-dose chemotherapy
withstem cell transplant - After
leukemia is not always chemotherapy is completed, stem
treated right away. It usually cells that were previously donated and
frozen are thawed and infused.
gets worse more slowly than Donor lymphocyte infusion (DLI) -
acute leukemia. This is a treatment that may be used
after a stem cell transplant. With DLI,
Treatment of Chronic a person is given more of their donor's
Leukemia white blood cells (lymphocytes).
Chronic Myelogenous
Surgery - If thespleenstarts
destroying red blood cells and
Leukemia platelets, it may need to be removed.
This operation is called a splenectomy.
Overview: http://
www.cancer.ca/Canada-wide/About cancer/Types of cancer/Treatment for leukemia
Leukemia: References
The incidence of leukemia is highest among whites, and lowest among American
Indians, and the Asian and Pacific Islander population.
References
New leukemia therapy destroys cancer by turning blood cells into assassins, Ryan Jaslow, CBS
News http://www.cbsnews.com/8301-504763_162-20091135-10391704.html
Mechanism behind acute leukemia identified by VUMC researchers, Mary Beth Gardner,
Vanderbilt University Medical Center http://www.mc.vanderbilt.edu/reporter/index.html?ID=2190
Understanding Leukemia - Diagnosis and Treatment, WebMD http://
www.webmd.com/cancer/understanding-leukemia-treatment
Leukemia: Causes and Risk Factors, CancerCompass http://
www.cancercompass.com/leukemia-information/causes-and-risk-factors.htm
Ontario Task Force on the Primary Prevention of Cancer.: Recommendations for the Primary
Prevention of Cancer. Toronto, Canada: Queen's Printer for Ontario, 1995.
Cigarette Smoking: Health Risks and How to Quit, National Cancer Institute http://
www.cancer.gov/cancertopics/pdq/prevention/control-of-tobacco-use/HealthProfessional/page2
Leukemia - Treatment Overview, WebMD http://
www.webmd.com/cancer/tc/leukemia-treatment-overview