Leukemia by Vijay Sir

 

LEUKEMIA

  Leukemia

             Leukemia is a cancer  of the blood, characterized by the rapid growth of abnormal blood cells. This uncontrolled growth takes place in your bone marrow, where most of your body’s blood is made. Leukemia cells are usually immature (still developing)WBC.

How does leukemia develop?

Leukemia begins in bone marrow, the soft spongy tissue in the inner cavity of your bones, where your body’s blood cells are made. Blood cells go through multiple stages before reaching their fully mature forms. Mature, normal blood cells include:

• Red blood cells: Cells that carry oxygen and other vital materials to all tissues and organs in your body.
• White blood cells: Cells that fight infection.
• Platelets: Cells that help your blood clot.

These blood cells start as hematopoietic stem cells. The stem cells develop into either myeloid  cells or lymphoid  cells. If blood cells were to continue to develop normally, the mature forms of these cells are as follows:

• Myeloid cells develop into red blood cells, platelets and certain types of white blood cells (basophils, eosinophils and neutrophils).
• Lymphoid cells develop into certain white blood cells (lymphocytes and natural killer cells).

However, if you have leukemia, one of the developing blood cells begins to multiply out of control. These abnormal cells — called leukemia cells — begin to take over the space inside of your bone marrow. They crowd out the cells trying to develop into healthy red blood cells, white blood cells and platelets.

How does leukemia affect my body?

Having too many leukemia cells and too few normal cells is harmful for several reasons:

• Leukemia cells serve no purpose in keeping you healthy.
• Normal blood cells have very 
• little space and support to mature and multiply inside of your bone marrow because the leukemia cells overtake them.
• Fewer red blood cells, healthy white blood cells and platelets are made and released into your blood. As a result, your body’s organs and tissues won’t get the oxygen needed to work properly. Also, your body won’t be able to fight infections or form blood clots when needed.

What are the different types of leukemia?

There are four main types of leukemia and several subtypes. Healthcare providers classify leukemia based on how fast the disease worsens and whether leukemia cells arise from myeloid cells or lymphoid cells.

Classifications of leukemia

Healthcare providers classify leukemia based on how quickly it progresses and the type of blood cell involved.

By speed of disease progression

• Acute leukemia. The leukemia cells divide rapidly and the disease progresses quickly. If you have acute leukemia, you’ll feel sick within weeks of the leukemia cells forming. Acute leukemia is life-threatening and requires immediate initiation of therapy. Acute leukemia is the most common cancer in children.
• Chronic leukemia. Often, these leukemia cells behave as both immature and mature blood cells. Some cells develop to the point where they function as the cells they were meant to become — but not to the extent their normal counterparts do. The disease typically worsens slowly compared to acute leukemia. If you have chronic leukemia, you may not have noticeable symptoms for years. Chronic leukemia is more common in adults than in children.

By cell type

• Myeloid leukemia develops from myeloid cells. Normal myeloid cells develop into red blood cells, white blood cells and platelets.
• Lymphocytic leukemia develops from lymphoid cells. Normal lymphoid cells develop into white blood cells that are an important part of your body’s immune system.

Types of leukemia

There are four main types of leukemia:

AML(Acute myeloid leukemia ) – AML is a type of cancer in which the bone marrow makes a large number of abnormal of blood cells.

CML( Chronic myeloid leukemia ) CML is a type of cancer that effects the white blood cells and tends to progress slowly over many years.

AML (Acute Myelogenous leukemia ) – AML is the most common type of leukemia in children , teens and young adults up to 39.

CLL ( Chronic lymphoytic leukemia ) – issee adults of any age.Symptoms may not appear for several years with CLL.

SYMPTOMS AND CAUSES

Common signs and symptoms of leukemia include:

• Fatigue, tiring easily.
• Fever or night sweats.
• Frequent infections.
• Shortness of breath.
• Pale skin.
• Unexplained weight loss.
• Bone/joint pain or tenderness.
• Pain or full feeling under your ribs on the left side.

What causes leukemia?

Leukemia starts when the DNA of a single cell in your bone marrow changes (mutates). DNA is the “instruction code” that tells a cell when to grow, how to develop and when to die. Because of the mutation, or coding error, leukemia cells keep multiplying. All cells arising from the original mutated cell also have the mutated DNA.

Are certain people at a higher risk for developing leukemia?

Anyone can develop leukemia. Still, studies have shown that certain factors may increase your risk, including:

• Previous cancer treatment. Past cancer treatments involving radiation or chemotherapy may increase the likelihood you’ll develop some types of leukemia.
• Smoking. If you have a history of smoking or exposure to second-hand smoke, you’re at increased risk of developing acute myelogenous leukemia.
• Exposure to industrial chemicals. Benzene and formaldehyde are known cancer-causing chemicals found in building materials and household chemicals. Benzene is used to make plastics, rubbers, dyes, pesticides, drugs and detergents. Formaldehyde is in building materials and household products such as soaps, shampoos and cleaning products.
• Certain genetic disorders. Genetic disorders, Such as Down’s Syndrome.
• Family history of leukemia. Research suggests that some types of leukemia may run in families. In most cases, however, having a relative with leukemia doesn’t mean that you or another family member will also develop leukemia. Tell your healthcare provider if you or a family member has a genetic condition. They may recommend genetic testing to assess your risk.

DIAGNOSIS AND TESTS

            Diagnostic exams and tests may include:

• Physical exam: Your healthcare provider will ask about your symptoms and feel for swollen lymph nodes and an enlarged spleen or liver. They  also inspect your gums for bleeding and swelling. They may look for a skin rash associated with leukemia that may appear red, purple or brown.
• CBC  :    This blood test lets your healthcare provider know if you have abnormal levels of red blood cells, white blood cells and platelets. If you have leukemia, you’ll likely have higher than normal counts of white blood cells.
• Blood cell examination: Your healthcare provider may take additional blood samples to check for markers that indicate the presence of leukemia cells or a specific type of leukemia.
• Bone Marrow Biopsy : Your healthcare provider may perform a biopsy if you have an abnormal white blood cell count. A long needle inserted into your bone marrow (usually in your pelvic bone) draws out fluid during the procedure. The fluid sample gets tested in a lab for leukemia cells. A bone marrow biopsy helps determine the percentage of abnormal cells in your bone marrow, confirming a leukemia diagnosis.
• Imaging and other tests: Your doctor may order a X-Ray, MRI  if symptoms indicate leukemia has affected your bones, organs or tissue. The leukemia cells don’t show up on imaging.

MANAGEMENT AND TREATMENT

            Common treatments often include a combination of the following:

• Chemotherapy :  Chemotherapy is the most common form of leukemia treatment. It involves using chemicals to kill leukemia cells or keep them from multiplying. During treatment, you may receive the chemicals (medication) as a pill, an injection into a vein or a shot under your skin. Usually, you’ll receive a combination of chemotherapy drugs.
• Immuno Therapy :  This treatment uses certain drugs to boost your body’s defense system — your immune system — to fight leukemia. Immunotherapy helps your immune system identify cancer cells and produce more immune cells to fight them.
• Radiation Therapy :  This treatment uses strong energy beams or X-rays to kill leukemia cells or stop them from growing. During treatment, a machine directs radiation to the exact spots in your body where the cancer cells are or distributes radiation over your whole body. Distributing radiation throughout your body may happen before a hematopoietic cell transplant.
•  Stem cell  : This treatment replaces the cancerous blood-forming cells killed by chemotherapy and/or radiation therapy with new, healthy hematopoietic cells. Your healthcare provider may remove these healthy cells from your blood or bone marrow before chemo and radiation, or they may come from a donor. The healthy new cells multiply, forming new bone marrow and blood cells that become the red blood cells, white blood cells and platelets your body needs.