LEUKEMIA 

Leukemia is cancer that starts in the tissue that forms blood. Most blood cells develop from cells in the bone marrow called stem cells. In a person with leukemia, the bone marrow makes ABNORMAL WHITE BLOOD CELLS. The abnormal cells are leukemia 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. 

The four main types of leukemia are:

• Acute lymphoblastic leukemia (ALL)

• Acute myelogenous leukemia (AML)

• Chronic lymphocytic leukemia (CLL)

• Chronic myelogenous leukemia (CML)

ETIOLOGY: THE RISK FACTORS OF LEUKEMIA

Genetic disorders:

 Down syndrome

 Klinefelter syndrome

 Patau syndrome

 Ataxia telangiectasia

 Shwachman syndrome

 Kostman syndrome

 Neurofibromatosis

 Fanconi anemia

 Li-Fraumeni syndrome

Radiation exposure

 Nontherapeutic, therapeutic radiation 

Physical and chemical exposures

 Benzene Drugs such as pipobroman

 PesticidesCigarette smoking

 Embalming fluids

 Herbicides

 Chemotherapy

 Alkylating agents

 Topoisomerase-II inhibitors

 Anthracyclines

 Taxanes

MANIFESTATIONS:

The symptoms of Acute Leukemia develop very quickly (within a few days or weeks ) whereas, Chronic Leukemia can go unnoticed for years and is usually found in a routine blood test.

The following conditions can develop in Leukemia patients

• Anemia (a deficiency of red blood cells and hemoglobin)

• Thrombocytopenia (a low blood platelet count)

• Enlarged liver or Spleen (leukemia cells build up in the liver or spleen )

• Leukopenia (A low white blood cell count

• Other Symptoms

o Leukemia can also cause vomiting, confusion, loss of muscle control and seizures.

o Swollen Lymph nodes

o Fever or Chills

o Night Sweating

o Joint and bone pain

CHRONIC MYELOID LEUKEMIA

• This type affects the lymphoid cells created in the bone marrow. It is classified as chronic leukemia, because the affected cells carry out some of their normal functions initially, making it difficult to detect.

ACUTE MYELOID LEUKEMIA

• The more severe form of the disease is acute myeloid leukemia, which is characterized by faster progression of the disease. This is the most commonly incident type among adults. If detected early, statistics show that 20% to 40% of patients survive for at least 60 months.

CHRONIC LYMPHOCYTIC LEUKEMIA

• This type almost never occurs among children and has a very high incidence rate among people aged more than 60.

• Men are more likely to be affected by it, than women.

• Progression of this disease is slow.

• If the disease has affected the B-cells, then life expectancy can be anywhere between 10 to 20 years, if treatment begins early. However, those with T cell chronic lymphocytic leukemia have a very low life expectancy.

ACUTE LYMPHOCYTIC LEUKEMIA

• The most common form of cancer in children is acute lymphocytic leukemia. One-fourth of all cancers in children belong to this type.

• It has a high incidence rate among adults, older than 45 years of age. Chemotherapy is the established treatment method for this disease.

• Before chemotherapy and other cancer cure methods were invented, a patient with acute lymphocytic leukemia could survive for 4 months at the most.

• However, thanks to modern treatment methods, about 80% of the affected children are completely cured. Adults have been seen to have a 40% chance of complete cure.

• The prognosis for this type will vary, depending on the stage of disease progression, but children in the age group of 3 to 7 seem to have the highest chance of complete recovery.

DIAGNOSTICS:

• Physical exam. Your doctor will look for physical signs of leukemia, such as pale skin from anemia and swelling of your lymph nodes, liver and spleen.

• Blood tests. By looking at a sample of your blood, your doctor can determine if you have abnormal levels of white blood cells or platelets, which may suggest leukemia.

• Bone marrow test. Your doctor may recommend a procedure to remove a sample of bone marrow from your hipbone. The sample is sent to a laboratory to look for leukemia cells.

TREATMENT:

Most treatment plans for acute lymphoblastic leukemia have 3 steps. These are induction, consolidation, and maintenance.

• Induction Therapy: Killing of leukemia cells in the blood and bone marrow. Treatments include chemotherapy. Induction usually lasts for 4 weeks.

• Consolidation Therapy: Killing of leukemia cells that may be present even though they don’t show up in tests. If these cells are not killed, they could regrow and could cause a relapse. Treatment include chemotherapy and may include stem cell transplant (replacement of damaged bone marrow cells with healthy ones).

• Maintenance Therapy: Preventing any remaining leukemia cells from growing by using low doses of chemotherapy and intravenous treatment (the infusion of liquid substances directly into a vein).