The word leukemia, which means ‘white blood’, is derived from the two Greek words leukos, meaning “white”, and haima, meaning “blood”, is a group of cancers that usually begin in the bone marrow and result in high numbers of abnormal white blood cells , was named by pathologist Rudolf Virchow in 1845. It is actually a group of different cancers of the blood cells ,can be acute or chronic, and people with chronic leukemias may not notice any symptoms before the condition is diagnosed with a blood test.
There are four main types of leukemias
1.Acute Myeloid Leukemia (AML)
2.Acute Lymphoblastic Leukemia(ALL)
3.Chronic Myeloid Leukemia(CML)
4.Chronic Lymphocytic Leukemia(CLL)
The number of new cases of leukemia was 13.3 per 100,000 men and women per year.In 2012, leukemia developed in 352,000 people globally and caused 265,000 deaths, represents about 3% of the almost seven million deaths due to cancer that year,. It is the most common type of cancer in children, with almost 75% of leukemia cases in children being the acute lymphoblastic type. However, about 90% of all leukemias are diagnosed in adults, with AML and CLL ,being most common in adults.
CANCER & US
Dr. Rajeev Gupta
In India, the average rate of Leukemia incidence is lower than that of developed countries, ALL is commonest Leukemia in Children & CML amongst Adults. But,in the past five years, there has been a 30 % rise in the number of victims affected by Leukemia in India ,especially in Childhood Leukemia where mortality is high.
Leukemia begins in the immature cells of the bone marrow in the central cavities of bones. The bone marrow produces all types of blood cells: red blood cells that carry oxygen and other materials to the tissues of the body, white blood cells that fight infection, and platelets that help the blood clot. Hundreds of billions of new blood cells are produced in the bone marrow each day, providing the body with a constant supply of fresh, healthy cells. In a patient with leukemia, many of the white blood cells produced in the bone marrow do not mature normally. These abnormal cells, called leukemic cells, are unable to fight infection the way healthy white cells can. As they accumulate, the leukemic cells also interfere with the production of other blood cells. Eventually, the body has too few red cells for supplying oxygen to the body’s tissues, too few platelets for proper clotting and too few healthy white cells for fighting infection. As a result, people with leukemia are at risk for bruising, bleeding and infections.
Dr. Rajeev who himself, is a Hematologist, has treated and cured many leukemia patients in his practice says In order to fight leukemia it is important to understand the types of leukemia and how it can be prevented or detected early so that it can treated as early as possible.
Types of leukemia
1. Acute Myeloid Leukemia (AML) : Acute myeloid leukemia is the most common type of leukemia in adults, although it also can occur in children. If untreated, this form of leukemia usually progresses quickly.
2. Chronic Myeloid Leukemia (CML) : Chronic myeloid leukemia originates from the presence of a genetic abnormality in blood cells, called the Philadelphia chromosome, and progresses through distinct phases. CML occurs mainly in adults, but a very small number of children also develop this disease.
3. Acute Lymphoblastic Leukemia (ALL) : Acute lymphoblastic leukemia is the most common type of leukemia in young children in developed countries, but it also affects adults, especially those ages 65 and older.
4. Chronic Lymphocytic Leukemia (CLL): Chronic lymphocytic leukemia usually gets worse slowly. CLL is the second most common form of leukemia in adults and rarely occurs in children. More than half of people diagnosed with CLL are older than 70, and cases rarely occur in individuals younger than 40.
For the diagnosis of leukemia, the doctor must examine cells from the blood and, in most cases, the bone marrow. An initial blood test (complete blood count [CBC]) showing an abnormal white cell count may indicate the need for a bone marrow biopsy to confirm the diagnosis and to identify the specific type of leukemia. During this procedure, the doctor removes a sample of bone marrow tissue (biopsy) from a pelvic bone and tests the sample for cancer cells.
Treatment options of Leukemia depends on the type of leukemia
* Chemotherapy is the administration of drugs that kill rapidly dividing cells such as leukemia or other cancer cells.
* Biological therapy or immunotherapy uses the body’s immune system to fight cancer, using antibodies to target and destroy leukemia cells, example of a monoclonal antibody is Alemtuzumab used in the treatment of CLL & Interferons in the treatment of CML.
* Targeted therapy ,are drugs that interfere with one specific property or function of a cancer cell, rather than acting to kill all rapidly growing cells indiscriminately like chemotherapy . Imatinib and dasatinib are examples of targeted therapies that are used to treat CML
* Sometimes,Radiation therapy is used for leukemia in the central nervous system or testicles as well as for pain caused by bone destruction. However, radiation is not the primary treatment for leukemia.
* Stem cell transplant, high doses of chemotherapy and/or radiation are given to destroy leukemia cells along with normal bone marrow. Then, transplant stem cells are delivered by an intravenous infusion. The stem cells travel to the bone marrow and begin producing new blood cells. Stem cells may come from the patient , known as autologous stem cell transplantation or from a donor, known as allogeneic stem cells transplant ,
Stem Cell or Bone Marrow Transplants are probably the best bet for a cure in many cases of leukemia Esp AML & ALL. It is performed when leukemia is in remission or when the patient relapses during or after treatment.
Now a days, patients are surviving longer, thanks mainly to advances in treatment and medical facilities. Acute Lymphoblastic Leukemia (ALL), for example, represents one of the most dramatic success stories in cancer treatment. Almost 90 percent of children diagnosed with the disease attain remission. Also Adult patients treated for ALL have an 80 percent to 90 percent chance of attaining remission. Patients treated for Acute Myeloid Leukemia (AML) have a 60 percent to 70 percent chance of remission; about 20 percent of those survive at least three years, with a possibility of a full cure.
(The author is working as Assistant Professor at Sri Guru Ram Dass Institute of Medical Sciences & Research, Amritsar & consultant Medical Oncologist & Hematologist at Sanjeevani Cancer Clinic, Jammu.)
Causes & Risk Factors of Leukemia
* Exposure to large amounts of high energy radiation
* Occupational exposure to the chemical benzene
* Viral infections
* Cigarette smoking
* Previous chemotherapy for cancer treatment
* Human T-cell leukemia virus 1 (HTLV-1)
* Down syndrome and other genetic diseases
Symptoms of Leukemia
* Fever, chills, night sweats and other flu-like symptoms
* Weakness and fatigue
* Swollen or bleeding gums
* Enlarged liver and spleen
* Swollen tonsils
* Bone pain
* Pinhead-size red spots on the skin
* Weight loss
(If any query, Dr Rajeev Gupta can contacted @ email: firstname.lastname@example.org)