LEUKEMIA

•Cancer of WBC

•WHAT IS LEUKEMIA?

Leukemia is cancer of the

blood cells. It starts in the bone

marrow, the soft tissue inside

most bones. Bone marrow is

where blood cells are made.

Platelet WBCRBC

•When you are healthy, your bone marrow makes:

• White blood cells , which help your body

fight infection.

• Red blood cells , which carry oxygen to all

parts of your body.

• platelets, which help your blood clot.

But When you have leukemia, the bone

marrow starts to make a lot of abnormal white

blood cells, called leukemia cells. They don't

do the work of normal white blood cells, they

grow faster than normal cells, and they don't

stop growing when they should.

Over time, leukemia cells can crowd out the

normal blood cells. This can lead to serious

problems such as anemia, bleeding, and

infections. Leukemia cells can also spread to

the lymph nodes or other organs and cause

swelling or pain.

DEVELOPMENT OF LEUKEMIA IN THE

BLOODSTREAM :

Stage 1- Normal Stage 2- Symptoms Stage 3- Diagnosis

Stage 4- Worsening

Stage 5a- Anemia

Stage 5b- Infection

Legend

White Cell

Red Cell

Platelet

Blast

Germ Sources from Leukemia, by D. Newton and D. Siegel

PICTURES OF BLOOD

Normal human blood

White Cell Red Cell

Platelet

Blood with leukemia

BlastsRed Cell

Platelet

White Cell

Sources from Arginine.umdnj.eduSources from beyond2000.com

ARE THERE DIFFERENT TYPES OF LEUKEMIA?

In general, leukemia is grouped by how fast it

gets worse and what kind of white blood cell it

affects.

It may be acute or chronic. Acute leukemia

gets worse very fast and may make you feel

sick right away. Chronic leukemia gets worse

slowly and may not cause symptoms for

years.

It may be lymphocytic or myelogenous.

Lymphocytic (or lymphoblastic) leukemia

affects white blood cells called lymphocytes.

Myelogenous leukemia affects white blood

cells called myelocytes

•THE FOUR MAIN TYPES OF LEUKEMIA ARE:

Acute lymphoblastic leukemia, or

ALL.

Acute myelogenous leukemia, or

AML.

Chronic lymphocytic leukemia, or

CLL.

Chronic myelogenous leukemia,or

CML.

In adults, chronic lymphocytic leukemia (CLL) and acute myelogenous leukemia (AML) are the most common leukemia. In children, the most common leukemia isacutelymphoblastic leukemia (ALL).

. Childhood leukemias also include acute myelogenous leukemia (AML) and other myeloid leukemias, such as chronic myelogenous leukemia (CML) and juvenile myelomonocyticleukemia (JMML).

WHAT CAUSES LEUKEMIA?

You are more likely to get leukemia if you:

Were exposed to large amounts of radiation.

Were exposed to certain chemicals at work,

such as benzene.

Had some types of chemotherapy to treat

another cancer.

Have Down syndrome or some other genetic

problems.

Smoke.

These things are called risk

factors.

But most people who have these

risk factors don't get leukemia.

And most people who get

leukemia do not have any known

risk factors.

HOW IS LEUKEMIA DIAGNOSED?

To find out if you have leukemia, a doctor will:

Ask questions about your past health and symptoms.

Do a physical exam. The doctor will look for swollen

lymph nodes and check to see if your spleen or liver is

enlarged.

Order blood tests. Leukemia causes a high level of

white blood cells and low levels of other types of blood

cells.

If your blood tests are not normal, the doctor may want

to do a bone marrow biopsy. This test lets the doctor

look at cells from inside your bone. This can give key

information about what type of leukemia it is so you

can get the right treatment.

•WHAT ARE THE SYMPTOMS?

Symptoms may depend on what type of leukemia you

have, but common symptoms include:

Fever and night sweats.

Headaches.

Bruising or bleeding easily.

Bone or joint pain.

A swollen or painful belly from an enlarged spleen.

Swollen lymph nodes in the armpit, neck, or groin.

Getting a lot of infections.

Feeling very tired or weak.

Losing weight and not feeling hungry.

SWOLLEN LYMPH

NODES

RED SPOTS ON THE

SKIN

SOME SYMPTOMS :

TREATMENT OF LEUKEMIA :

There are several ways to treat

leukemia : --Chemotherapy

--Stem cell transplant

--Radiation therapy

--Targeted therapy

--Surgery

TREATMENT OPTIONS

The treatment approach differs from patient to

patient, from one leukemia type to another, and

from a leukemia stage or phase to another.

There are a certain number of factors that

influence the treatment approach:

- The leukemia type

- The patient’s age and symptoms

- Whether or not the leukemia cells are present

in the cerebrospinal fluid

- Features of the leukemia cells

- Whether or not the leukemia was treated

before

CHEMOTHERAPY

Most of the patients that suffer from leukemia

receive chemotherapy and targeted therapy .

Chemotherapy is a systemic treatment

(affects cells throughout the entire body) that

uses drugs either to stop the abnormal

growth and dividing process of the leukemia

cells, or to kill the leukemia cells. This type of

treatment can be administered as a single

drug or in combination with other drugs.

HOW WE CAN GIVE THE CHEMOTHERAPY DRUGS?

1) Oral , administration as pills

2) Intravenous , as an injection into the vein

3)Injectable

- into the cerebrospinal fluid.

- into the spinal (the drugs are injected

straight into the lower part of the spinal

column).

The advantage of this last type of treatment

approach is that the drugs travel on a direct

path from the brain and spinal cord to the

leukemia cells.

STEM CELL TRANSPLANT

Sometimes high doses of chemotherapy are used to treat leukemia that has come back or if there is a high risk that it may come back. High-dose chemotherapy destroys the bone marrow cells as well as the leukemia cells, so the bone marrow will need to be replaced with a transplant of stem cells. All blood cells develop from stem cells found in the bone marrow and in the bloodstream.

Before high-dose chemotherapy is given, stem cells will be taken from you or from a donor whose bone marrow is a close match to your own. Soon after the chemotherapy treatment, the stem cells are put back into your blood. Within a few weeks, the new stem cells will start to make blood cells.

A stem cell transplant is a very complex procedure. For this reason, stem cell transplants are done in specialized transplant centers or hospitals by a team of highly trained healthcare professionals. Side effects can be very serious and may even be life-threatening. You will be watched very closely after a stem cell transplant and carefully followed up for a period of time after leaving the hospital. It may take several months to fully recover after a stem cell transplant.

RADIATION THERAPY :

In external beam radiation therapy, a large machine is

used to carefully aim a beam of radiation. The

radiation damages the cells in the path of the beam –

normal cells as well as cancer cells. Radiation side

effects will be different depending on what part of the

body receives the radiation. You may feel more tired

than usual, have some diarrhea, or notice changes to

the skin (it may be red or tender) where the treatment

was given.

Radiation may be used for some types of leukemia to

treat the disease or prevent it from spreading. If you

need a stem cell transplant, you may also be given

radiation to the whole body to destroy the bone

marrow cells. This is called total body irradiation

TARGETED THERAPY :

Targeted therapies use drugs that attack specific types of cancer cells without damaging healthy cells. Cancer growth inhibitors are a type of targeted therapy. They interfere with a cancer cell’s ability to grow and divide. Some cancer growth inhibitors can be used to treat people with CML, ALL and AML. These drugs are taken by pill or capsule. Side effects are most likely to occur during the first few months of treatment. Side effects may get better as treatment continues.

:SURGERY

Surgery is rarely used to treat chronic leukemia, but some people with chronic leukemia will need to have their spleen removed. The spleen is located in the abdomen and is attached to the stomach, left kidney and colon. In chronic leukemia, the spleen may become enlarged. An enlarged spleen can cause discomfort and pain. It also destroys red blood cells and platelets, causing anemia and bleeding. If chemotherapy or radiation doesn't shrink the spleen, then it may be removed by surgery. Surgery to remove the spleen is called splenectomy. It is done under general anesthetic .

After surgery you may have some pain or bleeding. These side effects are temporary, and can usually be controlled. Without a spleen, you may be more at risk of infections.

GAMMA GLOBULINS (USE AS CLL DRUGS):

One of the major portions of proteins that are

dissolved in the plasma. When plasma proteins are

separated in the laboratory, they are given the

designation of globulin. The globulins can be

separated into three major groups called alpha,

beta, or gamma fractions. The gamma globulins

contain the antibodies in the plasma. These

antibodies are now sometimes referred to as

immune globulins because they are globulins made

by immune cells, specifically B-lymphocytes and

immunoglobulin, are key products of the immune

system because they contain the antibodies that

protect us from infection.

Patients with immune deficiencies such as

those with Chronic Lymphocytic Leukemia

and some patients with lymphoma, whose B-

lymphocytes cannot make gamma globulin,

may be given pooled human gamma globulin

periodically as a treatment in an effort to

correct the deficiency and decrease the risk

of infection. This process is imperfect

because the gamma globulin pooled from

several normal human plasma donors may

not always carry enough of the specific

antibodies needed by the patient.

LEUKEMIA - PREVENTION

There is no known way to prevent most types of leukemia. Most people with leukemia do not have known risk factors. A risk factor is anything that raises your chances of getting a disease.

Some types of leukemia may be prevented by avoiding high doses of radiation, exposure to the chemical benzene, smoking and other tobacco use, or certain types of chemotherapy used to treat other types of cancer.

10\12\2012