Treatment leukemia How Treatable Is Leukemia ?

Treatment leukemia How Treatable Is Leukemia ?

treatable is leukemia

Leukemia facts

Leukemia is a cancer of the blood cells (and therefore sometimes known as blood cancer).

Although the exact causes of leukemia are not known, they have been identified risk factors, such as exposure to radiation, some chemotherapy for cancer, smoking, a family history of leukemia and exposure to Some chemicals such as benzene.

Common symptoms of chronic or acute leukemia may include

Pain in the bones or joints,
Swelling of the lymph nodes that usually not bad,
Fevers or night sweats,
Feeling weak or tired,
Bleeding and bruising easily,
Frequent infections,
Malaise or swelling of the abdomen,
Weight loss or loss of appetite.

Leukemias are grouped by the speed with which the disease (acute or chronic) develops, as well as the type of blood cells (affected lymphocytes or myelocytes). The four main types of leukemia, including acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML) and chronic myeloid leukemia (CML).

People with leukemia have a significantly higher risk of developing infections, anemia and bleeding. Other symptoms and signs include bruising, weight loss, night sweats and unexplained fever.

The diagnosis of leukemia is based on the results of history and clinical examination and examination of blood and bone marrow samples under the microscope.

The treatment of leukemia depends on the type of leukemia, certain characteristics of the leukemic cells, the extent of the disease and a history of treatment, as well as the age and health of the patient.

Most patients with leukemia are treated with chemotherapy. Some patients may also have radiotherapy and / or bone marrow transplant.

There is no known way to prevent leukemia.

The prognosis of leukemia depends on several factors, including the age of the patient, the type of leukemia and the extent to which the cancer is spread.

What is leukemia? What are the different types of leukemia?

Leukemia is a malignant tumor (cancer) of the blood cells. In leukemia, the abnormal blood cells produced in the bone marrow. Usually, leukemia involves the production of abnormal white blood cells - the cells responsible for fighting infection. However, abnormal cells in leukemia function not in the same way as normal white blood cells. Leukaemic cells continue to grow and divide, possibly leading to normal blood cells. The end result is that it becomes difficult for the body to fight infections, bleeding control and oxygen transport.

There are different types of leukemia, depending on how quickly the disease and the type of abnormal cells produced develops. Acute leukemia called leukemia if it develops rapidly. A large number of leukemic cells accumulate very rapidly in the blood and bone marrow, resulting in symptoms such as fatigue, bruising and sensitivity to infections. Acute leukemia requires rapid and aggressive treatment.

There are approximately 62,000 new cases of leukemia each year in the United States and about 24,500 deaths from leukemia. Leukemia accounts for about 3.7% of all new cases of cancer.

Chronic leukemias develop slowly over time. These leukemias can not cause specific symptoms at the beginning of its course. If untreated, the cells can reach a high number, as in acute leukemias that cause similar symptoms.

Leukemias are further classified as lymphoid or myeloid, depending on the type of white blood cells that includes leukemic cells. A basic understanding of the normal development of blood cells to understand the different types of leukemia is necessary. Normal blood cells develop from stem cells that have the potential to develop into several cell types. Myeloid stem cells mature in the bone marrow and become immature white cells called myeloid explosions. These mature myeloid explosions further into the red blood cells, platelets or certain types of white blood cells. Mature lymphoid stem cells in the bone marrow to become lymphoid explosions. Lymphoid develop more T- or B-cell explosions, special types of white blood cells. Myeloid leukemias are composed of cells resulting from myeloid, lymphoid while the leukemias come from lymphoid cells. Knowing the type of cell involved in leukemia is important in choosing the appropriate treatment.

Common types of leukemia

The four types of leukemia are acute lymphoblastic leukemia, chronic lymphocytic leukemia, acute myeloid leukemia and most common chronic myeloid leukemia.

Acute lymphoblastic leukemia (LAL, also known as acute lymphoblastic leukemia) is the most common type of leukemia in children but can also affect adults. In this leukemia, immature lymphoid cells develop rapidly in the blood. It affects more than 6,000 people a year in the United States

Acute myeloid leukemia (LMA, also known as acute myeloid leukemia) involves rapid growth of myeloid cells. It occurs in adults and children and affects approximately 21,000 people each year in the United States

Chronic lymphocytic leukemia (CLL) is a slow-growing cancer of lymphoid cells that usually affects people over 55 years of age. It is estimated that approximately 20,000 people in the United States are affected each year. Rarely occurs in children or adolescents.

Chronic myeloid leukemia (CML, also known as chronic myeloid leukemia) primarily affects adults and occurs in about 8950 people each year in the United States

Less common types of leukemia count for about 6,000 cases of leukemia each year in the US

Hairy cell leukemia is a rare type of chronic leukemia.

• Chronic myelomonocytic leukemia (LMMC) is another type of chronic leukemia that develops from myeloid cells.
• Juvenile myelomonocytic leukemia (LMMJ) is a type of myeloid leukemia that usually occurs in children under 6 years of age.
• Large granular lymphocytic leukemia (LGL leukemia) is a type of chronic leukemia develops from lymphoid cells. It can be slow or fast growing.
• Acute leukemia Promeylocítica (APL) is a subtype of AML

leukemia

What causes leukemia? Is hereditary leukemia?

The exact cause of leukemia is unknown, but it is thought to involve a combination of genetic and environmental factors. Leukemia cells have acquired mutations in DNA that cause abnormal growth and lose typical white blood cell functions. One does not know what causes these mutations to occur. One type of DNA modification of cells is common in leukemias known as a chromosomal translocation. In this process, part of a chromosome breaks off and adheres to another chromosome. Translocation observed in almost all cases of CML and sometimes in other types of leukemia is a DNA exchange between chromosomes 9 and 22, leading to what is known as the Philadelphia chromosome. This creates an oncogene (cancer gene promoter) known as BCR-ABL. This change in DNA is not hereditary, but occurs at some point in the life of the person concerned.

No cases of leukemia are considered hereditary, but some genetic mutations and conditions can be passed on to children who increase the chances of developing leukemia. A condition known as Li-Fraumeni syndrome is characterized by a hereditary mutation in a tumor suppressor gene known as TP53, and individuals with this disease have a higher risk of leukemia and other cancers. Other hereditary diseases that may increase the risk of developing leukemia include Down syndrome, neurofibromatosis type 1, ataxia telangiectasia and Noonan syndrome.

What are the risk factors for leukemia?

It is known that exposure to radiation increases the risk of developing AML, CML or ALL. Increases were observed in leukemia in people who survived atomic bombs. Radiation therapy for cancer can also increase the risk of leukemia. Exposure to certain chemicals, including benzene (commonly used in the chemical industry), increases the risk of leukemia. It is known that smoking increases the risk of developing AML.

Some genetic disorders may increase risk; Down syndrome, Li-Fraumeni syndrome and other medical conditions may increase the risk of developing leukemia. Blood disorders called myelodysplastic syndromes confer an increased risk of AML. Type 1 human T-cell leukemia virus (HTLV-1) is a virus that causes a rare form of leukemia. Some chemotherapy drugs for cancer may increase the risk of AML or ALL.

Having risk factors does not mean that a person really leukemia, and most people with risk factors will not develop the disease. Similarly, all those who develop leukemia have an identifiable risk factor.

Symptoms and signs of leukemia depend on the type of leukemia. As mentioned above, or slow-growing chronic leukemia can not cause early symptoms, while leukemia with rapid or aggressive growth can result in severe symptoms. The symptoms of leukemia come from a loss of normal blood cell function or abnormal cell accumulation in the body.

The signs and symptoms of leukemia are usually the following:

• fever
• night sweats
• Swelling painless lymph nodes usually
• The feeling of fatigue, fatigue
• Bleeding or bruising, causing bluish spots or purplish skin or tiny red spots on the skin, or recurrent nosebleeds
• Frequent infections
• Pain in the bones or joints
• Weight loss that would otherwise not be explained, or loss of appetite
• Enlargement of the spleen or liver, which can result in abdominal pain or swelling
• Red spots (petechiae)
• If the leukemic cells have infiltrated the brain, there may be symptoms such as headache, convulsions, confusion, loss of muscle control and vomiting.

How do doctors diagnose leukemia?

Hematologists are medical specialists who diagnose and treat blood diseases, including leukemia; Hematologists and oncologists treat blood diseases such as leukemia and other cancers.

In addition to a medical history (learn about symptoms and risk factors) and a physical examination for signs of leukemia (enlarged lymph nodes, enlarged spleen), the diagnosis of leukemia usually involves Laboratory of a blood sample. An abnormal number of blood cells may suggest a diagnosis of leukemia, and a blood sample can also be examined under the microscope to see if the cells appear abnormal. It can also get a bone marrow sample for diagnosis. For a bone marrow aspirate, a long and fine to take a sample of bone marrow from the hip, under the local anesthesia needle is used. A biopsy of the bone marrow involves inserting a thick, hollow needle into the hip bone to take a sample of bone marrow using local anesthesia.

Blood cells and bone marrow are further tested if leukemia cells. These additional tests look for genetic alterations and expression of certain cell surface markers by cancer cells (immunophenotyping of). The results of these tests are used to help determine the precise classification of leukemia and to decide the optimal treatment.

Other tests that may be useful include a chest x-ray to determine if the lymph nodes or other signs of lumbar puncture disease and to take a cerebrospinal fluid sample to determine whether leukemia cells have infiltrated into the Membranes and the space surrounding the brain and spinal cord.

Imaging tests such as MRI and CT may also be useful for some patients to determine the extent of the disease..

What is the treatment of leukemia?

There are a number of different medical approaches to treating leukemia. The treatment will generally be a function of the type of leukemia, the age of the patient and the state of health and whether the leukemia cells have spread to the cerebrospinal fluid. Genetic modifications or specific characteristics of leukemic cells determined in the laboratory can also determine the type of treatment may be more appropriate.

Waiting under surveillance may be an option for some people with chronic leukemia who have no symptoms. This involves close monitoring of the disease so that treatment can begin when the symptoms develop. Vigilant waiting allows the patient to avoid or delay the side effects of treatment. The risk of waiting is that it can eliminate the possibility of control leukemia before it gets worse.

Treatments for leukemia include chemotherapy (primary mode of leukemia treatment), radiotherapy, biological therapy, targeted therapy and stem cell transplantation. They can be used combinations of these treatments. Splenectomy may be a part of the treatment if the spleen grows.

Acute leukemia should be treated at the time of diagnosis, in order to induce remission (absence of leukemic cells in the body). After remission, treatment can be administered to prevent relapse of leukemia. This is called consolidation or maintenance treatment. Acute leukemias can often be cured with treatment.

It is unlikely that chronic leukemias are cured with a treatment, but treatments can often control the symptoms of cancer and control. Some people with chronic leukemia may be candidates for stem cell transplantation, which provides an opportunity for healing.

Many patients choose to receive a second opinion before beginning the treatment of leukemia. In most cases, it is time for a second opinion and consider treatment options without making treatment less effective. However, in rare cases of very aggressive leukemia, treatment should begin immediately. Someone should discuss with a doctor the possibility of getting a second opinion and any delay in treatment. Most doctors welcome the possibility of a second opinion and should not be offended by a patient's desire to get one.

chemotherapy

Chemotherapy is the administration of drugs that kill rapidly dividing cells, such as leukemia and other cancer cells. Chemotherapy can be taken orally in the form of a pill or tablet, or can be administered via a catheter intravenously or directly into the bloodstream. Combined chemotherapy is usually given, which involves a combination of more than one drug. The drugs are administered in cycles with intermediate rest periods.

Sometimes, chemotherapy drugs for leukemia are administered directly into the cerebrospinal fluid (known as intrathecal chemotherapy). Intrathecal chemotherapy given in addition to other types of chemotherapy and can be used to treat leukemia in the brain or spinal cord or in some cases to prevent the spread of leukemia to the brain and spinal cord. Ommaya tank is a special catheter placed under the scalp to deliver chemotherapy drugs. It is used for children and some adult patients as a way to avoid injections into the cerebrospinal fluid.

The side effects of chemotherapy depend on the particular medications taken and the dose or diet. Some side effects of chemotherapy drugs include hair loss, nausea, vomiting, sores in the mouth, loss of appetite, fatigue, bruising or bleeding and an increased likelihood of infection due To the destruction of white blood cells. There are medications to help control the side effects of chemotherapy.

Some adult men and women receiving chemotherapy suffer damage to the ovaries or testicles, resulting in infertility. Most children receiving chemotherapy for leukemia have normal fertility in adulthood, but depending on the drugs and doses used, some may have infertility in adulthood.

Biological therapy

Biotherapy is a treatment using living organisms, substances from living organisms, or synthetic versions of these substances to treat cancer. These treatments help the immune system to recognize abnormal cells and attack them. Various biological therapies cancers can include antibodies, tumor vaccines or cytokines (substances produced in the body to control the immune system). Monoclonal antibodies are antibodies that react against a specific target used in the treatment of many cancers. An example of a monoclonal antibody used in the treatment of leukemia is alemtuzumab, which targets the CD52 antigen, a protein present in chronic B-cell lymphocytic leukemia (CLL) cells. Interferons are cellular signaling chemicals that have been used in the treatment of leukemia.

The side effects of biological therapies tend to be less severe than those of chemotherapy and may include a rash or swelling at the injection site for intravenous infusion of therapeutic agents. Other side effects may include headaches, muscle aches, fever or fatigue.

Targeted therapy

Targeted therapies are drugs that interfere with a particular property or function of a cancer cell, rather than acting to indiscriminately kill all rapidly growing cells. This means that there is less damage to normal cells with targeted therapy with chemotherapy. Targeted therapies can cause the target cell to stop growth instead of dying, and interfere with specific molecules that promote the growth or spread of cancer. Cancer-directed therapies are also called targeted drugs, molecularly precise treatments or molecularly targeted medicines.

Monoclonal antibodies (described above in the section on biological therapy) are also considered targeted therapies as they interfere and interact specifically with a specific target of the protein on the surface of cancer cells. Are examples of targeted therapies Imatinib (Gleevec) and dasatinib (Sprycel) used to treat CML, ALL some cases and other cancers. These drugs target cancer-promoting protein that is formed by translocating the BCR-ABL gene.

Targeted therapies are given as tablets or by injection. Side effects can include swelling, swelling and sudden weight gain. Other side effects may include nausea, vomiting, diarrhea, muscle cramps or rash.

Radiotherapy

Radiation therapy uses high-energy radiation to direct cancer cells. Radiation therapy can be used in the treatment of leukemia that has spread to the brain, or can be used to attack the spleen or other areas where leukemia cells have accumulated.

Radiation therapy can cause side effects, but it is unlikely to be permanent. The side effects depend on the location of the radiating body. For example, radiation to the abdomen can cause nausea, vomiting and diarrhea. With radiation treatment, the skin in the treated area can become red, dry and tender. Generalized fatigue is also common during radiotherapy.

Stem Cell Transplantation

In stem cell transplantation, high-dose chemotherapy and / or radiation are given to kill leukemic cells with normal bone marrow. Then, stem cell transplantation is administered by intravenous infusion. Stem cells go into the bone marrow and start producing new blood cells. Stem cells can come from the patient or from a donor.

Autologous stem cell transplantation refers to the situation where the patient's own stem cells are removed and attempt to destroy leukemic cells. Then they returned to the body after the leukemic cells of the bone marrow were destroyed.

Allogeneic stem cells refers to stem cells grafted from a donor. These can be a parent or unrelated donor. A syngeneic stem cell transplant using stem cells taken from a healthy twin patient.

Stem cells can be removed (harvested) in different ways. As a general rule, they are taken from blood. They can also be harvested from bone marrow or umbilical cord blood.

Stem cell transplant is done in a hospital, and you have to stay in the hospital for several weeks. Procedural risks include infection and bleeding due to the depletion of normal blood cells. A risk of stem cells with donor cells is known as graft versus host disease (GVHD). In GVHD, white blood cells of donors react against the normal tissues of the patient. The LV Permit can be mild or severe and often affects the liver, skin or gastrointestinal tract. GVHD can occur at any time after the transplant, or even years later. Steroids can be used or drugs that suppress the immune response to treat this complication.

Support treatments

As many of the treatments for leukemia depletion of normal blood lymphocytes, which increases the risk of bleeding and infection, supportive treatment may be needed to help prevent these complications from treatment. Support treatments may also be needed to help reduce and manage the unpleasant side effects of medical treatment or radiation therapy.

Types of treatments and preventive support that can be used for patients undergoing treatment for leukemia include:

• Vaccines against influenza and pneumonia

• Blood transfusions or platelets

• Anti-nausea medications

• Antibiotics or antiviral drugs to treat or prevent infections

• Growth factors of white blood cells to stimulate white blood cell production (such as granulocyte colony stimulating factor [G-CSF], formed by filgrastim [Neupogen] and pegfilgrastim [Neulasta], and to stimulate growth of colon Granulocytes macrophage [GM-CSF], sargramostim compound [Leukin])

• Red cell growth factors to stimulate the production of red blood cells (darbepoetin alfa [Aranesp] or epoetin alfa [Procrit])

• Intravenous immunoglobulin to help fight infection