Leukemia – What we Know So Far

Leukemia – What we Know So Far

Known to attack the blood system and to cause abnormalities in white blood cells, Leukemia has always been a dread disease with unknown origins. The cancer is known to start in the bone marrow and eventually brings about abnormalities in the white blood cells. These white blood cells aren’t fully developed and are known as Blasts or Leukemia cells.


Symptoms that follow Leukemia are bruising and bleeding, the feeling of fever, increased risk for infection, and feeling tired. The lack of normal blood cells causes the reactions associated with this disease. Leukemia can be detected by having a bone marrow, or a blood test diagnosis.

There are various types of Leukemia, and each can cause a different variation in the disease. These different variations have different causes connected with them. Environmental and genetic factors play are an important part in contracting this type of cancer. The risk factors associated with Leukemia involves chemicals such as benzene, ionizing radiation, smoking, Down syndrome, and previous chemotherapy treatments. Those who retain a genetic trace with the disease are considered to be very high-risk candidates for contracting this form of cancer.

Leukemia can be broken up into several different classes of the cancer, but the four primary types of this cancer are acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML).

(1) Acute Lymphoblastic Leukemia (ALL) is when an increased amount of immature blood cells are manufactured in the body. Because of the greater number of immature cells, the crowding causes the bone marrow to be unable to build healthy blood cells. Treatment for this type of Leukemia must be immediate due to the fact of the high progression and accumulation of malignant cells in the body. These cells can filter into the blood stream and contaminate other organs causing severe complications. This form of Leukemia is diagnosed high among children.


(2) Chronic Lymphocytic Leukemia (CLL) can be defined as the extensive manufacturing of abnormal, but yet still mature white blood cells. This process usually takes a while to progress, taking months or even years to manifest, eventually producing an outcome where the body has a high rate of abnormal white blood cells that must be treated. The treatment for this type of Leukemia is not as immediate as Acute Lymphoblastic (ALL) because of its slow progression, allowing the physician to plan the most effective course to eradicate the cancer. Most of the time the doctor will wait until the number of abnormal white blood cells are at a potential that will result in the most effective outcome for the patient. Another type of leukemia that is rarely consider to be a subset of this type is Hairy Cell Leukemia. This type of cancer finds itself difficult to be classified into the same ranking as chronic lymphocyctic leukemia. This type of cancer is known to effect eighty percent of adult males, but has not been reported to be diagnosed with children. This form of leukemia has no cure, but is treatable and has a ten-year survival rate that is ranked at ninety-six to one hundred percent.


(3) Acute Myeloid Leukemia (AML) is seen more in adults than children. Men are diagnosed with the cancer more than women and is usually treated with chemotherapy. The rate for those surviving five years is at 40 percent excluding results for Acute Promyelocytic Leukemia which is ranked with a survival rate at 90 percent. Other types of acute myeloid leukemia include acute promyelocyctic Leukemia, acute megakaryoblastic leukemia, and acute myeblastic leukemia.


(4) Chronic Myelogenous Leukemia (CML) is found primarily in adults and in a very small number of children. The cancer is treated with imatinib which is manufactured by Gleevec in the United states and Glivec in Europe.) Other drugs are also used to treat the cancer. The rate of survival for chronic myelogenous leukemia for five years is ninety percent. A derivative of this type of cancer is called chronic myelomonocytic leukemia.


Other specific forms of this cancer type include T-Cell Prolymphotic Leukemia, Granular Lymphocytic Leukemia, Adult T-Cell Leukemia, and Clonal Esosinophilias.


(1) T-Cell Prolymphocyctic Leukemia is rarely diagnosed, but yet is a very aggressive and prevalent form of cancer. This type of leukemia effects more adult men than women. This cancer is ranked to be the most common type of T-Cell Leukemia, as most leukemias effect the B-cells. This type of cancer is hard to treat and the average survival rate is months.


(2) Large Granular Lymphocytic Leukemia has its origins with infected T-cells or NK cells, which is very similar to Hairy Cell Leukemia. This type of cancer is rare to be diagnosed and is not aggressive or indolent.


(3) Adult T-Cell Leukemia has its origins in the human T-lymphotophic virus, which is like HIV. This form of cancer, just HIV, attacks and infects CD4+ T-cells which it then uses to replicate itself. Unlike HIV, it doesn’t destroy the cell.


(4) Clonal Eosinophilias are created by genetic errors in the hematapoietic stem cells which leads to chronic eosinophilic leukemia or to other forms of cancer such as of myeloid neoplasms, myelofibrosis, lymphoid neoplasms, or myelodysplastic syndrome. More mature forms of this disease are associated with tissue and blood eosinophilia.


The treatment for these various types include: radiation therapy, targeted therapy, chemotherapy, and last but not least, bone marrow transplant which also includes palliative and supportive care. These procedures may also include a combination of various methods as well as a combination of each other. Some types of Leukemia may be controlled with the means of ‘watchful waiting.’


Success rates for Leukemia greatly depend upon the particular variation in the cancer which they have as well as the age of the person. Much progress has been made in developing world on how to handle the progressions of this cancer and its outcomes. The average rate in the United States for survival is 57 percent for five years. Children that are under the age of 15 increase the five-year survival rate by 60 to 80 percent, that is based upon the type of Leukemia that they had contracted. For children that are free from cancer after five years, have very low rate for having re-occurrences.


It is estimated that by the year 2015, the disease was recorded to be effecting 2.3 million people with an outcome of 353,500 deaths occurring from the result. This type of cancer is one of the most prevalent in children with most of them suffering from Acute Lymphoblastic Leukemia (ALL). Ninety percent of the cases involving Leukemia are adults that are diagnosed with acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL). Leukemia cases are commonly located in the developed nations of the world.

Common means of curing leukemia can range from the small to the drastic depending upon the rate of the infection and the health of the patient. Each type has its own set of treatment procedures and thus is managed differently according to the patient and the physician.


(1) Acute Lymphoblastic is managed through several means, but the focus is to regulate the bone marrow of the individual. In addition to the normal procedures to regulate the cancer, other locations must have treatments administered to those locations as well to prevent the spread of the disease into other parts of the body. The treatment is separated into different steps or directives to follow and administer. (a) Induction Chemotherapy is used to bring about the remissions in the bone marrow. (b) Consolidate therapy or intensification therapy is incorporated into the procedure in order to eliminate and reduce the remaining leukemia cells still present within the patient. (c) CNS Prophylaxis is a preventative step in high-risk patients to halt the spread of cancer from infecting the brain and nervous system. (d) Maintenance treatments is used in conjunction with chemotherapy to prevent the reoccurrence of the cancer. This part of the treatment may last up to three years. In some cases of high-risk or with relapsed cancer, allogeneic bone marrow transplantation is incorporated to reduce the veracity of leukemia.


(2) Chronic Lymphocyctic usually leads to a decision of wither to treat or not. These complications derived from the fact that the procedure to use on one patient, may not be effective with another. For example, treating patients with a low-grade ranking may not benefit from the treatment, but those with more advanced stages of the cancer may find beneficial outcomes. The usual means to discover if treatment is adequate or not stems from these following variables. (a) The count of your hemoglobin or platelet count is lowering. (b) The progression of the cancer is in a later stage. (c) the lymph nodes and spleen are painful due to a diseased-related overgrowth of the organs. (d) There is an increased rate of lymphocytes in the body. This type of leukemia doesn’t have a cure, so the focus is suppressing the cancer, instead of eliminating. The primary method for regulating this cancer is a combination of chlorambucil, cyclophosphamide with chemotherapy along with a corticosteroid like prednisone or prednisolone. Those who are younger my find that treatment is more effective with autologous or allogeneic bone transplants.


(3) Acute Myelogeous has a wide variety of treatments that can be incorporated into the procedure of eliminating leukemia from the body. Steps to rid the body of this type of leukemia is largely based upon age. The primary strategy is to manage bone marrow and systemic disease, while also regulating care for the central nervous system. (a) A multitude of chemotherapy related drugs are used in the induction phase. (b) Maintenance and consolidation treatments help to stop re-occurrences. The drug doses for this step of the procedure are lower than those introduced in the induction phase.


(4) Chronic Myelogenous comprise many treatments, but the usual care surrounds imatinib therapy (Gleevec). The procedure for treatment has low side effects, allowing ninety percent of the patients to manage their leukemia. For those who have a low tolerance for imatinib or would prefer a more permanent procedure, their option is a allogeneic bone marrow transplant. This does involve high dosages of chemotherapy and radiation treatments as well as bone marrow infusions from a donor. This procedure has about a seventy percent survival rate.


(5) Hairy Cell Leukemia treatments have to be based upon an individual assessment because the treatment is not necessarily needed unless signs or symptoms are showing. The typical treatment procedures include one week of cladribine or six months of pentostatin. In most cases, one session will bring about the results of remission in the patient.


(6) T-cell Prolymphotic is rare and very aggressive with a low survival rate and requires immediate treatment. It is difficult to treat this form of cancer as it doesn’t respond well to most procedures. The most successful outcome with research into this field surrounds a monoclonal antibody that eliminates white blood cells. Many patients also go through stem cell transplantation to increase their responses for recovery.

When treating Leukemia, a successful prognosis depends upon the type of cancer that they are dealing with as well as the age and health of the individual. Many improvements in procedures to properly treat people have been achieved, but sometimes with limited success in areas surround T-cell sourced cancers. Those who are under 15 years old have a very high survival rate depending upon what stage they are in the progression of the cancer.


The outcome of the results also depends if the cancer is acute or chronic as well as the white blood cell count that is in the body. What is the severity of anemia and thrombocytopenia, and the abnormality in the tissue? What are the states of lymph node, bone marrow, and metastasis infiltration? More experience held by a clinic will greatly increase the chances of survival as well as having all of the relevant information to help the patient to psychologically, and physically deal with fact of having leukemia, which can be a very traumatic event, if you are not prepared with the correct information. By having the correct information you will be prepared to handle all questions when it comes to Leukemia and its treatments.