2009StanfordE25 Ramon Qiu and Alex Dao

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Leukemia Project

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  • In 1996, one of our brothers, Evan Chen, was diagnosed with Leukemia. Our fraternity, along with many of his friends, organized a joint effort to find a bone marrow donor. What resulted was the largest bone marrow typing drive in the history of the National Marrow Donor Program and AADP.
  • In 1996, one of our brothers, Evan Chen, was diagnosed with Leukemia. Our fraternity, along with many of his friends, organized a joint effort to find a bone marrow donor. What resulted was the largest bone marrow typing drive in the history of the National Marrow Donor Program and AADP.
  • In 2003, Chloe Chang was diagnosed with Acute Promyelocytic Leukemia (APML). Chloe is of Asian and Western European descent and is the daughter of Stanford History Professor Gordon Chang. There are relatively few biracial or minority potential donors in the registry maintained by the National Marrow Donor Program, which matches unrelated donors to patients. That year, Chloe became the primary focus of our organization’s efforts to raise awareness for the importance of becoming a bone marrow donor.
  • Yul Kwon, Cook Islands: Survivor winner, is a spokesman for the AADP. Yul and Evan Chen were best friends at Stanford, and it was largely due to Yul’s initiative and drive that led to the immense success of what was then the largest bone marrow typing drive.
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  • Well, there are actually four different types of Leukemia<number>
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  • For the purpose of our presentation, we will only concentrate on AML because<number>
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  • Here we have a picture of what AML looks like<number>
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  • This crowds out the rest of the cells in the Bone Marrow and causes<number>
  • Anemia is a condition where not enough oxygen is circulating in the body. This is because red blood cells carry oxygen. Anemia causes a person to be pale, tired, and short of breath.<number>
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  • Platelets are crucial in forming blood clots. This is the reason why Leukemia patients get bruised easily and can’t stop bleeding if they have a cut.<number>
  • This is a picture of and AML cell reproducing.<number>
  • Hematopoietic are forces to transform into Leukemia cells through this process<number>
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  • Essentially, steps 2 through 5 allow the Leukemia cells to stay alive and remain undetected by the body’s immune system<number>
  • Essentially this step is where the Leukemia cell reproduces.<number>
  • You see that here circled in this diagram<number>
  • I know we talked about both the traditional treatments as well as emerging solutions, but I wanted to concentrate on the traditional treatments in depth for this project.<number>
  • There are two parts to treating leukemia<number>
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  • For AML patients, chemotherapy is needed as soon as possible because it is so serious.Chemotherapy is where the patient is treated with a multitude of drugs and drug combination.<number>
  • The goal of this is to kill as many AML cells as possible. However because drugs cannot yet differentiate between the cells, it destroys a lot of the good cells as well.<number>
  • Once a patient achieves remission, they begin to feel better. Leukemia cells can’t really be detected in the patient at this point through common tests.<number>
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  • To destroy the undetected AML cell, or to make sure that there aren’t any AML cells left. <number>
  • Generally stem cell transplants use Peripheral blood stem cells from donors. This is the most common form of stem cell transplant today. In some cases however, marrow from a donor is needed as well. <number>
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  • These last steps are the same as mentioned in class. In addition however, each case is catered to the patient depending on 4 factors: age, physical wellbeing, blood and marrow test results, stem cell donor availability<number>
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  • 2009StanfordE25 Ramon Qiu and Alex Dao

    1. 1. Leukemia Ramon Qiu Alex Dao 2009StanfordE25
    2. 2. Asian American Donor Program Modest beginnings in 1989 123 Asian donors in national registry Encourage typing of minorities Launched Latino Outreach Program in 2008
    3. 3. ΛΦΕ Lambda Phi Epsilon is the first and only international Asian American interest fraternity Our National Philanthropy: Raise awareness for Leukemia
    4. 4. AADP
    5. 5. What is Leukemia?
    6. 6. From Lecture: Leukemia is a cancer of a white blood cell. For example, B cell leukemia is when B cells proliferate indefinitely.
    7. 7. Four Types of Leukemia: Acute Myelogenous Leukemia (AML) Acute Lymphocytic Leukemia (ALL) Chronic Myelogemous Leukemia (CML) Chronic Lymphocytic Leukemia (CLL)
    8. 8. Four Types of Leukemia: Acute Myelogenous Leukemia (AML) – Most common form Acute Lymphocytic Leukemia (ALL) Chronic Myelogemous Leukemia (CML) Chronic Lymphocytic Leukemia (CLL)
    9. 9. Four Types of Leukemia: Acute Myelogenous Leukemia (AML) – Most common form Acute Lymphocytic Leukemia (ALL) – Most common in children Chronic Myelogemous Leukemia (CML) Chronic Lymphocytic Leukemia (CLL)
    10. 10. Four Types of Leukemia: Acute Myelogenous Leukemia (AML) – Most common form Acute Lymphocytic Leukemia (ALL) – Most common in children Chronic Myelogemous Leukemia (CML) – More common in adults Chronic Lymphocytic Leukemia (CLL)
    11. 11. Four Types of Leukemia: Acute Myelogenous Leukemia (AML) – Most common form Acute Lymphocytic Leukemia (ALL) – Most common in children Chronic Myelogemous Leukemia (CML) – More common in adults Chronic Lymphocytic Leukemia (CLL) – Only occurs in adults
    12. 12. Acute Myelogenous Leukemia (AML)
    13. 13. Most common form (occurs in adults and children) Most dangerous (fastest acting)
    14. 14. Begins with 1 cell
    15. 15. Begins with 1 cell Cell multiplies into trillions of copies
    16. 16. Begins with 1 cell Cell multiplies into trillions of copies Red blood cells under produced (anemia)
    17. 17. Begins with 1 cell Cell multiplies into trillions of copies Red blood cells under produced (anemia) White blood cells under produced (immune system failure)
    18. 18. Begins with 1 cell Cell multiplies into trillions of copies Red blood cells under produced (anemia) White blood cells under produced (immune system failure) Platelets under produced (stops blood clotting)
    19. 19. http://images.the-scientist.com/content/images/articles/23273/ecology_infoL.jpg
    20. 20. Event 1: BCR-ABL, MLL-ENL, AML1-ETO, etc… Expression of these genes inhibits cell differentiation Forces cells to copy the Leukemia cell.
    21. 21. Event 1: BCR-ABL, MLL-ENL, AML1-ETO, etc… Event 2: Anti-senescence Senescence is a mechanism that forces cells to stop dividing Leukemia cells disable this mechanism
    22. 22. Event 1: BCR-ABL, MLL-ENL, AML1-ETO, etc… Event 2: Anti-senescence Event 3: Anti-apoptotic Apoptosis is a mechanism where a cell destroys itself Apoptosis is necessary when a cell is damaged or infected Leukemia cells disable this mechanism
    23. 23. Event 1: BCR-ABL, MLL-ENL, AML1-ETO, etc… Event 2: Anti-senescence Event 3: Anti-apoptotic Event 4: Apoptosis receptor pathway silenced Apoptosis can also be triggered from surrounding tissue Same idea as Event 3
    24. 24. Event 1: BCR-ABL, MLL-ENL, AML1-ETO, etc… Event 2: Anti-senescence Event 3: Anti-apoptotic Event 4: Apoptosis receptor pathway silenced Event 5: Evade immune cells Events 1-4
    25. 25. Event 1: BCR-ABL, MLL-ENL, AML1-ETO, etc… Event 2: Anti-senescence Event 3: Anti-apoptotic Event 4: Apoptosis receptor pathway silenced Event 5: Evade immune cells Event 6: Activate and over express self renewal path genes
    26. 26. http://images.the-scientist.com/content/images/articles/23273/ecology_infoL.jpg
    27. 27. Treating Leukemia
    28. 28. Induction Therapy Consolidation Therapy
    29. 29. Induction Therapy
    30. 30. Induction Therapy Chemotherapy
    31. 31. Induction Therapy Chemotherapy Kill as many AML cells as possible
    32. 32. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission
    33. 33. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission 3-4 weeks
    34. 34. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission 3-4 weeks Consolidation Therapy
    35. 35. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission 3-4 weeks Consolidation Therapy More chemotherapy
    36. 36. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission 3-4 weeks Consolidation Therapy More chemotherapy Stem cell transplant
    37. 37. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission 3-4 weeks Consolidation Therapy More chemotherapy Stem cell transplant Get blood cell count back to normal
    38. 38. Induction Therapy Chemotherapy Kill as many AML cells as possible Achieve remission 3-4 weeks Consolidation Therapy More chemotherapy Stem cell transplant Get blood cell count back to normal Take immunosuppressant drugs
    39. 39. Myths and Facts
    40. 40. Myth: Donating Bone Marrow is Painful
    41. 41. Myth: Donating Bone Marrow is Painful Fact: Anesthesia is always used Donors feel no pain or needle injections Donors feel a little pain in the lower back a few days after the procedure
    42. 42. Myth: Donating Bone Marrow involves surgery
    43. 43. Myth: Donating Bone Marrow involves surgery Fact: Majority of donations do not involve surgery Usually taking peripheral blood stem cells is enough
    44. 44. Myth: Pieces of Bone are removed from the donor
    45. 45. Myth: Pieces of Bone are removed from the donor Fact: Majority of donations involve taking only blood In marrow donation, only marrow is taken from inside bone, not the bone itself
    46. 46. Myth: Donating Bone Marrow is dangerous
    47. 47. Myth: Donating Bone Marrow is dangerous Fact: The procedure is relatively safe and there are rarely any long term side effects from donating All the donated marrow is replenished within 1 month
    48. 48. Myth: Bone Marrow donation involves a lengthy recovery
    49. 49. Myth: Bone Marrow donation involves a lengthy recovery Fact: Most donors take the drug filgrastim and experience minor symptoms that disappear 2 days after donating Marrow donors will feel tired and some soreness for less than a week, with all symptoms disappearing after 2-3 weeks
    50. 50. Nick Glasgow
    51. 51. Nick Glasgow • 28 years old • Diagnosed with AML in March 2009 • 75% Caucasian and 25% Japanese • Desperately needs your HELP
    52. 52. What you can do NOW • Where do I register? You can register in one of three ways: 1.) Visit a local drive near you. 2.) Call or e-mail AADP for a HOME-TEST KIT if you cannot attend a drive. • 3.) Visit the AADP office in Alameda or a local donor center in Stanford, Oakland, or Sacramento, to register in person. Appointments must be made beforehand. • 4.) Encourage family/friends/dormmates/fraternity brothers/sorority sisters to get their bone marrow typed!
    53. 53. Thank you for registering. SAVE A LIFE TODAY!

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