causes of leukemia

Leukemia
I. Introduction
II. Causes
III. Symptoms
IV. Types
V. Diagnosis
VI. Treatment
VII. References
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What is Leukemia?
Leukemia is a type of cancer of the blood or bone marrow characterized by
an abnormal increase of immature white blood cells called "blasts". Leukemia
is a broad term covering a spectrum of diseases. In turn, it is part of the even
broader group of diseases affecting the blood, bone marrow, and lymphoid
system, which are all known as hematological neoplasms.
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Leukemia: Causes
Experts do not know what
causes leukemia. They do not
know why some people get it
and others do not. It is likely
that the different types of
leukemia have different
causes.
A serious fact
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What is Leukemia?
Leukemia is a treatable disease. Most treatments involve chemotherapy,
medical radiation therapy, or hormone treatments. The rate of cure depends
on the type of leukemia as well as the age of the patient. Children are more
likely to be permanently cured than adults. Even when a complete cure is
unlikely, most people with a chronic leukemia and many people with an
acute leukemia can be successfully treated for years.
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Causes of Leukemia
Working with certain chemicals — Exposure to high levels of
benzene in the workplace can cause leukemia. Benzene is used
widely in the chemical industry. Formaldehyde is also used by the
chemical industry. Workers exposed to formaldehyde also may be at
greater risk of leukemia.
Benzene as a cause of leukemia had documented since 1928. In 1948, the American
Petroleum Institute officially reported a link between this solvent used in many of their
industries used and cases of leukemia in their workers. Their findings concluded that the
only safe level of benzene exposure is no exposure at all.
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Causes of Leukemia
Very high levels of radiation — People exposed to very high levels of
radiation are much more likely than others to develop leukemia. Medical treatment
that uses radiation can be another source of high-level exposure. Radiation used for
diagnosis, however, exposes people to much lower levels of radiation and is not
linked to leukemia.
Very high levels of radiation have been caused by atomic bomb explosions (such as those in
Japan during World War II) and nuclear power plant accidents (such as the Chernobyl [also
called Chornobyl] accident in 1986).
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Causes of Leukemia
Chemotherapy — Cancer patients treated with certain cancer-fighting
drugs sometimes later develop leukemia. For example, drugs known as
alkylating agents are associated with the development of leukemia
many years later.
For patients treated for Hodgkin lymphoma (HL), cumulative doses of alkylating agent (AA)
is associated with the risk of therapy-related acute myeloid leukemia/myelodysplastic
syndrome (t-AML/MDS), according to a study published online Jan. 7 in the Journal of Clinical
Oncology.
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Causes of Leukemia
Smoking— Tobacco products are the single, major avoidable cause of
cancer. Smoking is also causally associated with cancers of the pancreas,
kidney, bladder, stomach, and cervix and with myeloid leukemia.
SMOKING cigarettes may increase a person's risk of contracting leukemia by 30 percent and
cause up to 3,600 cases of adult leukemia a year in the United States. (Published February 3,
1993)
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Causes of Leukemia
Down syndrome and certain other genetic diseases — Some diseases
caused by abnormal chromosomes may increase the risk of leukemia.
Down syndrome was linked to leukemia for the first time in a case report published in 1930.
Since then, Down syndrome has been recognized as one of the most important leukemia-
predisposing syndromes and patients with Down syndrome and leukemia have unique clinical
features and significant differences in treatment response and toxicity profiles compared to
patients without Down syndrome.
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Leukemia: Symptoms Over 1 million Americans are
living with, or are in
remission from, leukemia,
lymphoma or myeloma.Cure means that there are no
traces of your cancer after
treatment and the cancer will
never come
back. Remission means that the
signs and symptoms of
your cancer are
reduced. Remission can be
partial or complete
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Symptoms
Like all blood cells, leukemia cells travel through the body. Depending on the
number of abnormal cells and where these cells collect, patients with leukemia may
have a number of leukemia symptoms.
Acute leukemia symptoms appear and get worse quickly. Chronic leukemia
symptoms may not appear for a long time; when leukemia symptoms do appear,
they generally are mild at first and get worse gradually.
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General Symptoms
• Swollen or tender lymph nodes, liver,
or spleen;
• Easy bleeding or bruising
• Tiny red spots (called petechiae) under
the skin
• Swollen or bleeding gums;
• Sweating, especially at night; and/or
• Bone or joint pain.
• Fever, chills, and other flu-like
symptoms
• Weakness and fatigue
• Frequent infections
• Loss of appetite and/or weight
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Symptoms
• In acute leukemia, the abnormal cells may collect in the brain or spinal cord (also
called the central nervous system or CNS). The result may be headaches, vomiting,
confusion, loss of muscle control, and seizures. Leukemia cells also can collect in the
testicles and cause swelling. Also, some patients develop sores in the eyes or on the
skin. Leukemia also can affect the digestive tract, kidneys, lungs, or other parts of the
body.
• In chronic leukemia, the abnormal blood cells may gradually collect in various parts of the body. Chronic
leukemia may affect the skin, central nervous system, digestive tract, kidneys, and testicles.
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Types
There are several types of leukemia. The different types of
leukemia are grouped in two ways. One way is by how quickly the
disease develops and gets worse. The other way is by the type of
blood cell that is affected.
• by how quickly the disease develops
• Chronic
• Acute
• by the type of blood cell that is affected
• Lymphoid cells
• Myeloid cells
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Chronic leukemia
• In chronic leukemia, the leukemia cells come from mature,
abnormal cells. The cells thrive for too long and accumulate.
The cells grow slowly. It is not unusual in chronic cases for
symptoms to take a long time to even appear.
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Acute leukemia
• Acute leukemia develop from early cells, called "blasts".
Blasts are young cells, that divide frequently. They target
immature cells, causing symptoms to appear quickly. In
acute leukemia cells, they don't stop dividing like their
normal counterparts do.
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Lymphocytic leukemia
• Lymphocytic leukemia begins from white blood cells called
lymphocytes or immature types of lymphocytes. It
commonly affects lymph nodes in the body but can invade
all body tissues.
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Myelogenous or Myeloid
• Myelogenous leukemia involves the other 3 common types
of white blood cells known as granulocytes. They are the
neutrophils, eosinophils, or basophils.
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Diagnosis
The diagnosis of leukemia frequently occurs following a routine
blood test that results in an abnormal blood cell count. If you have
symptoms that suggest leukemia, your doctor will try to find out
what's causing the problems. Your doctor may ask about your
personal and family medical history.
You may have one or more of the following tests:
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Blood tests
• Blood tests: The lab does a complete blood count to check
the number of white blood cells, red blood cells, and
platelets. Leukemia causes a very high level of white blood
cells. It may also cause low levels of platelets
and hemoglobin, which is found inside red blood cells.
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Diagnosis
• Biopsy: Your doctor removes tissue to look for cancer cells. A
biopsy is the only sure way to know Your doctor removes some
bone marrow from your hipbone or another large bone. A
pathologist uses a microscope to check the tissue for leukemia
cells. There are two ways your doctor can obtain bone marrow.
Some people will have both procedures during the same visit:
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Diagnosis
• Biopsy
• Bone marrow aspiration: The doctor uses a thick, hollow
needle to remove samples of bone marrow.
• Bone marrow biopsy: The doctor uses a very thick,
hollow needle to remove a small piece of bone and bone
marrow.
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Diagnosis
• Cytogenetics: The lab looks at the chromosomes of cells from
samples of blood, bone marrow, or lymph nodes. If abnormal
chromosomes are found, the test can show what type of leukemia
you have. For example, people with CML have an abnormal
chromosome called the Philadelphia chromosome.
• Chest x-ray: An x-ray can show swollen lymph nodes or other signs
of disease in your chest.
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Diagnosis
• Spinal tap: Your doctor may remove some of the cerebrospinal fluid
(the fluid that fills the spaces in and around the brain and spinal cord).
The doctor uses a long, thin needle to remove fluid from the lower
spine. The procedure takes about 30 minutes and is performed with
local anesthesia. You must lie flat for several hours afterward to keep
from getting a headache. The lab checks the fluid for leukemia cells or
other signs of problems.
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Leukemia: Treatment
Hispanic children of all races under the age of 20
years have the highest rate of leukemia.
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Treatment
The goal of treatment for leukemia is to destroy the leukemia cells and allow normal
cells to form in your bone marrow. Treatment decisions are based on the kind of
leukemia you have, its stage, and your age and general health. Many times, leukemia is
treated with one or more types of treatment.
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Treatment for Acute Leukemia
Chemotherapy - Chemotherapy is the use of drugs that either kill cancer cells or
preventing the cells from dividing. Chemotherapy can be given in a variety of
ways, with IV infusion and pill being more common. The type of chemotherapy
given depends on the stage and type of lung cancer. Some types of acute
leukemia spread to the brain and spinal cord. Regular chemotherapy cannot
reach those areas, because your body puts up a special barrier to protect them. A
different way of giving chemotherapy, called intrathecal chemotherapy, treats
these areas by injecting the drugs directly into your spinal canal to attack any
leukemia cells there.
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Treatment
Radiation Therapy - Radiation therapy uses high doses of radiation,
such as X-rays, to destroy cancer cells. Radiation is usually given from a
machine outside the body that directs radiation to the cancer (external
radiation). Radiation is also used to treat acute leukemia that has spread
to the brain and spinal cord.
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Treatment
Stem cell transplant may be part of the treatment plan for people who have high-risk
acute leukemia. Most stem cell transplants for leukemia are allogeneic, meaning the
stem cells are donated by someone else. The goal of a transplant is to destroy all the
cells in your bone marrow, including the leukemia cells, and replace them with new,
normal cells.
Stem cell transplant . Donated cells from a "matched" donor can rebuild your supply
of normal blood cells and your immune system.
Chemotherapy. Sometimes medicines or doses that are different from those used
during your initial chemotherapy can help.
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Treatment of Chronic Leukemia
Chronic Lymphocytic Leukemia
Chronic lymphocytic
leukemia is not always
treated right away. It
usually gets worse more
slowly than acute leukemia.
Watchful waiting - CLL usually gets
worse very slowly, and you may have no
symptoms for some time. You and your
doctor may decide to hold off on
treatment for a while. During this time
your doctor will watch you carefully.
Radiation therapy - Radiation may be
used to destroy cancer cells. It also may
be used to shrink swollen lymph nodes or
a swollen spleen. Sometimes radiation is
used on the whole body to prepare for
a bone marrow transplant.
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Treatment
• Chemotherapy - Chemotherapy is the use of medicines that attack cancer cells. Many
medicines are available to fight leukemia and help you live longer.
• Surgery - If the spleen starts destroying red blood cells and platelets, it may need to
be removed. This operation is called a splenectomy.
• Targeted therapy with a monoclonal antibody. These antibodies can kill cancer cells,
stop their growth, or keep them from spreading.
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Chronic Myelogenous
Leukemia
• Targeted therapy with a tyrosine kinase inhibitor, such
as imatinib or dasatinib, is the first treatment used for CML.
• Chemotherapy - Chemotherapy is the use of medicines that
attack cancer cells. Many medicines are available to fight
leukemia and help you live longer.
• Biological therapy - This is the use of special medicines that
improve your body's natural defenses against cancer.
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Chronic Myelogenous Leukemia
• High-dose chemotherapy with stem cell transplant - After chemotherapy is
completed, stem cells that were previously donated and frozen are thawed and
infused.
• Donor lymphocyte infusion (DLI) - This is a treatment that may be used after a stem
cell transplant. With DLI, a person is given more of their donor's white blood cells
(lymphocytes).
• Surgery - If the spleen starts destroying red blood cells and platelets, it may need to be
removed. This operation is called a splenectomy.
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