Topic for BAMS

1. Leukemia

2. What is Leukemia?
Leukemia is a group of blood cancers that usually begin in the 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.

3. Hematopoiesis

4. Causes of Leukemia
Benzene as a cause of leukemia had
documented since 1928. In 1948, theAmerican
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.
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.

5. Causes of Leukemia
Very high levels of radiation have been caused
by atomic bomb explosions (such as those in
Japan during World War II) and nuclearpower
plant accidents (such as the Chernobyl [also
called Chornobyl] accident in 1986).
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
a likely cause.

6. Causes of Leukemia
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 ofClinical
Oncology.
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.

7. Causes of Leukemia
SMOKING cigarettes may increase a person's
risk of contracting leukemia by 30 percentand
cause up to 3,600 cases of adult leukemia a
year in the United States. (PublishedFebruary
3, 1993)
Smoking— Tobacco products are the
single, major avoidable cause of cancer.
Smoking is also causally associated
with cancers of the
pancreas, kidney, bladder, stomach, an
d cervix and with myeloid leukemia.

8. Causes 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 oneof
the most important leukemia-predisposingsyndromes
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.
Down syndrome and certain other
genetic diseases — Some diseases
caused by abnormal chromosomes may
increase the risk of leukemia.

11. Types
Different types of leukemia are
grouped in two ways.
 by duration of onset
Chronic (slow and long history)
Acute (short history rapid devlop)
 by the type of blood cell that is
affected
Lymphoid cells
Myeloid cells

12. Types
 In chronic leukemia, the
leukemia cells come from
mature, abnormal cells.
 The cells thrive for too long
and accumulate. These
cells grow slowly.
 In chronic cases symptoms
may take a long time to
even appear.
 Acute leukemia develops
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 don't
stop dividing like their
normal counterparts do.

13. Types
 Lymphocytic leukemia
Cancerous transformation
occurs in the type of
marrow that makes
lymphocytes.
It commonly affects lymph
nodes but can invade all
body tissues.
 Myelogenous leukemia
Cancerous change
occurs in the type of
marrow cells that
produce red blood
cells, other types of
white blood cells,
and platelets.
Involves the
granulocytes i.e.
neutrophils,
eosinophils, or
basophils.

14. ALL
CLL
AML
CML

15. 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:
 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.

16. 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:
 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.

17. 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:
 Biopsy
Bone marrow aspiration:
The doctor uses a
thick, hollow needle to
remove samples of bone
Marrow fluid and cells.
Bone marrow biopsy:
The doctor uses a very
thick, hollow needle to
remove a small piece of
bone.

19. Diagnosis
 The tests that your doctor
orders for you depend on
your symptoms and type of
leukemia. You may have
other tests:
 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.

20. Diagnosis
 The tests that your doctor
orders for you depend on
your symptoms and type of
leukemia. You may have
other tests:
 Lumbar puncture or 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 lab checks the
fluid for leukemia cells or other
signs of problems.

21. Treatment
 Chemotherapy
Intrathecal chemotherapy
 Radiation therapy
 Surgery
 Stem cell transplant.

22. Treatment
Chronic lymphocytic leukemia is
not always treated right away. It
usually gets worse more slowly
than acute leukemia.
 Treatment of Chronic
Leukemia
 Chronic Lymphocytic
Leukemia
 Watchful waiting - Not getting
cancer treatment right away is called
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.

23. Thank You