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Leukemia By: Dimple Patel
Overview ,[object Object]
Relevance
What is leukemia?
Background on leukemia
Seeking medical advice
Tests for leukemia
Progression
Which cells affected?
Types of leukemia
Treatments/side effects
Follow up
Children with leukemia
Research
Hospitals in our area
Coping & support
Application
Conclusion
Class activity
Works cited,[object Object]
Relevance to ME Majoring in Biochemistry at ASU next year I want to work in the healthcare field
Relevance to YOU ,[object Object]
Since cancer is one of the leading causes of death, you will know at least One person in your life with cancer  and dealing with  it,[object Object]
General information The body has three different types of cells Red blood cells White Blood cells Platelets (Silverstein)
Not known exactly Abnormal chromosomes Myelodysplasia Environmental factors Pollution Household chemicals Benzene and petroleum containing products “few studies have examined the association between home use of solvents and the risk of childhood leukemia.” Results: “ALL risk was significantly associated with paint exposure.” (Scelo, Ghislaine)( 133-139) Causes and Risk Factors
Exposure to radiation and certain chemicals Genetics Cancer therapy This is a rare and unfortunate risk , but it is certainly possible Scelo,  133-139.  Causes Cont’d
Fever and chills Frequent infections Loss of appetite Swollen lymph nodes Enlarged liver or spleen Shortness of breath Petechaie Tiny red spots on the skin Bruising and bleeding very easily Pain in the bones Lots of sweating, mainly at night. Symptoms (Ball, Edward D, and Gregory A Lelek)
When common symptoms start to show more frequently and do not go away May want to see your family doctor or oncologist When to find medical advice (Ball, Edward D, and Gregory A Lelek)
Physical exam Blood Tests Immunophenotype Cytogenetic analysis Bone marrow samples Tests
Chronic leukemia Acute leukemia Progression of Leukemia (Silverstein)
Lymphocytic leukemia Myelogenous leukemia Which cells are affected? Silverstein, Alvin, Virginia Silverstein, and Laura Silverstein Nunn.
Acute Myelogenous Leukemia (AML) Acute Lymphocytic Leukemia (ALL) Chronic lymphocytic Leukemia (CLL) Chronic Myelogenous Leukemia (CML) TYPES OF Leukemia (Belson, Martin, Beverely Kingsley, and Adrianne Holmes) : p.138-145
Based on the type of leukemia Present in cerebrospinal fluid Treated before? Features of leukemia cells Patients symptoms and health Influences of Treatments (Ball, Edward D, and Gregory A Lelek)
Leukemia & chemotherapy Single drug or combination of two or more drugs Can be given by Mouth Injection into vein Catheter Inject directly into cerebrospinal fluid Inject straight into spine (Silverstein)
Radiation therapy 	-high energy rays kills cancer cells Large machine 	-rays are directed at body part There are side effects to this treatment! Leukemia & radiation therapy (Silverstein)
Side effects of Treatments ,[object Object]
Radiation,[object Object]
Side effects of Transplants          GVHD (Graft versus host disease) Ball, Edward D, and Gregory A Lelek
Peripheral Blood Stem Cell PBSC (Preidt)
Follow Up . Ball, Edward D, and Gregory A Lelek
Children With Leukemia Each year about 2000 children in the United States are diagnosed with Leukemia.  Two main types of leukemia in children Acute Lymphoblastic Leukemia (ALL) Acute Myelogenous Leukemia (AML) Belson, Martin, Beverely Kingsley, and Adrianne Holmes.

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Sgpfinal

  • 2.
  • 20.
  • 21. Relevance to ME Majoring in Biochemistry at ASU next year I want to work in the healthcare field
  • 22.
  • 23.
  • 24. General information The body has three different types of cells Red blood cells White Blood cells Platelets (Silverstein)
  • 25. Not known exactly Abnormal chromosomes Myelodysplasia Environmental factors Pollution Household chemicals Benzene and petroleum containing products “few studies have examined the association between home use of solvents and the risk of childhood leukemia.” Results: “ALL risk was significantly associated with paint exposure.” (Scelo, Ghislaine)( 133-139) Causes and Risk Factors
  • 26. Exposure to radiation and certain chemicals Genetics Cancer therapy This is a rare and unfortunate risk , but it is certainly possible Scelo,  133-139. Causes Cont’d
  • 27. Fever and chills Frequent infections Loss of appetite Swollen lymph nodes Enlarged liver or spleen Shortness of breath Petechaie Tiny red spots on the skin Bruising and bleeding very easily Pain in the bones Lots of sweating, mainly at night. Symptoms (Ball, Edward D, and Gregory A Lelek)
  • 28. When common symptoms start to show more frequently and do not go away May want to see your family doctor or oncologist When to find medical advice (Ball, Edward D, and Gregory A Lelek)
  • 29. Physical exam Blood Tests Immunophenotype Cytogenetic analysis Bone marrow samples Tests
  • 30. Chronic leukemia Acute leukemia Progression of Leukemia (Silverstein)
  • 31. Lymphocytic leukemia Myelogenous leukemia Which cells are affected? Silverstein, Alvin, Virginia Silverstein, and Laura Silverstein Nunn.
  • 32. Acute Myelogenous Leukemia (AML) Acute Lymphocytic Leukemia (ALL) Chronic lymphocytic Leukemia (CLL) Chronic Myelogenous Leukemia (CML) TYPES OF Leukemia (Belson, Martin, Beverely Kingsley, and Adrianne Holmes) : p.138-145
  • 33. Based on the type of leukemia Present in cerebrospinal fluid Treated before? Features of leukemia cells Patients symptoms and health Influences of Treatments (Ball, Edward D, and Gregory A Lelek)
  • 34. Leukemia & chemotherapy Single drug or combination of two or more drugs Can be given by Mouth Injection into vein Catheter Inject directly into cerebrospinal fluid Inject straight into spine (Silverstein)
  • 35. Radiation therapy -high energy rays kills cancer cells Large machine -rays are directed at body part There are side effects to this treatment! Leukemia & radiation therapy (Silverstein)
  • 36.
  • 37.
  • 38. Side effects of Transplants GVHD (Graft versus host disease) Ball, Edward D, and Gregory A Lelek
  • 39. Peripheral Blood Stem Cell PBSC (Preidt)
  • 40. Follow Up . Ball, Edward D, and Gregory A Lelek
  • 41. Children With Leukemia Each year about 2000 children in the United States are diagnosed with Leukemia. Two main types of leukemia in children Acute Lymphoblastic Leukemia (ALL) Acute Myelogenous Leukemia (AML) Belson, Martin, Beverely Kingsley, and Adrianne Holmes.
  • 42. Childhood (ALL) risk factors Belson, Martin, Beverely Kingsley, and Adrianne Holmes.
  • 43.
  • 45. Bleed or bruise very easily
  • 46. Fever
  • 49. Painless blue or purple lumps in neck, underarm, stomach or groin areaBelson, Martin, Beverely Kingsley, and Adrianne Holmes.
  • 51.
  • 52. Hospitals in our area treating leukemia University of Pennsylvania Cancer Center Thomas Jefferson Kimmel Cancer Center Wistar Institute cancer Center of Philadelphia. Mercy Suburban Cancer Center
  • 53. “The latest cancer treatments aren’t always prescribed by doctors” Look Good…Feel Better! CTFA foundation
  • 54. Living With Leukemia Challenging Support groups Depression Financial tensions Worrying about family Apel
  • 55. Helping yourself at home to make yourself healthier and better Home Treatment Bets Davis
  • 56. The American Cancer Society Support American Cancer Society
  • 57. Emotions Thinking about death Your life is not over Bets Davis
  • 59. Application Mr. Gohla passed away a little less than a year ago, leaving his wife and three kids with no family income. I met Mrs. Gohla in India in November through relatives. (she is not related to me) Mrs. Gohla makes about 200 rupees a month working as a maid. 200 R = 5 US dollars I am donating 7,500 rupees to the Gohla family! ($150)
  • 60. Conclusion Living with a disease such as cancer is very difficult to handle physically, mentally, and emotionally to not only the patient but also the family members and any other person associated with the patient.
  • 61. Class Activity I need your help to finish up my scrap book! Everyone will get a strip of paper and I want everyone to write down their favorite quote or just a nice saying or a few words to inspire the Gohla family to not give up and stay strong.
  • 62. Works Cited http://a.abcnews.com/images/Nightline/ht_00120760-181_081125_ssv.jpg http://myhealth.hollandhospital.org/library/healthguide/en-us/illnessconditions/topic.asp?hwid=ncicdr0000258006 http://farm4.static.flickr.com/3062/2869815349_b08f18185d.jpg http://chronicmyelogenousleukemia.net/images/leukemia/leukemia_250x251.jpg www.uiowa.edu/~cemrf/archive/sem/large/ http://www.ottawahospital.on.ca/sc/cancer/img/linac2.jpg http://www.adventisthealthcare.com/adam/graphics/images/en/12665.jpg www.mdconsult.com/.../0/0/10041/12664_en.jpg www.web-books.com/.../OPS/images/image022.jpghttp://www.flickr.com/photos/jasoncainephotography/2546899649/ http://zingasays.files.wordpress.com/2009/03/lab_research1.jpg http://www.medcitynews.com/wordpress/wp-content/uploads/hospital-sign.jpg http://prconversations.files.wordpress.com/2009/01/makeup.jpg
  • 63. Works Cited http://www.stacyyork.com/img/kids/excercise.jpg http://www.wichesrestaurant.com/main/assets/images/AMERICAN-CANCER-SOCIETY.jpg worldofcure.comhttp://www.flickr.com/photos/shmoolio/319894626/ Apel, Melanie Ann. Coping with Leukemia. New York: Rosen Publishing Group, 2001. Print. Ball, Edward D, and Gregory A Lelek. 100 Questions and Answers about Leukemia. Sudbury: Jones and Bartlett, 2003. Print Belson, Martin, Beverely Kingsley, and Adrianne Holmes. "Risk Factors for Acute Lukemia in Children: A Review." Environmental Health Perspectives115.1 (2007): p.138-145. JSTOR. Web. 2 Dec. 2009. <http://www.jstor.org/stable/ 4133080> Lackritz, Barbara. Adult Leukemia. Ed. Linda Lamb. Beijing: O'Reilly, 2001.Print. Patenaude, Robert. Surviving Leukemia. Buffalo: Firefly , 1999. Print.
  • 64. Works Cited Scelo, Ghislaine, et al. "Household Exposure to Paint and Petroleum Solvents, Chromosomal Translocations, and the Risk of Childhood Leukemia." Environmental Health Perspectives 117.1 (2009): 133-139. JSTOR. Web. 3 Jan. 2010. <http://www.jstor.org/stable/40066689>. Silverstein, Alvin, Virginia Silverstein, and Laura Silverstein Nunn. Leukemia. Berkeley Heights: Enslow, 2000. Print. Wilson, Henery E, and Geraldine Price. "Leukemia." American Journal of Nursing 56.5 (1956): p.601-605. Print. http://www.poemhunter.com/poem/present-6/ http://www.brainyquote.com/quotes/topics/topic_life.html http://www.umgcc.org/gjump/leukemia.html?gclid=COvK9IOo7qECFV_G3AodKkx1Kg

Editor's Notes

  1. During my research on leukemia, I have found that due to the new treatments and a more variety of options for treatments, more victims are surviving longer and are healthier.
  2. I am attending Arizona State University next year, majoring in biochemistry. I have a passion for healthcare and just learning about all sorts of diseases and since Leukemia is a rare cancer, I wanted to learn more about it.
  3. Why is it relevant to you? I believe that everyone should know about treatment options and symptoms of cancer and since cancer is one of the leading causes of death, you will know at least one person in your lifetime with cancer and this way you will be ready to overcome this problem the best way possible.
  4. So leukemia is a type of cancer that occurs in the bone marrow and the lymphatic system. White blood cells are the cells in your body that fight infections and help the immune system. They usually grow, develop, and divide depending on when your body is in the need for them, but with this cancer, the bone marrow forms these white blood cells rapidly and abnormally, therefore they do not function properly. So basically, too many white blood cells are producing and therefore they are not functioning properly.
  5. Some general information that you should know to help you more about this cancer is about the roles of cells in our body. Our body has three different types of cells, which are red blood cells, white blood cells, and platelets .Redblood cells are the cells that carry oxygen throughout the body. The white blood cells are the cells that fight off infections, and platelets help clot the blood. All of these cells are produced everyday in the bone marrow,
  6. Still today, we do not know exactly what causes this cancer, but there are many possibilities such as chromosome abnormalities. These abnormalities are also linked with a preleukemic disease called myelodysplasia. Environmental factors such as pollution, household products that contain chemicals with benzene and petroleum are considered to be the most likely causes for leukemia especially in children but no evidence has backed up that theory. A study examined hundreds of leukemia patients and the results of the study showed that your are at risk for ALL (acute lymphoblastic leukemia) when exposed to paint and other harmful household chemicals.
  7. In addition with environmental factors and abnormalities, exposure to high levels of radiation have a high risk of developing leukemia. Genetics is always a huge risk factor of developing leukemia as well. If a family member had it, that gene may increase your risk for having leukemia. Lastly, cancer therapy is a rare risk for developing this cancer, but there have been cases. If people have had chemo or radiation therapy in their past due to another cancer, it is possible that leukemia may develop many years later, due to the exposure of radiation and chemo.
  8. Symptoms vary from which type of leukemia a patient has. The signs and symptoms varies on the the amount of abnormal blood cells and where they are being collected. Many people overlook these symptoms because they are the similar symptoms of the flu and other common colds, but if these symptoms are occurring frequently, then you should see you doctor.
  9. When there is persistent fever, fatigue, bleeding, swollen lymph nodes, and weakness please see your family doctor to get tested. Again, many people overlook these symptoms, but when you have “that feeling” that something is not right, please seek for medical advice from a family doctor because it is better to be safe than sorry. Also people think its “nothing” and later symptoms get worse, they are usually “too late” because the cancer has progressed a vast amount by time they find the cancer.
  10. Most doctors will find leukemia in a simple blood test, but there are many other ways to detect for leukemia. A physical exam may not be the most accurate way to diagnose blood cancer, but it could help the doctor see if you have any swelling in the liver and spleen area. When looking at blood tests results, we want to see if the patient has any abnormal levels of blood cells, especially the white blood cells. Immunophenotyping helps identify whether or not the patient has a very high number if lymphocytes in the blood. This test also help see the difference of which type of leukemia it may be. Cytogenetic analysis diagnoses any abnormalities in the chromosomes. This is seen through a microscope. After doing all of these tests and your doctor suspects that it is leukemia, you will have to give a bone marrow sample, this test would most likely be taken by an oncologist. Here they use a needle to remove a little piece of your bone marrow to find leukemia cells.
  11. In chronic leukemia, mature blood cells are replicating more slowly. Chronic leukemia sometimes shows no symptoms and this cancer may never be diagnosed until many years later. On the other hand, in acute leukemia, immature blood cells are replicating rapidly, so the condition of the patient gets more worse quicker than chronic leukemia.
  12. Lymphocytic leukemia mainly affects the lymphocytes (lymphiod cells). These cells form in lymphatic tissue. This tissue is very important because it is the main component of the lymphatic system and found throughout the body.Myelogenous leukemia affects the myeloid cells. These are the cells that later form into red blood cells, white blood cells and platelets.
  13. AML is the most common type of blood cancer. This type occurs mainly in children and in adults. ALL is the most common type of blood cancer in young children. CLL is the leukemia that is common in most adults. This type does not affect children. CML also affects adults. This is the type that is linked with the abnormality of the chromosomes.
  14. Things that may influence the decision on which treatment is necessarily needed, are based upon by whether or not the leukemia cells are present in the cerebrospinal fluid. Another influence may be if the patient has gotten treated for this cancer before. If a patient has already gotten treated for it before, you do not want to give them too much of a treatment. Another important influence is the features of the leukemia cells. Oncologists and hematologists have to study this so they can see which type of treatment could fight off the cancer cell, and which kind of treatment can not. Lastly, but certainly not least. It all also depends on the patient’s health and symptoms. You would not want to give a patient chemotherapy if they have been extremely weak and ill. This could make their condition worse.
  15. Chemotherapy is a type of cancer treatment that uses drugs to kill the cancer cells. In our case, chemotherapy is using drugs to kill leukemia cells. Chemotherapy can be give to a person by mouth, injection into a vein, catheter, or injection into cerebrospinal fluid or into the spine, depending on which type of leukemia that patient is diagnosed with. But the most common way to give chemo is by IV through a port. The port has been inserted under the skin so its ready to deliver the medications. This port makes it easier for the doctor to draw blood to test for complete blood count. There should be 4 1/2 -5 mil/mm red blood count,5000-10000 white blood cell count, and approx 300,000platlet count per mm of bld. If the numbers of cells are below this range, then chemo can not be given because chemo is killing cancer cells along with healthy cells and we need a good number of healthy cells.
  16. Radiation therapy uses high energy rays to kill the leukemia cells. A large machine is directed to the area of a body part at which the cancer cells have spread to. Although radiation therapy is an option for treatment, there are a few side effects. This treatment may cause the patient’s skin to become red and dry in some areas, but doctors will give alternative medications and to ease the side effects.
  17. Even though there are a few treatments available for treating leukemia, there are also side effects to understand before getting treated. For chemo therapy there will be hair loss, a lot of nausea and vomiting along with weakness and in women their period will become very irregular or their periods may just stop overall. More side effects for chemo varies on the type of person and how much a person’s body can handle. For radiation therapy the side effects depend on where the beam of radiation hits. For example if the bean hit the head, then hair would fall out. There is also a lot of redness and itching of the skin and again there is a lot of weakness feelings as well. For both chemo therapy and these side effects may go away after some time.
  18. Bone marrow transplant replaces the abnormal stem cells to healthy normal stem cells. You may need to get this treatment done because of the leukemia is destroying your body very quickly or also maybe because the doses of the chemotherapy and radiation therapy were so high that it destroyed parts of your bone marrow. Bone marrow transplants are becoming more and more successful and survival rates of patients with leukemia have also increased. For someone to donate bone marrow they must match the genetic makeup of the patients bone marrow. Most likely a sibling, twin or family member can be candidates. Although bone marrow transplant is successful, it is not 100 percent successful. So how is the bone marrow transplanted? The patient is under anesthesia. A needle is inserted into the cavity of the rear hip bone or &quot;iliac crest&quot; where a large quantity of bone marrow is located. The bone marrow a thick, red liquid - is extracted with a needle and syringe. Several skin punctures on each hip and multiple bone punctures are usually required to extract the requisite amount of bone marrow. There are no surgical incisions or stitches involved - only skin punctures where the needle was inserted. The patient receives this bone marrow through IV.
  19. Patients who have a blood and bone marrow transplant will face an increased risk of infection, bleeding, and other side effects with a large dose of chemo therapy and radiation therapy. Graft versus host disease (GCHD) may occur in patients who receive bone marrow from a donor . In Graft versus host disease, the donated marrow reacts against the patient’s tissue. GVHD can be mild to very severe and it can occur any time after the transplant. Drugs can be given to reduce the risk of GVHD. The one benefit of GVHD is that the graft attacks the leukemia itself and this side effect can actually help cure the patient.
  20. Stem Cell transplants are used only for some leukemia patients. This stem cell transplant allows a patient to be treated with doses (fairly high) of drugs, radiation, or even both. These doses of drugs will kill all of the leukemia cells, as well as normal cells in the bone marrow. Then the patient will receive stem cells through a flexible tube that has been placed in a vein of a chest or arm. The new blood cells will develop from the transplanted stem cells through a machine. This process takes several hours.
  21. After the completion of treatment the doctor will examine the patients once again, repeating with the same tests and will look for signs and symptoms of leukemia. They will also see how the treatment effected the patient&apos;s leukemia and whether or not the leukemia is in remission. Remission is when it looks like the cancer has left, but actually it is still there not doing any harm to the patient or showing any symptoms. If the patient is in remission, the doctor will watch the patient for signs that the leukemia is coming back.
  22. Each year about 2000 children in the United States are diagnosed with leukemia and about 29,000 adults are diagnosed. Cancer in general in children is rare, but childhood acute lymphoblastic leukemia is the most common cancer in children. Acute lymphoblastic leukemia occurs 1 of every 29,000 children in the United States each year and acute myelogenous leukemia accounts for about 10,600 cases each year.
  23. A few risk factors of childhood acute lymphoblastic leukemia may be if a child has a brother or sister with leukemia, if the race of the child is Caucasian of Hispanic, if they were exposed to x-ray or other types of radiation before birth or after birth, having a very weak immune system, or even having a genetic disorder such as down syndrome.
  24. Symptoms of adults and children are very similar. A few symptoms that may occur to children that are suspected to having leukemia may be looking pale often, feeling very weak and tired all of the time. They may bleed and bruise very easily and frequently. They may have fever, fatigue , infections, and headaches often as well. If you see them with any lumps in a bluish/purplish color in the neck area, underarm area, or stomach or groin area, please take your child to a family physician immediately to get tested. This symptom is the most important sign to know whether or not a child has leukemia.
  25. The latest European study says that patients with leukemia who have received stem cell transplants or bone marrow transplants survived longer. Ten years after transplantation about 49 percent of patients who were stem cell recipients and about 57 percent of bone marrow recipients are still alive. In patients with acute myeloid leukemia, the rates were 62 percent and for bone marrow transplants and about 47 percent for PBSC transplant. This research states that patients would benefit more form transplantation with bone marrow.
  26. Although the cause of leukemia is still unknown, we have figured out that people who have occupations with certain jobs that expose a chemical called Benzene have a very high risk of getting acute myelogenous leukemia. Some jobs with these risk factors are truck drivers, tanker men, shoe/leather workers, refinery workers, painters, newspaper press workers, gasoline distribution workers, and many other types of workers.
  27. These are a few well known cancer centers that will treat and research on cancer in our area of Philadelphia. University of Pennsylvania Cancer Center does bone marrow and stem cell transplants and chemo and radiation treatments as well. There are many small cancer center throughout our area that give chemo and radiation treatments, but these are just a few of very large hospitals that also do surgeries and more serious and intense treatments.
  28. The LookGood..Feel Better is a free nonmedical product-neutral program offered in partnership with the American Cancer Society, the National Cosmetology Association, and The Cosmetic Toiletry and Fragrance Association. This organization comes around a couple times a year to cancer centers to make patients with cancer feel better by giving them a makeover. They put makeup on the ladies and give them new looks. Since patients get a little depressed due to hair loss, weight loss, and their looks after cancer, these organizations want to make them feel a little better about themselves and help them look and feel great.
  29. Living with leukemia is a huge challenge. Many patients may get the right guidance and will join support groups or talk to counselors to help them get though with it, and others may lean more towards depression. They may be worried about financial hardships because of the hospital bills. They start to feel depressed, thinking they may not live much longer, and others may worry about their family and what would happen to them when they are no longer around. So there are support groups out there to help you cope with cancer!
  30. Having a nice healthy balanced diet, enough sleep and rest throughout your day and exercising a couple time a week are a few of the many things you can do to make yourself healthier and stronger. This could help you from dramatic weight loss from all of the drug and treatments for cancer and it prepares your body to handle strong treatments and side effects.
  31. The American Cancer Society is a community-based voluntary health organization dedicated to elimination cancer as a major health problem and saving lives. This society is one of the oldest and largest volunteer health agencies in the United States. It is a nonprofit cancer research fund in the United States. The American Cancer Society provides service and rehabilitation programs to patients and their families nationwide.
  32. After being diagnosed with cancer, it is very important that you talk about how you feel and “spill” out your emotions. Keeping it all inside may make your emotional state worse. Most people feel denial, anger and grief. These feelings are completely normal and it is okay to feel this way. Talking about your emotions and feelings will reduce stress and there is a less chance of a patient going through depression.
  33. I raised money through family, friends and neighbors, due to Haiti earthquake I did not want to put flyers up asking for donations, instead I felt that asking a person straight up sharing my story, it was a more effective way to raise money.