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Medical & Legal Information on Leukemia: Causes & Treatment Options
• Leukemia Overview
• Leukemia: What Is Going On
• Leukemia Causes
• Risk Factors
• Diagnosing Leukemia
• Treating Leukemia
Leukemia is a cancerous condition of the blood cells characterized by the uncontrollable growth of malignant cells in bone marrow. Often considered a children’s disease, leukemia affects many more adults than children. Doctors believe the disease is caused by acquired mutations of the blood cell’s DNA.
Statistics maintained by the Leukemia and Lymphoma Society reveal that more than 340,000 individuals in the U.S. live with leukemia that is either active or in remission. An estimated 60,000 more individuals are expected to receive a diagnosis of leukemia in 2016, and over 24,000 individuals will likely to die from the disease. Since 1960, the overall five-year survival rate for the disease has increased to more than four times as high among Caucasian (only data collected since then). Today, the relative five-year survival rate is estimated to be over 60 percent.
Leukemia: What Is Going On
Blood cells are made up of three specific types including oxygen-carrying red blood cells, infection-fighting white blood cells, and blood clot-forming platelets. Every day inside bone marrow, the body creates new blood cells (mostly red blood cells) by the billions. However, when leukemia is present, the body creates more white blood cells than is required.
The white blood cells are made up of myeloid cells and lymphoid cells, and leukemia can occur in either one. When leukemia is present, the white blood cell no longer has the capacity to fight infection. The disease causes abnormal white blood cells to form and begin affecting major organ functions.
Researchers, scientists, and doctors will group or categorize the types of leukemia in two specific ways that include:
- How fast the disease progresses since it was initially detected
- The type of blood cell (myeloid or lymphoid) involved
Once the disease has been categorized, the doctor will then determine if the problem is acute or chronic. Acute leukemia involves abnormal blood cells that never mature and lack the capacity to act normally. This damaging condition tends to progress quickly. Acute leukemia occurs when immature cells work alongside normal functioning cells. Even so, chronic leukemia can be just as deadly but progresses slower than the acute condition.
Research has yet to determine exactly what cause of leukemia but studies indicate that individuals with the disease have specific abnormal chromosomes. However, a correlation between the abnormal chromosomes and the cause of leukemia has never been made.
The abnormality or mutation inside the DNA of the blood cell can cause it to grow and divide at a progressive rate and continue to live and reproduce more abnormal cells. This lifespan is much different than a normal cell that typically dies after it reproduces once. The ever-increasing numbers of abnormal cells will eventually become overcrowded, causing damage to healthy blood cells still residing in bone marrow.
Doctors are just now learning what happens inside bone marrow during the development of blood cells and recognize there are specific risk factors that can increase the potential of developing some forms of leukemia. These factors include:
- Genetic Disorder – An abnormality in the genetic makeup of the cell seems to play a crucial role in developing the disease. Specific genetic disorders including Down syndrome are known to have a direct link to leukemia.
- Prior Cancer Treatments – Individuals who have had radiation and chemotherapy to treat other cancers have an elevated potential risk of developing some forms of leukemia.
- Smoking – Smoking tobaccos is known to increase the risk of developing acute myelogenous leukemia.
- Chemical Exposure – Individuals who have been exposed to benzene (found in gasoline products) and other chemicals have an increased potential developing leukemia.
- Heredity – If there is a history of leukemia with parents, siblings, and grandchildren, there is likely an increased potential of developing the disease.
The doctor will first take a medical history and ask the patient about risk factors and symptoms before performing a comprehensive physical examination. The doctor is looking for specific indicators of leukemia including an enlarged spleen, enlarged lymph nodes and the diagnosis of the disease found in blood sample laboratory results.
The doctor might also obtain a sample of bone marrow through aspiration. While the patient is under anesthesia, a thin, long needle will be inserted into the hip bone to remove a sample. Other useful tests as a part of the diagnosis include:
- Chest X-Ray is beneficial to detect enlarged lymph nodes
- Lumbar Puncture can remove a minimal amount of cerebral spinal fluid to see if cancerous cells have invaded the spinal cord and brain
- Imaging Tests including an MRI (magnetic resonance imaging) and CT (computerized tomography) Scan to determine the extent of leukemia.
Fortunately, there are options for treating chronic and acute leukemia and many more are in development. Often, the doctor will recommend a combination of effective treatments to increase the success rate.
- Acute Leukemia – This form of leukemia is often cured but requires treatment immediately after the disease has been diagnosed. The doctor will develop an effective plan designed to induce a remission, where the leukemia cells become absent in the body. This is typically followed up with maintenance or consolidation therapy to prevent a relapse.
- Chronic Leukemia – This form of leukemia is less likely to be cured with treatment but can be controlled to prolong survival rates and manage symptoms. Some doctors recommend stem cell transplantation to increase the potential success of a cure.
Before receiving any treatment, it is essential to get a second opinion unless the disease is highly aggressive and any delay in treatment could cause a significant undesired outcome. The doctor will likely recommend one or more treatments that include:
- Chemotherapy – Chemotherapy uses medications designed to rapidly kill reproducing leukemia cancer cells. The drug might be given orally or delivered intravenously or through a catheter into the bloodstream. Most chemotherapy treatments are a combination of more than a single medication that often delivers serious side effects including hair loss, mouth sores, vomiting, loss of appetite, nausea, easy bleeding or bruising, tiredness or the development of infections.
- Biological Therapy – This treatment is based on living organisms or synthetic substances and substances derived from living organisms. These include immune system controlling cytokines, tumor vaccines, and antibiotics. Some biological therapies including monoclonal antibodies are designed to cause a reaction against specific cancer targets. These treatments tend to produce less severe side effects compared to chemotherapy like tiredness, fever, muscle aches and headaches.
- Targeted Therapy –Administered medications interfere with cancer cell functions instead of indiscriminately killing all growing cells. This causes significantly less damage to normal healthy cells and instead targets cancerous cells to minimize their growth and ability to metastasize (spread). Some targeted therapy drugs including Sprycel (dasatinib) and Gleevec (imatinib) that can produce side effects including sudden weight gain, bloating, swelling, rash, muscle cramps, diarrhea, vomiting, and nausea.
- Radiation Therapy – High energy radiation beams can target and kill cancer cells. However, this treatment produces side effects including diarrhea, vomiting, and nausea.
- Stem Cell Transplant – Once abnormal blood cells are destroyed, transplant stem cells can be implanted using intravenous fusion and kept alive by suppressing the immune system’s response to the invading new cells using medications or steroids.