Leukemia
Lindsey Jeppson
July 26, 2011
As one of the major causes of death, cancer has worked itself into everyday life. About
1,500 people die each day of cancer, and approximately 8 million world wide are diagnosed each
year. So every 1 out of 3 people will develop cancer in their lifetime (Bozzone, 6). Leukemia,
“cancer of the organs that make blood- the lymph system and the bone marrow” (Morra, Potts,
675), is not like the typical cancer cases. It does not cause production of tumors or odd growths;
it instead causes severe blood problems leading to fatigue, bruising, infections, and slow healing
cuts (Bozzone, 22). It affects those of any age, gender, race, etc. But, those factors are important
in determining the level of severity and the type. This cancer is not a modern disease. Meaning, it
has been around since the beginning of the human existence. In the records of ancient cultures,
we find similar symptoms related to different types of cancers. Cancer has been a battle since the
beginning and will be to the end. Living with it is the real trial.
There is no specific cause to Leukemia. In the early 1600s is when physicians began to
realize the cause for these diseases was not of evil spirits, but of the different environments,
lifestyles, and diets of people (Bozzone, 34). But, since Leukemia does not produce unnatural
growths, it was much harder to detect until around the nineteenth century (Bozzone, 37) when
physicians observed a man’s swollen spleen and abundance of white blood cells. After studies of
chromosomes and other genes, scientist were able to determine “Leukemia…is a genetic disease
in the sense that an accumulation of specific gene mutations is necessary for a cell to become
fully malignant” (Bozzone, 115). These genes that are important to developing Leukemia are
oncogenes and tumor suppressors. These genes both influence the cell division. Also, due to the
Philadelphia chromosome study of German scientist David von Hanseman, the rearrangement of
chromosomes also influences the development of Leukemia (Bozzone, 115).
As far as Leukemia goes, there are different types associated. The level of severity and
speed of progression depends on those types. The four types of Leukemia are 1) acute
lymphocytic (ALL) 2) acute myelogenous (AML) 3) chronic lymphocytic (CLL) and 4) chronic
myelogenous (CML) (Morra, Potts, 675). Acute means brief and severe; when having an acute
disease, you have fast progressing symptoms. Chronic means having long had; when having a
chronic disease, it is more slow and gradual. Children with leukemia generally have ALL/AML
while adults generally have CLL/CML. As far as studies go in determining who is more likely to
be affected by Leukemia, they are: “whites more often that blacks, people of jewish ancestry
more often than other whites, males more often than females, those exposed to high or repeated
does of ionizing radiation, patients who received are last two grays as treatment for a spinal
condition called akylosing spondylitis, some patients with Hodgkin’s disease who received
radiation and chemotherapy, those with some genetic abnormalities, those who have been
exposed to Agent Orange, those who have had long-term exposure to certain chemicals and
drugs, and identical twins” (Morra, Potts, 676).
“Acute leukemia is a rapidly progressing type” (Morra, Potts, 681) where “abnormal
cells, called blasts, do not grow into normal cells” (Morra, Potts, 681) and stay as immature cells
and can not carry out their job for the body, but, can be cured. ALL is more common in children,
while AML is more common in adults. AML starts in the myelogenous cell; “abnormal,
immature where blood cells are produced in the bone marrow” (Morra, Potts, 683) and can not
perform their specific job duties in the body causing “infection and uncontrolled bleeding”
(Morra, Potts, 683). For treatment, intense chemotherapy is needed in order to defeat. After
treatments, no “leukemic blast cells will be left in your blood or bone marrow” (Morra, Potts,
685) with continuation of treatment to maintain remission. ALL is where too many “white blood
cells (lymphocytes) are found in the blood and bone marrow” (Morra, Potts, 687). Chemotherapy
is used to treat ALL in adults. The treatment is divided into “three phases: induction therapy,
central nervous system prophylaxis. And post remission treatment” (Morra, Potts, 687).
Childhood ALL has come a long way in treatment and is considered “one of the most curable
forms of cancer” (Morra, Potts, 687).
Chronic leukemia is where “too many mature white blood cells are produced” (Morra,
Potts, 688). Development is slow and may go undetected often. CLL is more common in men
over the age of 60 and almost never occurs in children. “Lymphocytes multiple very slowly but
in a poorly regulated manner, liver much longer than normal, and are unable to perform their
proper function (Morra, Potts, 689)”. Patients who suffer from CLL often don’t have any
symptoms, are diagnosed with regular blood test, and might have “enlarged lymph nodes”.
Treatment is usually done in a conservative manner. Standard chemotherapy can usually cure it.
But as time progresses, removal of the spleen is sometimes necessary. CML accounts for about
20% of leukemia cases and is more common in men age 45 and “accounts for about 5% of
children’s leukemia” (Morra, Potts, 689). It is associated with the Philadelphia chromosome, and
eventually progresses to a more “acute form”. Treatment is difficult to undergo since “present
treatments do not cure the disease or prevent blastic crisis” (Morra, Potts, 692). Treatments
include “bone marrow transplants, biological response modifiers, and combination
chemotherapy” (Morra, Potts, 693).
There is no one population that isn’t affected by leukemia or cancer in general. Has the
population increases, so does the number of cases. Unlike other cancers such as lung, the
probability of getting leukemia cannot be change unless there is a scientific breakthrough. The
risk factors involved in leukemia depend on the area in which you live in. For example, the bomb
dropped on Japan increased the amount of radiation in the area increasing their risk for cancer.
Other environmental risk factors are benzene chemicals, pesticides, herbicides, and infections
(Bozzone,88). To reduce the risk of getting or preventing leukemia, a genetic counselor may be
an option. For you, it could help detect any genetic for the cancer, or it can help prevent any
future children from obtaining the disease. Considering leukemia is a genetic disease, the
influence the family genetics have is tremendous considering the cell mutations come from
genes.
For treating cancer, the ultimate goal is to remove and kill any trace of cancer cells. In the
case of leukemia, surgery is not the answer because the cancer is spread through out the body,
not gathered together. There are three typical treatment options; radiation, chemotherapy, and
stem cell transplant.
As radiation treatment developed, it is aimed to kill any tumor the leukemia cells have
formed. The radiation beam is aimed at the tumor and is done so consistently; usually done
everyday for 8-6 weeks. While the treatment is painless, the “potential side effects include
fatigue and red, dry, tender skin at the sites of exposure”(Bozzone, 121).
Chemotherapy is another treatment form. It “interferes with some aspect of cell division
or survival” (Bozzone, 123) whether they be leukemic cells or other dividing cell populations
such as “hair follicles, the cellular lining of the digestive system, and for males, developing
sperm” (Bozzone, 123). Chemotherapy can be given in different ways, swallowing pills, a
catherter, and an ommaya reservoir. Chemotherapy can either produce permanent or temporary
remission.
If chemotherapy can’t produce permanent remission, stem cell transplantation is another
option. Sometimes leukemic cells develop a “resistance to chemotherapy”(Bozzone, 125). With
this treatment, the leukemic bone marrow is destroyed and a healthy bone marrow, containing
stem cells, from a donor replaces it. If it is successful, “stem cell transplantations” (Bozzone,
Sources
Donna M. Bozzone, Ph.D, Leukemia, 2009, Chelsea House Publishers, 132 West 31st Street New
York NY 10001
Marion Morra and Eve Potts, Choices , Fourth Edition, 1980, 1987, 1994, 2003, HarperCollins
Publishers Inc., 10 East 53rd Street, New York, NY 10022
127) can actually cure leukemia. This treatment can be difficult and can offer risks. First
of all a perfect match has to be found. Within that obstacle, many are created.