Blood Cancer (Leukemia)
Definition of Leukemia
Leukemia is a type of cancer. Cancer is a group of many related diseases. All cancers begin in cells, which make up blood and other tissues. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die and new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should die. Leukemia is cancer that starts in blood cells.
Normal Blood Cells
Blood cells are formed in the bone marrow (bone marrow). Bone marrow is the soft material in the center of most bones.
Blood cells are not yet mature (ripe) are called stem cells (stem cells) and blasts. Most blood cells mature in the bone marrow and then move into blood vessels. Blood flowing through blood vessels and heart is called the peripheral blood.
The bone marrow makes different types of blood cells. Each type has a specific function:
* White blood cells help fight infection.
* Red blood cells carry oxygen to tissues throughout the body.
* Platelets help form clots (clots) of blood that control bleeding.
Leukemia Cells
In people with leukemia, bone marrow produces white blood cells are abnormal. Abnormal cells are leukemia cells. First, the leukemia cells function almost normally. In time, they may push the white blood cells, red blood cells, and platelets are normal. It makes heavy blood to do its work.
Types of Leukemia
The types of leukemia are grouped by how quickly the disease develops and worsens. Leukemia is one of the chronic (gets worse slowly) or acute (gets worse quickly):
* Chronic leukemia-Early in the disease, blood cells are abnormal can still do their jobs, and people with chronic leukemia may not have any symptoms. Slowly, chronic leukemia worsens. It causes symptoms as the number of leukemia cells in the blood rises.
* Acute leukemia-The blood cells are very abnormal. They can not do their normal work. The number of abnormal cells increases rapidly. Acute leukemia worsens quickly.
Types of leukemia are also grouped by the type of white blood cells are affected. Leukemia can arise in lymphoid cells or myeloid cells. Leukemia that affects lymphoid cells is called lymphocytic leukemia. Affecting leukemic myeloid cells is called myeloid leukemia or myelogenous leukemia.
There are four common types of leukemia:
* Chronic lymphocytic leukemia (chronic lymphoblastic leukemia, CLL) accounts for about 7,000 new cases of leukemia each year. Most often, people diagnosed with the disease are over age 55. It almost never affects children.
* Chronic myeloid leukemia (chronic myelogenous leukemia, CML) accounts for approximately 4.400 new cases of leukemia each year. It affects mainly adults.
* Acute lymphocytic leukemia (acute lymphoblastic leukemia, ALL) accounts for approximately 3.800 new cases of leukemia each year. This is the most common type of leukemia in young children. He also affect adults.
* Acute myeloid leukemia (acute myelogenous leukemia, AML) accounts for approximately 10.600 new cases of leukemia each year. It occurs in both adults and children.
Hairy cell leukemia is a rare type of chronic leukemia. Artiel did not deal with hairy cell leukemia or rare types of leukemia. Together, these rare leukemias are responsible for approximately 5.200 new cases of leukemia each year.
At Risk for Leukemia
No one knows the exact causes of leukemia. Doctors can seldom explain why one person gets this disease and others do not. However, research has shown that people with certain risk factors are more likely than others to develop leukemia. A risk factor is anything that increases a person's chance of developing a disease.
Studies have found the following risk factors for leukemia:
* Levels are very high radiation-People exposed to radiation levels are very high is much more likely than others to develop leukemia. Levels are very high radiation have been caused by atomic bomb explosions (such as those in Japan during World War II) and accident-nuclear power plant accidents (such as the Chernobyl accident in 1986).
Medical treatment that uses radiation can be another source of exposure to high levels. Radiation used for diagnosis, however, expose people to radiation levels are much lower and is not linked to 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 a greater risk of leukemia.
* Chemotherapy-Cancer patients who are treated with drugs against certain cancers sometimes later develop leukemia. For example, drugs known as alkylating agents are associated with the development of leukemia many years later.
* Down syndrome and certain genetic diseases-Some other diseases caused by abnormal chromosomes may increase the risk of leukemia.
* Human T-cell leukemia virus-I (HTLV-I)-This virus causes a rare type of chronic lymphocytic leukemia known as human T-cell leukemia. However, leukemia does not appear to be contagious.
* Myelodysplastic syndrome-People with this blood disease are at increased risk of developing acute myeloid leukemia.
In the past, some studies suggested exposure to electromagnetic fields as another possible risk factor for leukemia. Electromagnetic fields are a type of low-energy radiation that comes from power lines and electric appliances. However, the results of studies recently show that the evidence is weak for electromagnetic fields as a risk factor.
Most people who have known risk factors do not get leukemia. On the other hand, many who get the disease do not have none of these risk factors. People who think they may be at risk of leukemia should discuss this concern with their doctor. Doctors may suggest ways to reduce risk and can plan a schedule for checkups right.
Symptoms of Leukemia
Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells come together, patients with leukemia may have a number of symptoms.
Common symptoms of leukemia:
* Fever, fever or night sweats
* Infections are often
* Feeling weak or tired
* Headache
* Bleeding and bruising easily (bleeding gums, signs of purplish skin, or red dots are small under the skin)
* Pain in the bones or joints
* Swelling or discomfort in the abdomen (from an enlarged spleen)
* Swollen lymph nodes-nodes, especially in the neck or armpit
* Weight loss
The symptoms of this kind is not a definite sign of leukemia. An infection or another problem also could cause these symptoms. Anyone with these symptoms should visit a doctor as soon as possible. Only a doctor can diagnose and treat the problem.
In the early stages of chronic leukemia, the leukemia cells function almost normally. The symptoms may not appear for a long time. Doctors often find chronic leukemia during a routine checkup - before there are any symptoms. When symptoms appear, they generally are mild at the beginning and gradually worsened.
In acute leukemia, symptoms appear and worsen quickly. People with this disease go to the doctor because they feel sick. Other symptoms of acute leukemia are vomiting, confusion, loss of muscle control, and attacks (epilepsy). Leukemia cells can also be gathered in fruit-testicles (testicles) and cause swelling. Also, some patients develop sores in the eyes or on skin. Leukemia also can affect the digestive tract, kidneys, lungs, or other parts of the body.
Diagnosing Leukemia
If someone has symptoms that suggest leukemia, the doctor may perform a physical exam and ask about the patient's personal medical history and family. The doctor also may order laboratory tests, especially blood tests.
Inspections and tests may include the following:
* Physical Examination-The doctor checks for swollen lymph nodes, lymph nodes, spleen, and liver.
* Blood tests-The lab checks the level of blood cells. Leukemia causes a level of white blood cells are very high. He has also led to low levels of platelets and hemoglobin, found in red blood cells. Lab also may check the blood for signs that leukemia has affected the liver and kidneys.
* Biopsy-The doctor removes some bone marrow from the hipbone or another large bone. A pathologist examines the sample under a microscope. Appointment of tissue to look for cancer cells is called a biopsy. A biopsy is the only way that is sure to find out whether there are leukemia cells in bone marrow.
There are two ways the doctor can obtain bone marrow. Some patients will have both procedures:
o Bone marrow aspiration (suction bone marrow): The doctor uses a needle to remove samples of bone marrow.
o Bone marrow biopsy (Biopsy Bone Marrow): The doctor uses a very thick needle to remove a small piece of bone and bone marrow.
Local anesthesia helps make patients more comfortable.
* Cytogenetics-The lab on the chromosomes of cells from samples of peripheral blood, bone marrow, or lymph-lymph nodes.
* Spinal tap-The doctor removes some of the cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). The doctor uses a long needle to remove fluid from the tiny spinal column (spinal column). The procedure takes approximately 30 minutes and is performed with local anesthesia. Patients must lie for several hours afterward to keep from getting headaches. The lab checks the fluid for leukemia cells and other signs of problems.
* Chest x-ray, X-rays can reveal signs of disease in the chest.
Treating Leukemia
Many people with leukemia want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and options (choices) they care. However, surprise (shock) and stress after a cancer diagnosis can make it difficult / hard to think of everything that asked of a doctor. It is often helpful to make a list of questions before an appointment. To help remember what the doctor says, patients may notice or ask if they could use a tape recorder (tape recorder). Some also want to have a family member or friend with them when they talk to the doctor - to take part in discussions, for the record, or just listen.
Physicians may refer patients to doctors who specialize in treating leukemia, or patients may ask for a reference. Specialists who treat leukemia include a hematologist (hematologists), medical experts cancer (medical oncologists), and radiation cancer specialists (radiation oncologists). Experts in cancer children (Pediatric oncologists) and hematology specialists (hematologists) treating childhood leukemia.
Whenever possible, patients should be treated at a medical center that has doctors experienced in treating leukemia. If this is not possible, the patient's physician may discuss a treatment plan with a specialist at a center like that.
Getting An Opinion (Opinion) Second
Sometimes it is useful to get a second opinion about diagnosis and treatment plan. Some insurance companies require a second opinion; others may cover a second opinion if the patient or doctor needs it. There are a number of ways to find a doctor for a second opinion:
* Your doctor may be able to advise patients of a doctor who specializes in adult leukemia or childhood. At cancer centers, several specialists often work together as a squad / team.
* Cancer Information Service, can tell the people who called about the centers of adjacent treatments.
A local or state medical, a nearby hospital, or a medical school can usually provide the names of specialists.
* The American Board of Medical Specialties (ABMS) has a list of doctors who have met the requirements of education and specific training and has passed the special examinations. The Official ABMS Directory of Board Certified Medical Specialists lists the names of doctors together with their specialists and their educational background. ABMS offers this information on the Internet at http://www.abms.org.
Preparation For Treatment
The doctor can describe treatment options and discuss the results can be expected with each treatment option. Physicians and patients can work together to develop a treatment plan that fits with the purposes of the patient.
Treatment depends on a number of factors, including the type of leukemia, the patient's age, whether the leukemia cells present in the cerebrospinal fluid, and whether the leukemia has been treated previously. It also may depend on certain features of the leukemia cells. Doctors also enter into consideration your symptoms and general health of the patient.
People do not need to ask all the questions or understand all of the answers at once. They will have other opportunities to ask the doctor to explain things that are not clear and ask for more information.
Methods of Treatment
The doctor is the best person to describe treatment options and discuss the results expected. Depending on the type and extent of disease, patients may have chemotherapy, biological therapy, radiation therapy, or bone marrow transplantation. If the patient's enlarged spleen, your doctor may suggest surgery to remove it. Some patients received a combination of treatments.
People with acute leukemia need to be treated immediately. The goal of treatment is to bring a remission. Then, when signs and symptoms disappear, more therapy may be administered to prevent a recurrence. This type of therapy is called maintenance therapy (maintenance therapy). Many people with acute leukemia can be cured.
Chronic leukemia patients who have no symptoms may not require immediate treatment. Your doctor may suggest waiting while observing for some patients with chronic lymphocytic leukemia. Health care team will monitor the health of the patient so that treatment can be started if symptoms occur or worsen. When treatment for chronic leukemia is needed, it can often control the disease and its symptoms. However, chronic leukemia can seldom be cured. Patients may receive maintenance therapy (maintenance therapy) to help keep cancer in remission.
A patient may want to talk to your doctor about taking part in a clinical trial, a research study of treatment methods are new.
In addition to anticancer therapy, people with leukemia may have treatment to control pain and other symptoms of gejal-cancer, to eliminate the side effects of therapy, or to ease emotional problems. This kind of treatment is called symptom control (symptom management), supportive care (supportive care), or treatment that relieves (palliative care).
Chemotherapy
Most patients with leukemia receive chemotherapy. This type of cancer treatment uses drugs to kill leukemia cells. Depending on the type of leukemia, patients may receive a single drug or a combination of two or more drugs.
People with leukemia may receive chemotherapy in several different ways:
* By mouth
* With direct injection into a vein (IV or intravenous)
* Through a catheter (a small flexible tube) placed in a large vein, often in the upper chest - which dwelt A catheter is useful for patients who require many treatments are intravenous (IV). Health care workers injecting drugs into the catheter, rather than directly into a vein. This method avoids the need for many injections, which can cause discomfort and injure the veins and skin.
* By injection directly into the cerebrospinal fluid - If a pathologist found the leukemia cells in the fluid that fills the spaces in and around the brain and spinal cord (spinal cord), the doctor may order intrathecal chemotherapy. The doctor injects drugs directly into the cerebrospinal fluid. This method is used because drugs given by intravenous injection or taken by mouth often do not reach cells in the brain and spinal cord. Pembulh a network of blood vessels that filter blood going to the brain and spinal cord. Blood-brain barrier is to stop drugs from reaching the brain.
Patients may receive the drugs in two ways:
* Injections into the spine (vertebrae): The doctor injects the drug into the bat-spinal column the lower part.
* Ommaya reservoir: Children and some adult patients receive intrathecal chemotherapy through a special catheter called an Ommaya reservoir. The doctor puts a catheter under the scalp. The doctor injects the anticancer drugs into the catheter. This method avoids the discomfort of injections into the spine (spine).
Patients receive chemotherapy in cycles: a treatment period, then a period of recovery (recovery), and then another treatment period. In some cases, the patient has chemotherapy as an outpatient of the hospital, the doctor's office, or at home. However, depending on which drugs are administered, and the patient's general health, a hospital stay may be required.
Some people with chronic myeloid leukemia receive a new type of treatment called targeted therapy. Targeted therapy inhibits the production of leukemia cells but does not harm normal cells. Gleevec, also called STI-571, is the first targeted therapy approved for chronic myeloid leukemia.
Biological Therapy
People with some types of leukemia have biological therapy. This type of treatment is to improve the body's natural defenses against cancer. Therapy is given by injection into a vein.
For some patients with chronic lymphocytic leukemia, a type of biological therapy used is a monoclonal antibody. These compounds bind to leukemia cells. This therapy enables the immune system to kill leukemia cells in the blood and bone marrow (bone marrow).
For some patients with chronic myeloid leukemia, biological therapy is a natural compound called interferon. This compound can slow the growth of leukemia cells.
Radiation Therapy
Radiation therapy (also called radiotherapy) uses high-powered sinat-rays to kill leukemia cells. For most patients, a large machine directs radiation at the spleen, brain, or other parts of the body where leukemia cells have been gathered. Some patients receive radiation that is directed through the body. Irradiation or total body irradiation usually is given before a bone marrow transplant. Patients receiving radiation therapy in a hospital or clinic.
Transplantation of Stem Cells (Stem cell transplantation)
Some patients with leukemia have stem cell transplantation. A stem cell transplant allows a patient treated with doses of drugs is high, radiation, or both. High doses destroy both the leukemia cells and normal blood cells in the bone marrow. Then, patients received stem cells are healthy through a flexible tube placed in a large vein in the neck or chest area. New blood cells develop from stem cells are transplanted.
There are several types of stem cell transplantation:
* Bone Marrow Transplantation - Stem cells (stem cells) come from bone marrow (bone marrow).
* Peripheral stem cell transplantation-The stem cells (stem cells) from peripheral blood.
* Umbilical cord blood transplantation-For a child with no donor, the doctor may use stem cells from umbilical cord blood (umbilical cord blood). Umbilical cord blood is from seoarng newborns. Sometimes umbilical cord blood frozen for use in next day.
Stem cells (stem cells) may come from patients or from a donor:
* Autologous stem cell transplantation-This type of transplant uses the patient's stem cells themselves. The stem cells taken from patients, and the cells may be treated to eradicate leukemia cells are present anything. The stem cells frozen and stored. After the patients received high-dose chemotherapy or radiation therapy, stem cells are stored thawed and returned to the patient.
* Allogeneic stem cell transplantation-This type of transplant uses stem cells from a healthy donor. Brother, sister, parent or patient may be the donor. Sometimes the stem cells come from a donor who is not related. Doctors use blood tests to ensure the donor's cells match the patient's cells.
* Syngeneic stem cell transplantation-This type of transplant uses stem cells from the patient's identical twin brother is healthy.
After a stem cell transplant, patients usually stay in hospital for several weeks. Health care team protects patients from infection until the cells are transplanted stem cells begin to produce enough white blood cells.
Side effects Leukemia Treatment
Because cancer treatment may damage cells and tissues healthy, side effects are generally undesirable. Side effects that specifically depends on many factors, including the type and extent of treatment. Side effects may not be the same for everyone, and they even change from one treatment session to the next. Before treatment starts, your doctor will explain possible side effects and suggest ways to control them.
Chemotherapy
The side effects of chemotherapy depend mainly on the specific drugs and dosage. In general, Onat anticancer drugs affect cells that divide rapidly, especially leukemia cells. Chemotherapy can also affect other cells that divide rapidly:
* Blood Cells: These cells fight infection, help blood clot, and carry oxygen to all parts of the body. When blood cells are affected, patients are more likely to get infections, may bruise or bleed easily, and may feel very weak and tired.
* Cells At Root-Root Hair: Chemotherapy can lead to hair loss. Hair grows back, but the new hair may be somewhat different in color and texture.
* Cells that line the intestinal: Chemotherapy can cause mouth sores and lips, nausea and vomiting, diarrhea, and poor appetite. Many of these side effects can be controlled with medications.
Some anticancer drugs can affect fertility patients. Women may have menstrual periods or irregular periods might stop altogether. Women may have symptoms of menopause, like hot and vaginal dryness. Men may stop producing sperm. Because these changes may be permanent, some men have their sperm frozen and stored before treatment. Most children treated for leukemia appears to have normal fertility when they grow into adulthood. However, depending on the drugs and doses used and the age of the patient, some boys and girls may be infertile when they become adults.
Because targeted therapy (sometimes used for chronic myeloid leukemia) affects only leukemia cells, it causes fewer side effects than most other anticancer drugs. However, Gleevec may cause patients to retain water. This may cause swelling or bloating.
Biological Therapy
Side effects of biological therapy differ with the types of compounds used, and from patient to patient. Rashes or swelling where the biological therapy is injected are common. Influenza-like symptoms may also occur. Health care team may monitor the blood for signs of anemia and other problems.
Radiation Therapy
Radiation therapy may cause patients to become very tired as treatment continues. Resting is important, but doctors usually advise patients to try to stay active as they can. In addition, when patients receive radiation therapy, it is common for their skin becomes red, dry, and sensitive to the treated area. Other side effects depend on the treated areas of the body. If chemotherapy is given at the same time, side effects may be worse. Your doctor can suggest ways to reduce these problems.
Transplantation of Stem Cells (Stem cell transplantation)
Patients who had stem cell transplantation face an increased risk of infection, bleeding and other side effects because the doses of chemotherapy and radiation they receive. In addition, graft-versus-host disease (GVHD) may occur in patients who received stem cells from bone marrow of a donor. In GVHD, stem cells are donated to react against the tissues of the patient. Most often, liver, skin, or digestive tract is affected. GVHD can be mild or very severe / severe. It can occur at any time after the transplant (transplant), even years later. Steroids or other drugs may be helpful.
What Happens After Leukemia Treatment
Supporting Care
Leukemia and its treatment can lead to other health problems. Patients receive supportive care to prevent or control these problems and to improve the enjoyment (of life) and their quality of life during treatment.
Because people with leukemia get infections very easily, they may receive antibiotics and other drugs to help protect them from infections. Health care team may advise them to stay away from the collection of people and from people with colds and other infectious-disease Disease. If an infection develops, it can be serious and must be treated immediately. Patients may require a stay in the hospital for treatment.
Anemia and bleeding are other problems that often require supportive care. These patients may require transfusions of red blood cells to help them have a more stout effort. Platelet transfusions can help reduce the risk of serious bleeding.
Dental care also is very important. Leukemia and chemotherapy can make the mouth of a sensitive, easily infected, and possibly bloody. Doctors often advise patients to have a complete dental examination and, if possible, undergo the necessary dental treatment before chemotherapy began. Dentists show patients how to keep their mouth clean and healthy during treatment.
Nutrition
Patients need to eat well during cancer therapy. They need enough calories to maintain a good weight and protein to maintain strength. Good nutrition often helps people with cancer feel better and have more energy.
But eating well can be difficult. Patients may not appetite if they feel uncomfortable and tired. Also, the side effects of treatment, such as poor appetite, nausea, or vomiting, can be a problem. These foods may taste different.
The doctor, a nutritionist (diet), or other health care providers may suggest ways to maintain a healthy diet.
Follow-up Care
Follow-up care after treatment for leukemia is an important part of the overall treatment plan. Regular checkups ensure that any changes in the health record. The doctor can find problems and treat them as soon as possible. Checkups may include a physical examination that carefully, blood tests, x-rays, bone marrow aspiration, or spinal tap. The doctor can explain the follow-up plan - how often patients should visit a doctor and what tests are required.
Prepare NCI has a booklet for people who have completed their treatment to help answer questions about follow-up care and concern, other concerns.
Support For People With Leukemia
Living with a serious illness such as leukemia is not easy. Some people find they need help to cope with or control the emotional aspects and practical of their disease. Support groups can help. In these groups, patients or their families gathered to share what they have learned about the face / control of diseases and the effects of treatment. Patients may want to speak with a member of their health care team about finding a support group. Maybe groups offer support in person, by telephone, or on the internet.
People living with cancer may be concerned about services for their families, maintain their jobs, or continuing daily activities. Concerns-concerns about the care and control of side effects, hospitalization, hospitalization, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about care, employment, or other activities. Met a social worker, counselors, or members of the religious can be beneficial to those who want to talk about feelings or discuss their feelings concern-concern them. Often, a social worker can suggest resources for financial aid, transportation (transportation), home care, or emotional support.
Cancer Information Service can provide information to help patients, families find programs, services, and publications.
Future For Leukemia Patient-Patient
Doctors across the country are conducting many types of clinical trials. These are research studies where people take part voluntarily. The studies include methods of treatment of new and supportive care for patients with leukemia. Research has led to advances, and researchers continue to find more effective approaches.
Patients who join these studies have the first chance to benefit from treatments that have shown promise in early studies. They also make an important contribution to the science of medicine by helping doctors learn more about the disease. Although clinical trials may expose some risks, researchers take the steps very carefully to protect their patients.
Researchers are testing therapies that new biology and new anticancer drugs, dosages, and schedules maintenance. They are also working with various drugs and with combination of drugs, biological therapy, radiation therapy, and stem cell transplantation.
Patients who are interested in being part of a clinical trial should talk with their doctor. They might want to read the NCI booklets about taking part in research studies of cancer treatment. He explains how clinical trials carried out and explains the potential benefits and risks.
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