Ø ( Blood Cancer )
Cancer is a disease of the cells in the body. The rare many types of cancer which arise from different types of cell. What all cancers have in common is that the cancer cells are abnormal and do not respond to normal control mechanisms. Large numbers of cancer cells build up because they multiply 'out of control', or because they live much longer than normal cells,or both. With leukemia, the cancerous cells in the bone marrow spill out in to the blood stream. There are several types of leukemia. Most types arise from cells which normally develop into white blood cells. (The word leukemia comes from a Greek word which means 'white blood'.)
Ø (Leukemia )
Leukemia is a cancer of cells in the bone marrow (the cells which develop into blood cells).
Ø What is normal blood made up made?
Ø Blood cells,which can be seen under a microscope, make up about 40% of the blood's volume.Blood cells are divided into three main types:
Ø Red-cells (erythrocytes). The make blood a red color. One drop of blood contains about five million red cells. Red cells contain a chemical called hemoglobin.This binds to oxygen, and takes oxygen from the lungs to all parts of the body.
Ø White cells (leukocytes). There are different types of white cells, which are called neutrophils (poly morphs),lymphocytes, eosinophil, monocytes, and basophils.They are part of the immune system. Their main role is to defend the body against infection.
Ø Platelets,these are tiny and help the blood to clot if we cut our selves
Ø Plasma is the liquid part of blood and makes up about 60% of the blood's volume.Plasma is mainly made from water, but contains many different proteins and other chemicals, such as hormones, antibodies, enzymes, glucose, fat particles,salts, etc. When blood spills from your body (or a blood sample is taken into a plain glass tube) the cells and certain plasma proteins clump together to for maclot. The remaining clear fluid is called serum.
Ø The bone marrow, Stem Crlls and blood cell-production
Ø Bone-marrow:Blood cells are made in the bone marrow by 'stem' cells. The bone marrow is the soft 'spongy' material in the center of bones. The large flat bones,such as the pelvis and breast-bone (sternum), contain the most bone marrow. To make blood cells constantly you need a healthy bone marrow. You also need nutrients from your diet, including iron and certain vitamins.
Ø Blood Production
Ø You make millions of blood cells very day. Each type of cell has an expected life-span.For example, red blood cells normally last about 120 days. Some white blood-cells last just hours or days - some last longer. Every day millions of blood cells die and are broken down at the end of their life-span. There is normally a fine balance between the number of blood cells that you make, and the number that die and are broken down. Various factors help to maintain this balance.For example, certain hormones in the bloodstream and chemicals in the bone marrow called 'growth factors' help to regulate the number of blood cells that are made.
Ø The main types of leukemia are:
Ø Acute lymphoblastic leukemia -'ALL' (sometimes called acute lymphocytic leukemia).
Ø Acute myeloid leukemia - 'AML'.
Ø Chronic lymphocytic leukemia -'CLL'.
Ø Chronic myeloid leukemia - 'CML'.
Ø Acute Lymphoblastic Leukemia
Ø In acutely lymphoblastic leukemia (ALL) the bone marrow makes large numbers of abnormal immature lymphocytes called lymphoblast. There are various sub-types of ALL.For example, the abnormal lymphoblast can be immature B or T lymphocytes.Typically, ALL develop squite quickly (acutely) and rapidly become worse (over a few weeks or so)unless treated. ALL can occur at any age, but about 6 in 10cases occur in children. It is the most common form of leukemia to affect children (although it is an uncommon disease).
Ø Acute Myeloid Leukemia
Ø In acute myeloid leukemia (AML) the bone marrow makes large numbers of abnormal immature white blood cells which are derived from a myeloid stem cell. The abnormal immature cells are called blasts. There are various sub-types of AML,depending on exactly what cell type becomes cancerous and at what stage in the maturing process.Typically, AML develops quite quickly (acutely) and rapidly becomes worse (over a few weeks or so) unless treated. AML is a nun common disease. Most cases occur in people aged over 50.
Ø Chronic Lymphocytic Leukemia
Ø In chronic lymphocytic leukemia (CLL) you have many abnormal B lymphocytes. The main reason for the build-up of the abnormal lymphocytes is because they live to long - they do not die after the usual life span of a lymphocyte. (This is different to the acute types of leukemia where the cells rapidly multiply 'out of control'. In CLL the abnormal lymphocytes are not thought to multiply faster than normal lymphocytes.)Typically, CLL develops and progresses very slowly -over months or years, even without treatment. CLL is the most common type of leukemia. It occurs in around 2,750 people each year in the UK. Most cases occur in people over at the age of 60.
Ø Chronic Myeloid Leukemai
Ø Chronic myeloid leukemia (CML)develops due to a problem with a stem cell in the bone-marrow which become sub normal. The abnormal stem cell multiplies and the cells that are made from the abnormal stem cells mature and develop into near normal white-cells -mainly neutrophils, basophils and eosinophil (collectively called-granulocytes). Typically, CML develops and progresses slowly - over months or years, even without treatment. CML is the rarest of the four main types of leukemia.There are fewer than 1,000 cases in the UK each year. It occurs mainly in adults.and become more common with increasing age.
Ø What Causes leukemia?
Ø A leukemia is thought to start first from one abnormal cell. What seems to happen is that certain vital genes which control how cells divide, multiply and die,are damaged or altered. This makes the cell abnormal. If the abnormal cell survive sit may multiply 'out of control' or survive a long time, and develop in to leukemia.
Ø In most cases of leukemia, the reason why a cell becomes abnormal is not known.There are certain 'risk factors' which increase the chance that certain leukemias will develop, but these only account for a small number of cases.
Ø Some Types of risk Factors for Leukemia Include--
Ø Radiation for example,previous radiotherapy for another condition. Many of the survivors of the atom bomb used in World War II developed leukemia due to the fall out of radiation.
Ø Past treatment with the mother apply or other drugs that weaken the immune system.Certain genetic disorders, the most common being Down's syndrome. Exposure to certain chemicals such as benzene.
Ø What are the main symptoms of leukemia ?
Ø As large numbers of abnormal blood cells are made, much of the bone marrow fills with these abnormal cells.Because of this it is difficult for normal cells in the bone-marrow to survive and make enough normal mature blood cells. Also, the abnormal cells spill out into the bloodstream.
Ø The main Problems which can develop include:
Ø Anemia -This occurs as the number of red blood cells in the bloodstream goes down. This can cause tiredness, breathlessness and other symptoms. You may also look pale.
Ø Blood clotting problems. This is due to low levels of platelets in the bloodstream.This can cause easy bruising,bleeding from the gums and other bleeding-related problems.
Ø Serious infections.The abnormal white blood cells do not protect against infection.Also, there is a reduced number of normal white blood cells which usually combat infection.There fore, serious infections are more likely to develop.Depending on the type and site of infection which develops, the symptoms can vary greatly.
Ø The time take into develop these symptoms after the disease starts varies. Typically,it is with in weeks for ALL or AML. It may take months or years for symptoms to develop with CLL or CML, as these leukemias progress slowly.
Ø The abnormal cells may also buildup in lymph glands and in the spleen. You may there fore develop swollen glands in various parts of the body, and develop an enlarged spleen.
Ø Other Symptoms which may develop include:
Ø Pain in the bones or joints (mainly with ALL), persistent fever and weight loss.
Ø How is leukemia diagnosed and assessed?
Ø A Blood test:
Ø A blood test can often suggest the diagnosis of leukemia, as abnormal cells are of the detected in the blood test.Further tests are usually done to confirm the diagnosis.
Ø A bone marrow sample For this test a small amount of bone marrow is removed by inserting a needle into the pelvis bone (or sometimes the breast-bone (sternum)). Local anesthetic is used to numb the area. A small sample of bone may also betaken.The samples are put under the microscope to look for abnormal cells and are also tested in other ways. This can confirm the diagnosis. (See separate leaflet called 'Biopsy -Bone Marrow' for more detail.) A bone marrow test may not be needed to confirm the diagnosis of CLL.
Ø Cell and Chromosome analysis Detailed tests are often done on abnormal cells obtained from the bone marrow sample or blood test. These find out the exact type, or sub-type, of the cell that is abnormal.
Ø Lumbar puncture
Ø Test collects a small amount of fluid from around the spinal cord - cerebro spinal fluid (CSF) .It is done by inserting a needle between the vertebrae in the lower (lumbar) region of the back. (See separate leaflet called 'Lumbar Puncture' for more detail on this test.) By examining the fluid for leukemia cells, it helps to find out if the leukemia has spread to the brain and spinal cord. This is mainly done when assessing ALL and sometimes AML.
Ø Various Other tests
Ø A chest X-ray,blood tests and other tests are usually done to assess your general well being
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