Living With Leukemia

It wasn’t the similar symptoms that Neil Keller was in hospital in January 1995. It wasn’t even the back ace that left him immovable. It was the odd red stripe that Kathy Keller noticed running down the back of her husband’s calf that prompted Kathy Keller to take his husband to the hospital.

After examination of his body doctor discovered that he had leukemia and needed immediate medical treatment.

According to the American Cancer Society (ACS), about 30,000 new cases of leukemia were diagnosed in the United States in the year 2001. ACS says that leukemia is more common in adults than children. It can happen to anyone and the causes are also unknown. Certain risk factors, such as genetic conditions or adverse environmental exposure, are believed to increase the chances of developing the disease.

All types of leukemia can be diagnose and treated. Drugs or new uses for existing drugs have been approved by the Food and Drug Administration to treat various types of leukemia. The most recent approved drugs are Gleevec (imatinib mesylate). It helps by blocking the rapid growth of white blood cells.

More Than One Disease

Acute Myelogenous Leukemia (AML)

It is most common for adults, but more men than women are affected. Many different chemotherapeutic plans are available for the treatment of AML. Overall, the strategy is to control bone marrow and systemic disease while offering specific treatment for the central nervous system, if involved. In general, most oncologists rely on combinations of drugs for the initial, induction phase of chemotherapy. Such combination chemotherapy usually offers the benefits of early remission and a lower risk of disease resistance. Consolidation treatments may be given to prevent disease recurrence once remission has been achieved. Consolidation treatment often entails a repetition of induction chemotherapy or the intensification chemotherapy with added drugs.

It involves, the maintenance treatment typically involves drug doses that are lower than those during the induction phase.

Chronic Myelogenous Leukemia (CML)

The challenge of treating newly diagnosed CML is to determine the best overall strategy to control the disease. General strategies for management include a variety of options:

Leukapheresis, also known as a peripheral blood stem cell transplant, with stem cell cryopreservation prior to any other treatment. The patient’s blood is passed through a machine that removes the stem cells and then returns the blood to the patient. Leukapheresis usually takes 3 or 4 hours to complete. The stem cells may or may not be treated with drugs to destroy any cancer cells. The stem cells then are stored until they are transplanted back into the patient.

HLA (human leukocyte antigen) typing of all patients under age 60, as well as typing of siblings, parents, and children, if available. This procedure will determine whether a compatible donor is available for stem cell transplantation.

Symptoms

Depending upon the abnormal cells and where these cells collect, person with leukemia may have several symptoms as follows:

Most common symptoms of leukemia are:

  • Fevers
  • Frequent infections
  • Feeling weak and tired
  • Bleeding gums, purple patches in the skin
  • Weight loss
  • Swollen lymph nodes, especially in the neck

The above symptoms are not sure signs of leukemia. But anyone with the similar symptoms should immediately consult a doctor. Only doctor can diagnose and treat the problem.

Diagnosis

Common blood tests called as the complete blood cell count (CBC), as well the blood cell examination under a microscope can provide a clue that a person has leukemia. Most people with acute leukemia will have more number of white blood cells, not enough red blood cells.

In addition to the CBC, a bone marrow test is often performed to confirm the diagnosis and help determine the type of leukemia. Bone marrow is the soft, spongy tissue in the center of the bones that produces the white blood cells, red blood cells and platelets. Samples are taken for examination under a microscope. A bone marrow called as biopsy involves taking a piece of bone with marrow inside, using a larger needle.

Other diagnostic tests could include:

  • lymph node analysis
  • fluid from the spinal cavity in the lower back
  • measuring certain chemicals in the blood
  • Using X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasound imaging, to obtain detailed images of internal organs of the body.

Treatment

There are two types of treatment: induction therapy and continuation/maintenance therapy. In induction therapy, the main treatment is to reduce the number of leukemia cells and the main process is to induce a remission.

Remission is a period of time when the cancer is responding to treatment or is under control. Remission can be partial or complete. When cancer is in complete remission stage, all the symptoms of the disease disappear. Partial remission is when the cancer reduces to some extent, but does not completely disappear. Remissions process can last anywhere from several weeks too many years. Complete remissions may continue for years and be considered cures.

The second phase of treatment occurs after a patient goes through remission process. The main purpose of this phase is to kill any left-out cancer cells.

Chemotherapy and radiation therapy are methods of treatments.

Chemotherapy – The chemotherapy involves the use of drugs to kill cancer cells. Surgery is usually not an option. Surgery is usually not an option because leukemia cells can spread to all the organs via the blood stream and the lymph vessels.

Radiation therapy – Involves the use of x-rays or other high-energy rays to kill cancerous cells and kill tumors.

New Treatments

One of the more sobering scientific advances of the 20th century was the realization that cancer is not a single disease but perhaps hundreds of diseases and that there would be no single cure.

Then along came genomics with the hope that it would reveal the molecular origins of cancer and other diseases. Doctors might someday tailor treatments to individuals based on the molecular profiles of their diseases. But when and how that might happen has been anyone’s guess.

Now, recent studies of leukemia in children suggest that the era of genome-based medicine may be closer than many had imagined.

Using gene chips, or DNA micro arrays, to measure gene activity, researchers have characterized a distinct type of leukemia called mixed lineage leukemia, or MLL. They found a gene that is overactive in most MLL patients and have developed a potential new drug that targets the product of the renegade gene. The drug, which kills leukemia cells in mice, is expected to enter clinical trials next year.

MLL cells (labeled blue) injected in mice spread throughout the body in the absence of treatment (top). Treatment with PKC412 after one week halts the spread of cancer (bottom). The advance, although preliminary, epitomizes the future direction of cancer research.

The Future

Doctor’s are finding better ways to treat leukemia; hence chances of recovery keep improving. A seek professional help in the treatment of leukemia is in the best position to discuss a patient’s diagnosis and to offer the best treatment for a particular type of leukemia.