Leukemia

.. take anticancer drugs for treatment of diseases may have a chance of getting leukemia because the patients received cancer chemotherapy over a long period of time: “Up to 10 percent of patients with Hodgkin’s disease who have been intensively treated with chemotherapeutic drugs may ultimately display signs of an acute granulocytic leukemia” (356). There is antileukemia therapy for Hodgkin’s disease. They are far more effective and outweigh the chance of developing leukemia later on. According to The Cambridge World History of Human Disease, the early symptoms of leukemia are like many other medical problems.

Fever, loss of weight and fatigue are the general symptoms of leukemia: Fever may be the most common symptom. It is usually caused by an infection of the skin, lung, or urinary tract, but it also may be due directly to the leukemia itself or to the release of compounds by the abnormal white cells. Infections are frequently because the leukemic white cells cannot protect against invasion by bacteria or other organic causes of disease, and too few normal white cells remain to do so. (846) The book also states that since these symptoms are involved with many illnesses, doctors do not always have suspicion of leukemia. Early detection of chronic lymphocytic leukemia is often found in elders that are being examined for other medical problems.

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On the other hand, acute leukemia can occur very suddenly, especially in children because it seems like a flu or cold: “Common symptoms of the leukemias do not seem to be a direct result of the increase and spread of leukemia cells. Instead, the functioning of the remaining normal elements of the blood and bone marrow is impaired” (847). Up to one third of the patient with cancer in blood have normal or low circulation white blood counts. In leukemia, the bone marrow is too crowded with white blood cells that it cannot move out into the bloodstream. Bleeding problems are not serious in the early period of the disease, but they can become serious as it progresses: “Bleeding is usually mild at first, with only small patches of black and blue discoloration under the skin. Later, the suppression of the platelet-forming cells in the bone marrow reduces the number of platelets produced” (848). Sometimes, patients may feel pain in the joints and bones, but it is not a major effect.

Also, other organs in the body such as the liver, heart, kidney, brain and the digestive system will continue to function quite normal under the early stage of the disease. According to the Cancer Book, all the patients with leukemia must have a record from all the physical examinations and laboratory investigations. The record will provide the physician a base line for treatment and to see if there are any other kinds of medical problem. Usually leukemia can be suspected by the physician based on the patient’s history and other symptom: “The definitive diagnosis must be made by examination of the cells in the bone marrow” (382). Observation of blood samples can confirm the doctor with the suspect of the disease. Also, inserting a thin needle into the marrow-rich cavity, in the backbone or the breastbone can do a bone marrow test.

The test take about 15 to 20 minutes and it can be performed in local clinics or doctor’s offices. The test may seem frightened to many patients, but it only involves a little discomfort in the back of the body. The Cancer Book further states that if leukemia is confirmed, different types of study will be performed: “Immunologic tissue typing, blood typing, coagulation and transfusion studies will be done. This information is most valuable if acquired before transfusions have made it difficult to test the properties of the patient’s own blood” (382). Bone transplantation is dependent on the tissue typing. Brothers and sisters of the sick patient are strongly suggested to tissue typing because they will have a greater chance of success in the bone marrow transplantation. In the Cancer Book, the information shows that the first treatment for all types of leukemia is chemotherapy.

The purpose of this treatment is to destroy the lurkemic cells in the bone marrow. But at the same time, the normal cells are being destroyed. It is hoping that the destruction of the leukemic cells will let the body develop the bone marrow with new and healthy cells. Patients will receive combination of chemotherapeutic drugs. It depends on the types of leukemia the patients carry; a completed remission is possible in 50 to 90 percent of patients.

The chemotherapy protocol is divided into three stages-induction, consolidation, and maintenance: “During the induction stage, the patient receives intensive chemotherapy in an attempt to induce a complete remission. The largest number of leukemic cells are destroyed at this time” (384). When the first remission is completed, the consolidation stage will take place: “The purpose of this stage is to eliminate any remaining leukemic eliminate any remaining leukemic cells” (384). The consolidation stage primarily uses the same drugs as in the induction stage. Both of the stages last about 2 to 3 months, depending on the patient’s response to the treatment.

If the remission is succeed, the patient will enter the maintenance stage: “It is designed to keep the patient in remission by preventing leukemic cells from returning to the bone marrow” (384). This stage will provide treatment to the patients while they can maintain a near-normal life style. From the Mayo Clinic Family Health Book, there is an article that talks about other treatments beside chemotherapy: “A bone marrow transplant is another treatment option for patients with acute leukemia” (357). The procedure is still under investigation, and it is only performed at selected medical centers. This method is usually not being considered unless the chemotherapy is not effective.

Before the transplantation, the patient will require to take ultrahigh doses of radiation and chemotherapy to destroy all blood-forming cells. The success rate for bone marrow transplants vary. The average survival rate is 10 to 15 percent. In further discussion, it is found that problems can occur after injection of the donor marrow: “The recipient’s immune system can reject the marrow transplant or the donor’s marrow, in its immunologically foreign environment, can reject the host” (358). For this reason, the closer the genetic makeup between the donor and host, the better the transplant will succeed.

Some patients will try to match themselves with a donor from their family or closed relatives because it will give them a better chance of the transplant’s process. In the transplantation, the following steps will be done: “The donor’s cells are injected into the recipient’s bloodstream to re-seed the marrow with healthy cells. The leukemia patient is kept in isolation to diminish the chance of infection and is given transfusions and antibiotics as needed” (387). In the bone marrow transplantation, the donor’s cell is to develop into new healthy cells in the sick patient’s body. According to the Cancer Book, great progress has been make over the last thirty years in treating the disease.

An increasing number of patients are cured. Although the process of treatment is long and produces painful illnesses, but rate of success in remission and other methods are worthwhile for most patients.