Introduction:
Cancer is when some of the bodies cell begins to divide uncontrollably and are unable to stop and spreads to the surrounding tissues. Many cancers develop malignant tumours. (National Cancer Institute, 2018). Unlike the majorities of cancers, leukaemia does not produce a tumour but results in the mass production of abnormal leukocytes. Acute leukaemia cells progress quicker than chronic leukaemia which progresses over many years.
Leukaemia has four main sub-divisions. These groups are Acute Lymphocytic Leukaemia (ALL), Chronic Lymphocytic Leukaemia (CLL), Acute Myelogenous Leukaemia (AML) and Chronic Myelogenous Leukaemia (CML). Although these are the four main types of leukaemia’s there are also various subtypes for example the subtype to myelogenous leukaemia are promyelocytic, monocytic, erythroleukemia, and megakaryocytic leukaemia. (Cleveland 2018).
Leukaemia is further classified on what type of blood cells it affects. The majority of leukaemia’s affects the blood, primarily the leukocytes. However, leukaemia’s like ALL and CLL affect the lymph nodes and other organs. Lymphocytic leukaemia occurs if the cancerous changes, affects the type of marrow that make lymphocytes. Myelogenous leukaemia’s occur when the changes affect the type of marrow cells that go on produce red blood cells, other types of white blood cells and platelets.
For many cancers there is a distinct causality, for example lung cancer has a strong correlation to people who are smokers. Whereas, leukaemia is one where
Through all the studies done on the causes of leukaemia scientists are still unable to find the exact cause of this degenerate cancer that affects our immune system. It is said that the causes of leukaemia are derived from a combination of genetic and /or environmental factors.
People who develop leukaemia from their genetics usually show evidence of genetic abnormalities, such as down-syndrome. In regard to the environment having an influence on leukaemia, exposure to chemicals may be a factor. chemicals such as benzene which is found in gasoline, cigarettes and in the rubber industry (nhs.uk, 2018). Also, people who have under-gone previous cancer treatments such as radiation or chemotherapy have shown signs to being more susceptible to leukaemia.
Granted there are various categories of leukaemia the signs and symptoms are similar these include:
Poor blood clotting: Immature white blood cells crowd out platelets which are crucial for blood clotting. This causes a person to bruise or bleed easily.
Frequent infections: leukocytes are crucial for fighting off infections. As they consist of T and B cells. The T cells which has various types can destroy germs directly while on the other hand play a part in boosting or reducing the activities of the other immune system cells. The B cells protect the body by producing
antibodies that attach to germs in the body. If these leukocytes are not functioning properly frequent infections may occur and the immune system will attack other good cells in the body.
Other symptoms could be fever, chills, weight loss and studies have shown a correlation between AML and ascites. (Omicsonline.org, 2018)
If one experiences headaches the this may be a sign that the cancerous cells have invaded the central nervous system.
Signs:
Early signs may include: continuous fatigue, weight loss, having fever or chills and also getting constant / frequent infections.
Treatments
Before any treatment can be determined for someone with leukaemia the doctor must first decide on what type of leukaemia the person has. This is determined by various factors from the type of blood the leukaemia affects, to the stage of leukaemia the patient has if applicable. This is determined by carrying out blood tests. If you go for a routine blood test before initiation of leukaemia begins to show, the patient may undergo several exams such as a physical exam where the skin will be examined for pale skin usually from anaemia or swelling of the lymph nodes. Another way of testing a patient with leukaemia is by carrying out a bone marrow test where a sample of the bone marrow from the hipbone is exhumed and examined and checked for leukaemia cells. Once the type of leukaemia is determined, the doctors follow a treatment procedure to cure the leukaemia accordingly.
Chemotherapy: Consists of giving several drugs in a set regime as each medication destroys the tumour cells in different ways. Depending on the type of leukaemia the patient might receive this treatment orally in the form of a pill, intravenously (by means of injection) or intrathecally (injecting of drugs directly into the cerebrospinal fluid this type of chemotherapy in primarily used for patients whose leukaemia has spread into the central nervous system this is a
very specific method of chemo treating cancers) (chemotherapy, 2018). When dealing with acute leukaemia’s (AML and ALL) the type of chemotherapy used is divided into two stages firstly induction chemotherapy which is when a combination of drugs is used to destroy as many leukaemia cells as possible and then intensification therapy is induced where the remaining cells that are not seen in the blood stream are destroyed. On the other hand, patients with chronic leukaemia usually undertake their chemotherapy orally. Patients with CML may receive Gleevec® (imatinib), while patients with CLL may receive FCR (fludarabine, cyclophosphamide and rituximab) and bendamustine. (CancerCenter.com, 2018).
Radiation therapy: There are three types of radiation therapy for leukaemia these are EBRT, TBI and TMI. EBRT is most common for CLL to reduce the swelling in the liver, spleen and lymph nodes. This therapy minimizes the damage to healthy tissues and reduce side effects. TBI destroys cancerous cells in any place in the body. This is usually done in conjunction with patients who are also undergoing chemotherapy or stem cell transplant. TMI is usually used in conjunction with patients who are undergoing a stem cell transplant. This type of therapy allows the radiation to focus on the site where the leukaemia resides in the marrow. It targets the skeletal bone structure and reduces the patient’s exposure to radiation and prevent further damage to healthy organs (CancerCenter.com, 2018).
Stem transplant: This is a procedure where the diseased bone marrow is replaced with a healthy bone marrow. Before one can undergo a stem transplant they must receive a high dosage of chemotherapy or radiation therapy to destroy the bone marrow. Then afterwards they will receive an infusion of blood -forming stem cells that with enable a rebuild of bone marrow.
In recent years further research have been uncovered and approved by the FDA for treating acute myeloid leukaemia. They approved the use of the drug Daurismo to be used in combination with cytarabine in a low dosage to treat newly diagnosed AML patients in the age frame of 75 and above. Clinical trials have shown that there is a significant increase in the survival rate when these drugs are used in combination rather than cytarabine (form of chemotherapy) being used on its own. This is because the combination is much less abrasive for elder people to be able to cope. (Fda.gov, 2018)
The FDA have also approved the release of the drug enasidenib for patients with AML that targets forms of IDH2 proteins and liposomal cytarabine-daunorubicin CPX-351which is a two-drug combination chemo. This treatment is for patients who have relapsed or didn’t respond effectively to traditional treatments. (National Cancer Institute, 2018)
In conclusion we are now aware from all our research that leukaemia as a whole is a cancer that affects out immune system and prohibits our leucocytes from developing correctly and fighting against infections by overcrowding the blood stream with useless leukocytes. However, with our constant developments of treatments such as chemotherapy we are now able to help patients to rehabilitate their leucocytes to aid them back to functioning correctly. Chemotherapy which is one of the most popular form of treatments not just for patients with leukaemia but for a vast majority of cancers. While destroying the rapidly dividing cancer cells it also equally destroys the normal cells as well such as nails, hair, GI tract and bone marrow. Side effects to this form of treatment vary from patient to patient. These side effects include bleeding, hair loss nausea and infection. In recent years scientists have come out with less abrasive but yet more effective ways of treating leukaemia. A care team will also provide adequate care for the patient to help them through this process from pain management, oncology rehabilitation to naturophic medicine.