Written by: Kimora Sellers, Emma Wang, Winnie Chen, Manuel Pereira, Sarah Reidwan, and Cindy Wu
Introduction:
According to Leukemia & Lymphoma Society(LLS), 54,025 children and adolescents younger than 20 years old are living with leukemia, lymphoma, and myeloma. Numerous types of cancer, leukemia is the most common cancer diagnosed in children younger than 20 years old. The population of cancer diagnosed children is 25.1 percent of all cancer in the age-group(Childhood and Adolescent Blood Cancer Facts and Statistics). Acute lymphocytic leukemia(ALL) is the most common type among all four types of leukemia. ALL is a cancer of the blood and bone marrow; it can get worse in a really short time if patients do not get treatment immediately.
Cause:
General Cause of Leukemia:
Leukemia is a cancer that is caused by the bone marrow secreting an excessive amount of abnormal blood cells that do not function properly. These abnormalities are thought to occur when blood cells acquire changes (mutations) in their genetic material or DNA. It is unknown what causes these changes, however the mutations lead to uncontrolled blood cell production. There are 4 main subtypes of leukemia, each having their own characteristics, effects, causes, and treatments. They are divided based on whether or not the leukemia is slow growing (chronic) or fast growing (acute). They are then further classified into groups on whether or not they begin in myeloid or lymphoid cells. Both myeloids and lymphoids are the daughter cells of hematopoietic stem cells; immature cells that can develop into any blood cell type. This means that they are created once a hematopoietic cell undergoes division by mitosis. Although myeloid and lymphoid cells share an origin, they each develop differently. Lymphoid cells produce lymphocytes, whereas myeloid cells produce red blood cells, granulocytes, monocytes, and platelets.
Acute Lymphocytic Leukemia(ALL):
The most common form of Leukemia in children is a fast growing disease caused by a DNA mutation in the stem cells of the bone marrow, causing an excessive amount of lymphocytes to be produced. These cells normally assist in fighting infection, but in ALL, they are abnormal and do not properly function. These abnormal cells can also spread to other parts of the body, including the brain and spinal cord.
Effects:
The effects of leukemia can be roughly divided into two categories.
The first one is usually related to the destruction of hematopoietic function in the bone marrow. In other words, it's tough for normal blood cells to mature and multiply inside your bone marrow. Symptoms caused by the destruction of bone marrow hematopoietic function include:
Bruising and bleeding spot: due to the decrease in megakaryocytes that produce platelets.
Anemia: A decrease in the number of mother cells that make red blood cells, resulting in a lack of red blood cells.
Frequent or severe nosebleeds
Pale skin
Feeling fatigue
Feeling dizzy
Fever and frequent infections: Most white blood cells are cancer cells, which do not function normally, resulting in decreased immunity and susceptibility to disease.
The second leukemia symptom category is related to white blood cells' ability to enter body tissues. The effects include:
Lumps: caused by swollen lymph nodes in and around the neck, armpits, abdomen, or groin
Bone pain or joint pain: caused by the massive proliferation of blood cancer cells in the bone marrow.
Swollen, bleeding gums
Shortness of breath: caused by enlarged lymph glands in the chest and septum
Pain in the abdomen: due to the enlargement of kidneys, liver, and spleen.
Who's more at risk:
Ages: Children younger than 15 years old and older than 50.
Races: White people are more at risk than African American.
Gender: Males are more likely to develop ALL than females.
Genetic Syndromes:
Down Syndrome
Ataxia Telangiectasia
Li-Fraumeni Syndrome
Klinefelter Syndrome
Bloom Syndrome
Fanconi Anemia
Neurofibromatosis
Wiskott-Aldrich Syndrome
Smoking, and viruses also increase the risk of developing ALL.
Life Expectancy:
In terms of life expectancy for cancer, this rate is measured in 5-year relative survival which is the percentage of patients diagnosed with cancer after five years. For leukemia, this rate comes down to many factors including age, advancement of treatment, and patient’s response to treatment. See the graph below for the estimation of the rate for ALL(Acute Lymphocytic Leukemia) based on age.
Treatment:
There are five main types of treatment.
1. Chemotherapy
Chemotherapy involves the usage of drugs to kill the cancer cells. Based on the type of Leukemia present, the patient may either receive a single drug or a mix of 2 or more drugs. These drugs will then be administered via injection to the vein or cerebrospinal fluid or may even be given via oral intake. The process of chemotherapy takes place in cycles. There is typically a treatment cycle, followed by a rest period.
2. Targeted Therapy
Targeted Therapy involves the use of drugs which interfere with certain molecules vital for the propagation of cancer cells. These drugs can stop Leukemia cells from progressing, destroy Leukemia cells or even stimulate the immune system to identify and kill cancer cells while keeping the normal cells alive.
3. Biological Therapy
Biological Therapy uses substances to boost the patient's immune response. It can be given through the vein or injected into a muscle. These drugs can either decrease the rate of propagation of the cancer cells or aid the immune system in killing these cells.
4. Radiation Therapy
Radiation Therapy typically uses high energy X-rays or other types of radiation to destroy the cancer cells. In such instances, radiation will be focused on parts such as the spleen, brain or other parts of the body where leukemia is present.
5. Stem Cell Transplant
Stem Cell Transplants replace the cancer-stricken bone marrow with the stem cells or marrow from a compatible donor that does not have Leukemia. Prior to the transplant, the patient will receive high dosages of chemotherapy or radiation therapy or even both. This kills all the Leukemia cells and normal blood cells in the patient's bone marrow. Following which, the patient will receive healthy stem cells through a big vein.
There are three types of stem cell transplants that could be carried out.
Autologous Stem Cell Transplant (From the patient themselves) The patient's stem cells are removed before the high doses of chemotherapy or radiation therapy are administered. These cells are frozen, stored and will be thawed later for use after the Leukemia cells have been removed from the marrow.
2. Allogeneic Stem Cell Transplant (From another family member or a compatible donor) Blood tests let doctors know how close of a match the donor is with the patient.
3. Syngeneic Stem Cell Transplant (From an identical twin) If the patient has an identical twin, healthy stem cells from that twin can be used for the transplant.
Following the transplants, new and healthy blood cells will develop to replace the ones destroyed during the previous treatments.
Prevention:
There is no proven way of preventing leukemia but studies have shown some factors which might reduce the risk. Though many times the patients who suffer from leukemia might not have these risk factors. Some of these risk factors are :
Exposure to harmful chemicals , toxic radiations and pollution
Family history
Genetically inherited disorders which increase the risk
Smoking
A person who was previously diagnosed with cancer and used treatments like chemotherapy and radiation might end up getting diagnosed with leukemia in later life
Unhealthy Lifestyle
Avoid exposure to substances which contain Benzene and Formaldehyde
Also avoid exposure to pesticides
There are also risk factors which you cannot control like age (more common for children and people above the age of 50) , gender (Surveys show that it is a bit more common in males rather than in females) , and other genetically inherited syndromes which might increase the risk of leukemia.
Citation:
(Cover Image Source: Boston Children's Hospital)
"Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®)–Patient Version." National Cancer Inssitute , 2 Sept. 2022, www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq#:~:text=and%20treatment%20options.-,Childhood%20acute%20lymphoblastic%20leukemia%20(ALL)%20is%20a%20type%20of%20cancer,the%20blood%20and%20bone%20marrow.
"FACTS AND STATISTICS OVERVIEW." Leukemia & Lymphoma Society, www.lls.org/facts-and-statistics/facts-and-statistics-overview#Leukemia. Accessed 28 Dec. 2022.
Fayed, Lisa. "Can You Prevent Leukemia?" verywell Health, 19 Sept. 2022, www.verywellhealth.com/leukemia-prevention-514159.
"Leukaemia." Cancer Council, www.cancer.org.au/cancer-information/types-of-cancer/leukaemia. Accessed 28 Dec. 2022.
"Leukemia - Acute Lymphocytic - ALL: Risk Factors." Cancer.Net, May 2017, www.cancer.net/cancer-types/leukemia-acute-lymphocytic-all/risk-factors#:~:text=In%20general%2C%20ALL%20is%20most,more%20likely%20to%20develop%20ALL.
"Leukemia Prevention." Saint Francis Health System, www.saintfrancis.com/services/cancer-care/cancers-we-treat/leukemia/prevention-and-risk-factors#:~:text=Leukemia%20Prevention,-There%20is%20no&text=Nonetheless%2C%20studies%20indicate%20some%20types,treat%20other%20types%20of%20cancer. Accessed 28 Dec. 2022.
"Leukemia." Health Hub, 9 Dec. 2021, www.healthhub.sg/a-z/diseases-and-conditions/382/leukemia_ncis.
"Leukemia." Mayo Clinic, www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373. Accessed 28 Dec. 2022.
"Reducing your risk for leukemia." Canadian Cancer Society, cancer.ca/en/cancer-information/cancer-types/leukemia/risks/reducing-your-riskMayo Clinic, www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373. Accessed 28 Dec. 2022. "Signs and Symptoms of Acute Lymphocytic Leukemia (ALL)." American Cancer Society, 17 Oct. 2018, www.cancer.org/cancer/acute-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html. "What Is Chronic Myeloid Leukemia?" American Cancer Society, 19 June 2018, www.cancer.org/cancer/chronic-myeloid-leukemia/about/what-is-cml.html. Accessed 28 Dec. 2022.
"Signs and Symptoms of Acute Lymphocytic Leukemia (ALL)." American Cancer Society, 17 Oct. 2018, www.cancer.org/cancer/acute-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html.
"What Is Chronic Myeloid Leukemia?" American Cancer Society, 19 June 2018, www.cancer.org/cancer/chronic-myeloid-leukemia/about/what-is-cml.html.
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