LEUKEMIA

The World Health Organization fact sheet has revealed that cancer is a leading cause of death worldwide, accounting for 7.9 million deaths (around 13% of all deaths) in 2007. The most frequent types of cancer differ between men and women. About 30% of cancer deaths can be prevented. Tobacco use is said to be the single most important risk factor for cancer. Cancer arises from a change in one single cell. The change may be started by external agents or inherited genetics factors. The main types of cancer leading to overall cancer mortality each year are: lung (1.4 million deaths/year), stomach (866,000 deaths), liver (653,000 deaths), colon (677,000 deaths), and breast (548,000 deaths). About 72% of all cancer deaths in 2007 occurred in low – and – middle – income countries. It is projected already that cancer- related deaths are on the rise and would likely claim about 12 million people worldwide by 2030.

Leukemia is a type of cancer in the blood cells which is subtly killing people all over the world, so much so that something urgent must be done to curtail the spread and fatality rate. Simply known as cancer of the blood, researchers over the years have been focusing on effective means of treatment, better ways of treatment, improving the quality of life for patients, appropriate care in remission or after cures.

Healed From Leukemia

Do miracles still happen in our time? Many don’t believe that God still performs miracles especially these days of computer craze when everything is on the fast track; marvellously done by computers. To most people, especially those who have not experienced it, miracles remain a phenomenon of the past. But many still believe that miracles do still happen. Among them are just simple and ordinary people who have unshaken faith in what God can do.

Mary Ann Molina Besinga, a 39- year old mother from Manila, Philippines, who completely trusted God without wavering during the agonizing moments of her life is one of them. Her true-life story may serve as great evidence that God is still performing miracles in our time. Mary Ann is a survivor of that dreadful and fatal ailment known as Leukemia. It happened to her eighteen years ago when she was just a youth, fresh young lady of 23, working as a junior savings bookkeeper at Equitable Banking Corporation in Manilla. It was in August, 1990 when Mary Ann first experienced excruciating pains from her hips down to her knees. As she confessed, the pain was so unbearable that her shouts of agony could be heard from the ground floor of huge building up to the second floor.

The pains could only be compared with that of one suffering from bone cancer. When she tried to walk a few steps forward, it seemed she lost all the strength on earth to do that. These pains continued for a period of one month, making her family to seek the help of a Manila doctor’s hospital for explanation. After serious of physical examinations, it was then finalized that Mary Ann had the fatal ailment ,leukemia. “Mary Ann had LEUKEMIA!! That was the shattering reality. “At the tender age of 23, when people’s career are just starting to blossom, when she was just starting to reach out for her dreams, when it was just two years past her graduation from college, when she was just starting to build up her career – she had not even reached the half of her life – she was DYING.

The following month of medical treatment were moments of terrible battles for Mary Ann. It was just like experiencing hell on earth. Her family sought the help of Manila Medical Center for medical treatment. Her worst battle was her appointment with chemotherapy.

She underwent chemotherapy. This made her life truly miserable. She had to bear with the side effects of the medical treatment daily which included severe headaches, backaches and stomachaches, constipation, vomiting, loss of appetite, hair loss and even baldness. During this time, Mary Ann weighed only 70 pounds. She was not only suffering physically but grieving emotionally due to the break-up of her five-year-old relationship with a boyfriend. This made her suffering more intense. But there was a great consolation. God indeed provided for her medical treatment a miracle of sorts. Her country’s Social Security System and Equitable Banking Corporation, the bank where she was employed, picked her medical bills, a gesture she least anticipated. In addition, her family, friends and relatives showered her with unbelievable love and went all out to provide for her needs………..”

Mary Ann Molina Besinga is one of the lucky few that got healed from leukemia and is alive to tell the story online. There are lots of people worldwide, especially in Africa, who died from the disease. In Nigeria, Austin Oghide, the former Health Information and Promotion officer for World health Organization in Nigeria, reportedly died of leukemia. In addition, NTA;s ace sports commentator and broadcaster, Yinka Craig, is said to have died at age 60 from lymphoma,  an illness associated with leukemia. In 1998, it was estimated that each year, approximately 30,800 individuals would be diagnosed with leukemia in the United States and 21, 700 would die of the disease. This represents about 2% of all forms of cancer.

What is Leukemia?

Consultant Physician and Haematologist at the department of medicine, Lagos University Teaching Hospital, LUTH, Dr. Olufemi Kehinde, explain that “leukemia is a cancer of the blood that tends to affect the white cells of the blood. The blood has three cellular elements; one of them is the white blood cell that protects the body from many things especially infection. The second is the red cell that carries oxygen around the body for use, which is red and is known as blood. The third group is the platelet, a very small cell that helps a person from bleeding during injury. In the case of leukemia the white cells are involved in which the body productions of these white cells are not under any normal body control. They are produced at the rate determined by the disease irrespective of any reaction”.

Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place. Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. Leukemia is cancer that begins in blood cells.

Normal blood cells

 Blood cells form in the bone marrow. Bone marrow is the soft material in the center of most bones.

Immature blood cells are called stem cells and blast. Most blood cells mature in the bone marrow and then move into the blood vessels. Blood that flows through the blood vessels and heart is called the peripheral blood.

The bone marrow forms different types of blood cells. Each type has a special function:

White blood cells help fight infection. Red blood cells carry oxygen to tissues throughout the body.

Platelets help form blood clots that control bleeding.

In people with leukemia, the bone marrow produces abnormal white blood cells. The abnormal cells are leukemia cells. At first, leukemia cells function almost normally. In time, they may crowd out normal white blood cells, red blood cells, and platelets. This makes it hard for blood to its work.

Classification

Leukemia is clinically and pathologically subdivided into several large groups. The first division is between its acute and chronic forms:

Acute leukemia is characterized by rapid increase of immature blood cells. This crowding makes the bone marrow unable to produce healthy blood cells. Acute forms of leukemia can occur in children and young adults. (In fact, it is a more common cause of death for children in the US than any other type of malignant disease). Immediate treatment is required in acute leukemia due to the rapid progression and accumulation of the malignant cells, which then spill over into bloodstream and spread to other organs of the body. Central nervous system (CNS) involvement is uncommon, although the disease can occasionally cause cranial nerve palsies.

Chronic leukemia is distinguished by the excessive build – up of relatively mature, but still abnormal blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal white blood cells in the blood. Chronic leukemia mostly occurs in older people, but can theoretically occur in any age group. Whereas acute leukemia must be treated immediately, chronic forms are sometimes monitored for some time before treatment to ensure maximum effectiveness of therapy.

Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemia into lymphoblast or lymphocyte leukemia and myeloid or myelogenous leukemia:

-          In lymphoblastic or lymphocytic leukemia, the cancerous change takes place in a type of marrow cell that normally goes on to form lymphocytes.

-          In myeloid or myelogenous leukemia, the cancerous change takes place in a type of marrow cell that normally goes on to form red cells, some types of white cells, and platelets.

Combining these two classifications provides a total of four main categories:

 

 

 

Four major kinds of leukemia

Cell type     Lymphocytic leukemia (or “lymphoblastic”)     Myelogenous leukemia (also “myeloid” or “nonlymphocytic”)

Acute     Acute lymphocytic Leukemia (ALL)       Acute myelogenous leukemia (AML)

Chronic     Chronic lymphocytic Leukemia (CLL)       Chronic myelogenous leukemia (CML)

 

Within these main categories, there are typically several subcategories. Finally, hairy cell leukemia is usually considered to be outside of this classification scheme.

• Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those aged 65 and older. Standard treatments involve chemotherapy and radiation. The survival rates vary by age: 85% in children and 50% in adults.
• Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of affected people are men. The five-year survival rate is 75%. It is incurable, but there are many effective treatments.
• Acute myelogenous leukemia (AML) occurs more commonly in adults than in children, and more commonly in men than women.AML is treated with chemotherapy. The five year survival rate is 40%.
• Chronic myelogenous leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with imatinib (Gleevec) or other drugs. The five-year survival rate is 90%.
• Hairy cell leukemia (HCL) is sometimes considered a subset of CLL, but does not fit neatly into this pattern. About 80% of affected people are adult men. There are no reported cases in young children. HCL is incurable, but easily treatable. Survival is 96% to 100% at ten years.

Symptoms

There is damage to the bone marrow, by the way of displacing the normal bone marrow cells with higher numbers of immature white blood cells. Result is a lack of blood platelets, which are important in the blood- clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).

White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient’s immune system to be unable to fight off a simple infection or to start attacking other body cells.

Finally, the red blood cell deficiency leads to anaemia, which may cause dyspnea. All symptoms can be attributed to other diseases.

Some other related symptoms:

-           Fever, chills, night sweat and other flu-like symptoms

-          Weakness and fatigue

-          Swollen or bleeding gums

-          Neurological symptoms (headaches)

-          Enlarged liver and spleen

-          Frequent infection

-          Bone pain

-          Joint pain

-          Dizziness

-          Nausea

-          Swollen tonsils

-          Diarrhoea

-          Paleness

-          Malaise

-          Unintentional weight loss

The word leukemia, which means ‘white blood’, is derived from the disease’s namesake high white blood cell counts that most leukemia patients have before treatment. The high number of white blood cells appears when a blood sample is viewed under a microscope. Frequently, these extra white blood cells are immature or dysfunctional. The excessive number of cells can also interfere with the level of other cells, causing a harmful imbalance in the blood count.

Some leukemia patients do not have high white blood cells counts visible during a regular blood count. This less common condition is called aleukemia. The bone marrow still contains cancerous white blood cells which disrupt the normal production of blood cells. However, the leukemic cells are staying in the marrow instead of entering the bloodstream where they would be visible in a blood test. For an aleukemic patient, the white blood cell counts in the bloodstream can be normal or low. Aleukemia can occur in any of the four major types of leukemia, and is particularly common in hairy cell leukemia.

Diagnosis of leukemia

According to Dr. Olufemi Kehinde, leukemia can be diagnosed through bone marrow examination to look for abnormal number or forms of cells in the bone marrow. It also requires blood tests to look for an abnormal number of white blood cells.

Causes and risk factors

Most times, the main cause of the different types of leukemia is known, says Kehinde. He noted that they can generally be caused by exposure to radiation and some chemicals, for example benzene, which people should avoid. The doctor also noted that these different types of leukemia can be caused by the use of some medications that are used to treat other cancers in the body. They can also arise as a result of other haematological diseases.

Other experts categorized their suspicions on four possible causes: natural or artificial ionizing radiation certain kinds of chemicals some viruses genetic predispositions.

Leaukemia, like other cancers, results from somatic mutations in the DNA which activate oncogenes or deactivates tumor suppressor genes, and disrupt the regulation of cell death, differentiation or division. These mutations may occur spontaneously or a s result of exposure to radiation or carcinogenic substances and are likely to be influenced by genetic factors. Cohort and case-control studies have linked exposure to petrochemicals, such as benzene, and hair dyes to the development of some forms of leukemia.

Viruses have also been linked to some forms of leukemia. For example, certain cases of LL are associated with viral infections by either the human immunodeficiency virus or human T-lymphotropic virus (HTLV – 1 and 2, causing adult T-cell leukemia/lymphoma). However, a CNN Health report says children may be offered limited protection against leukemia by exposure to certain germs.

Fanconi anemia is also a risk factor for developing acute myelogenous leukemia.

Until the cause or causes of leukemia are found, there is no way to prevent the disease. Even when the causes become known, they may not be readily controllable, such as naturally occurring background radiation, and therefore not especially helpful for prevention purposes.

Research by Olufunke Osindele