Particularities of Different Types of Leukemia

Leukemia is a form of cancer that occurs at the level of the spinal marrow. Inside the spinal marrow there is a type of immature blood cells that are called stem cells. These cells have a neutral initial state and later develop into different types of blood cells (white blood cells, red blood cells and platelets). Leukemia interferes in the normal process of cell maturation, leading to an accumulation of partially developed blood cells in the marrow, blood and later in body organs. Most of these resulted cells are inefficient inside the organism, as they can’t carry out the activity of normal blood cells.

Depending on to the rate of development, the disease can either be acute leukemia (developing very rapidly), or chronic leukemia (slow developing).

Particular to acute leukemia is the inability of stem cells (immature cells that can be found within the bone marrow) to reach the state of maturity. These immature blood cells tend to continuously divide and they accumulate in the bloodstream. Acute leukemia develops very rapidly and people who suffer from it need immediate treatment and specific therapy. If mistreated or ignored, acute leukemia causes the death of affected patients within a few months. While certain forms of acute leukemia are usually successfully treated, other forms don’t respond well to the specific treatment.

A characteristic of the chronic type of leukemia is that the diseased cells usually come from more mature cells, but in most cases they aren’t developed normally. The leukemia cells have long periods of life and they tend to accumulate within the bloodstream. Although normal people have between 5000 and 10000 white blood cells in their body, people who suffer from chronic leukemia may have more than 100000.

Lymphocytic and myelogenous types of leukemia are developed from different types of cells: the lymphocytic type of leukemia develops from cells called lymphoblasts or lymphocytes in the spongious tissue of the bones, while the myelogenous type of leukemia (sometimes refered to as myeloid and myelocytic leukemia) develops from myeloid cells. Judging by the types of cells involved in the development of leukemia and by the rate of cellular division specific to each form of the disease, the main types of leukemia are: acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL).

In addition to the common forms of chronic leukemia, there are also some rare types. Hairy cell leukemia (HCL), just like chronic lymphocytic leukemia, has a slow progression. The cells of hairy cell leukemia are different from other diseased cells mainly through their aspect. Hairy cell leukemia doesn’t usually respond well to treatment. Prolymphocytic leukemia is a very rare and unusual form of chronic lymphocytic leukemia.

Some cancers, called lymphomas, are caused by abnormal blood cells that are present in the lymph nodes, liver, spleen or other organs. These particular types of cancer don’t occur at the levels of the bone marrow and have a development that is not characteristic to most forms of lymphocytic leukemia.

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Survival Rates of Patients with Leukemia

Although medical science has evolved significantly in the last decades, the treatment of leukemia is still a major issue in present. Modern medicine doesn’t hold the cure for leukemia and medical treatments available these days provide differentiated results. Survival rates depend on the promptitude of diagnosis, the type of treatment and the patients’ responsiveness to specific cancer therapies and treatments. Although leukemia can’t always be completely overcome, the progression of the disease can be slowed down and its malignant effects can be contained with the help of existent cancer treatments. Thus, the life expectancy of patients with leukemia has risen considerably in the last three decades. By contrast, the mortality rate registered among patients with leukemia has known a pronounced decrease in the last decade.

The treatment of leukemia is focused towards achieving a complete remission with minimal side-effects. Complete remission refers to absence of leukemia traces at cellular level. Patients who present no evidence of malignant cellular activity after completing the treatment of leukemia are considered to be completely cured. By contrast, relapse indicates a recurrence of leukemia specific symptoms and physiological signs.

In the case of patients with acute leukemia, a remission that lasts for more than five years after the treatment suggests a complete recovery. This five-year period is considered to be critical for leukemia sufferers, as it can make the difference between relapse and complete recovery.

In the last few decades, the five-year survival period of patients with leukemia has tripled. While in the 60’s the five-year survival rate was around 15 percent, nowadays it revolves around 50 percent. This five-year survival period is strongly influenced by patients’ age and the type of leukemia. Statistics indicate that the five-year survival rate for patients with acute lymphocytic leukemia (ALL) is around 60 percent, while the five-year survival rate for patients with chronic lymphocytic leukemia (CLL) is higher, reaching the value of 70 percent. By contrast, the prognosis of patients with myelogenous leukemia is less favorable. The same five-year survival rate for patients diagnosed with acute myelogenous leukemia (AML) is around 14 percent, while an estimated 32 percent of patients with chronic myelogenous leukemia (CML) exceed this five-year survival period.

The five-year survival rate for children diagnosed with acute lymphocytic leukemia revolves around the value of 80 percent, while the overall survival rate of children with acute lymphocytic leukemia is less than 45 percent. This type of leukemia is the most common form of cancer diagnosed in children. Due to the fact that it predominantly affects young patients with ages between 3 and 15, the disease is referred to as childhood leukemia.

In the United States, the mortality rate for children with leukemia has decreased with 60 percent in the last three decades. In spite of this fact, leukemia is still the leading cause of death among young patients with ages under 15.

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Promyelocytic Leukemia

Promyelocytic Leukemia a growth of the bone marrow in which there is a deficit of mature blood cells in the myeloid line of cells and a surplus of immature cells called promyelocytes. Promyelocytic leukemia is due to a translocation between chromosomes 15 and 17 which is symbolized t(15;17). This translocation is not a mere indicator of promyelocytic leukemia but the main cause. Promyelocytic leukemia generally comes under the acute form leukemia. It is also termed as acute promyelocytic leukemia (APL).
In 1957, promyelocytic leukemia was first accepted as an individual disease entity. It accounts for 5-10% of cases of acute myeloid leukemia (AML). The peak incidence of promyelocytic leukemia is amongst young adults. Promyelocytic leukemia is thought of as a type of AML and is classified as the M3 variant of AML.
Symptoms of promyelocytic leukemia are generally nonspecific and comprise of fatigue, minor infections, or hemorrhagic diathesis. There is usually pancytopenia with anemia, low levels of the granulocytes and monocytes, and low levels of platelets. Transfusion is thus an alternative that can be availed of.
Treatment of promyelocytic leukemia is different from that for all other forms of AML. Majority patients are now treated with all-trans-retinoic acid (ATRA). ATRA is a form of "differentiation therapy." It activates the retinoid receptor RAR and causes the promyeloctes to mature and this deters them from proliferating.
Even though ATRA cannot eliminate the leukemic clone it can stimulate a complete diminution in most patients suffering from promyelocytic leukemia by causing the promyelocytic leukemia -blasts to mature. ATRA is therefore used in combination with chemotherapy including an anthracycline drug.
Chances of survival are better with the combination of ATRA and chemotherapy than chemotherapy alone. This is because ATRA combined with chemotherapy accounts for a slightly higher rate of complete remissions while allowing significantly fewer relapses. Maintenance cure with ATRA, and possibly with low-dose chemotherapy, further reduces the occurrence of relapse. The advent of ATRA therapy has revolutionized the treatment of promyelocytic leukemia and clearly enhanced the prognosis.
Promyelocytic leukemia is connected with a characteristic cellular picture classified as M3 in the French-American-British Classification and responds positively to treatments including retinoids, chemotherapy and, most recently, arsenicals.

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Signs-Symptoms And Life-Expectation In Acute Leukemia

First occurring signs in the development of acute forms of leukemia are bruising and bleedings caused by the decreased number of platelets, fatigue and pales due to the anemia caused by insufficient red blood cells, reoccurring infections and late healing due to abnormal number and function of white blood cells. These symptoms are however not specific for the Leukemia condition and for a precise diagnose further testing is required such as analysis of blood and bone marrow.
A certain cause of Leukemia is not yet known as it can affect persons of all ages and both sexes. A link however between leukemia and benzene prolonged exposure or high doses of radiations could be established. But most cases cannot be rationally explained.
The main target of the Leukemia treatment is to annihilate all existing abnormal cells in blood and bone marrow. A complete remission means no left trace of cancerous modifications. Some of the treated cases show a reoccurrence of the disease with other signs and symptoms. In acute leukemia forms, after five years of remission after treatment the patient can be qualified as cured and the condition rarely reoccurs.
In the last 25 years the percent of surviving subjects has increased due to new therapy ways. The overall five-year survival rate is 44% today, with significant progresses compared to the 1960’s rate of only 14%. The rate of survival differs by age, type of leukemia and previous health status. In the case of acute lymphocytic Leukemia the rate is 58%, in the chronic form it reaches 71%, in acute myelogenous Leukemia the rate is 14% and the chronic form reaches 32% five-year survival.
In present there are about 144000 patients suffering from Leukemia in the USA. The rate of survival in children suffering from acute lymphocytic leukemia is 81% if detected in early stage. For children diagnosed with acute myelogenic Leukemia the rate is 43%.
In 2001 about 12500 male subjects are known to have died from Leukemia and a lower number of 9500 women, in the United States. The estimated number of chronic lymphocytic deaths yet to occur is 4600 and 1400 from acute lymphocytic forms. Acute myelogenous Leukemia is expected to produce 7200 deaths and chronic myelogenous Leukemia about 2300 deaths. Other forms of leukemia will be responsible for approximately 600 death cases.
For males under 40 and for women less than 20 leukemia represents the main cause of death. The estimated rate of deaths in males of Leukemia is 25% higher than in females. The percent of death cases in children has decreased in the last 30 years but the rate still remains high.
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General Aspects of Leukemia

Many people suffer from leukemia these days. A large number of cases of cancer are identified to be leukemia. Leukemia is a sort of cancer of the blood and marrow. The disease is characterized through the overproducing of immature blood cells (stem cells) that aren’t able to fully develop and to carry out the activities of normal blood cells.
According to their functions and structure, there are three different types of cells within the normal blood: red blood cells, white blood cells and platelets. Through the process of hematopoiesis, these three types of blood cells are developed from a distinctive type of blood cell called stem cell. Stem cells divide and go through several stages of development to finally form a mature blood cell of a particular type, with a certain, distinctive function in the body. The process through which a stem cell morphs into a mature blood cell takes place within the bone marrow.
According to the speed of development and the persistence of the disorder, there are two types of leukemia: acute leukemia and chronic leukemia. Acute leukemia is known to develop very rapidly, while chronic leukemia is developed slowly. According to the types of blood cells affected by the disease, leukemia can either be lymphocytic or myelogenous.
Lymphocytic and myelogenous types of leukemia are developed from different types of cells: the lymphocytic type of leukemia develops from cells called lymphoblasts or lymphocytes in the spongious tissue of the bones, while the myelogenous type of leukemia (sometimes refered to as myeloid and myelocytic leukemia) develops from myeloid cells.
In the case of acute forms of leukemia, the abnormal cells come from early, immature cells. Such forms of the disorder have a very fast rate of development, due to the fact that normal stem cells tend to multiply frequently. Leukemia cells usually don’t divide faster and more frequently than normal stem cells, they simply don’t stop their process of division when they should. Sometimes the numbers of white blood cells are very high, while in other cases they can be normal or low.
Chronic leukemia, apart from its slow development, is different from acute leukemia by the level of maturation that the diseased cells are able to reach. Stem cells affected by chronic leukemia reach a higher level of maturation but they present abnormalities and they can’t act as healthy white blood cells do. Unlike acute leukemia, in the chronic form of the disease the unhealthy cells have much longer periods of life and they tend to accumulate in different parts of the body.
Leukemia affects people of all age groups. While children usually respond better to the treatment for leukemia and sometimes deal well with the disease, adults difficultly cope with this form of cancer.
Regardless of age and sex, many people are diagnosed with forms of leukemia. Children tend to respond better to some types of leukemia, while adults difficultly cope with the disease. The cases of acute leukemia exceed those of chronic leukemia by approximately 10 percent. Older adults seem to be affected the most by acute leukemia. Around two thirds of acute leukemia cases seem to occur after the age of 60.
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