Posts Tagged ‘Acute Myeloid Leukemia’

Promyelocytic Leukemia

Comments: 0May 19th, 2011 by admin



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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What Is Acute Myelogenous Leukemia?

Comments: 0June 30th, 2009 by admin



AML, (acute myelogenous leukemia), is an aggressive cancer of the bone marrow and blood. It is the most common type of leukemia. AML is also known by the following names-acute myeloblastic leukemia, acute myeloid leukemia, acute granulocytic leukemia or acute nonlymphocytic leukemia. Blood cells are malformed and useless. The cells can accumulate in parts of the body.

Acute myelogenous leukemia statistics

o Rare in people under 40 years old

o More common in men than in women

o Average age is 65 years old

o 5-year survival rate

o under 65 years old-33%

o over 65 years old-4%

o 2007 it is predicted there will be 13,000 cases (majority will be adults)

The symptoms of acute myelogenous leukemia include abnormal blood counts, a general run-down, unwell feeling that never gets better, reoccurring infections, swollen lymph nodes, and bone/ joint pain. Symptoms are acute (comes on suddenly, and accelerates quickly) instead of chronic (mild symptoms that gradually worsen over years).

When the malformed cells collect around parts of the body, it can cause skin, lung, central nervous system, kidney, and even testicle problems. Initially, acute myelogenous leukemia may mimic other conditions. Blood tests identify the possibility of AML. The final diagnosis is usually made after a bone marrow test and sometimes by a spinal tap, also known as a lumbar (lower spine) puncture (LP).

There are several types treatments available, one or more will be used to treat a dignosis of AML.

Chemotherapy-strong drugs taken orally or intravenously that kills the cancer cells. Occasionally it’s injected directly into the spine. It is a systemic treatment because it travels throughout the whole body.

Radiation-high energy rays like X-rays kill the cancer cells

Bone marrow transplants-unhealthy cancer producing bone marrow is destroyed and replaced with matching bone marrow.

Immunotherapy-stimulates the immune system to destroy cancer cells or boosts natural defenses. It can be a made naturally or artificially.

Risk factors for AML

o Previous chemotherapy or radiation treatments

o Exposure to radiation and chemicals like benzene

o Genetic disorders like Downs Syndrome

o Smoking

o Blood disorders like myelodysplasia

People with risk factors should watch more closely for symptoms of AML because early treatment increases survival rate.

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Leukemia- A Battle Lost

Comments: 0February 14th, 2009 by admin



On 28 September 2006, I received an e-mail from a man seeking help for his wife. This is what he wrote:

I write this e-mail to you in order to seek your suggestion regarding my wife’s illness.

My wife had been diagnosed with Acute Myeloid Leukemia (AML) type M5 in late December 2005. I brought her to Singapore General Hospital (SGH) on 1 January 2006 for further management and chemotherapy. She had 3 cycles of chemotherapies in the first 3 months. Later she underwent a Bone Marrow Transplant procedure (BMT) in late April 2006 until mid May 2006. But unfortunately, on the 75th day after BMT, the leukemia cell relapsed. After that my wife had another cycle of chemotherapy and also received donor lymphocytes.

Due to financial consideration, I moved my wife for further treatment to Malaysia in mid August 2006. She was admitted into the Subang Jaya Medical Center (SJMC) until today. At SJMC she got another cycle of chemotherapy and received another donor stem cell on 12 August 2006.

But a week ago the leukemia cells were shown to be active again and they developed quickly before donor stem cells even could work. Five days ago my wife had another cycle of chemotherapy in order to reduce the white blood cell count.

I would like to find possible therapy and treatments that will be suitable for my wife. My wife and I are Indonesians. Within the next few days, I must make a decision whether to bring back my wife home to Jakarta or stay in Malaysia. I really need your help.

Comments

The above is a 33-year-old lady. Before her diagnosis she presented with the following symptoms: fevers for 1 to 2 weeks, gum pain and bleeding, headaches and diarrhea.

Over the years I have encountered many cases of bone marrow transplant (BMT). And all the cases that I know of resulted in death. There was this young lady of eighteen. She underwent BMT in Singapore. After spending so much money, her parents had to bring her home in a coffin. At her wake service, her mother said to me: “If we knew it is like this, we would have stuck to your advice!” She realized her mistake a bit too late!

I know of a person who had to spend well over 1.5 million ringgit (US$1 = 3.5 ringgit) to save his wife from leukemia. She too died. Then there was another young lady who just started to work after graduating from her studies in Australia. She had leukemia and she too underwent BMT. I was told (rightly or wrongly) that she died while on the “operation” table.

Tham is my patient who suffered from kidney lymphoma. After undergoing some initial chemo-treatment he decided to give up chemotherapy due to severe side effects. He opted for herbs. Within nine months, the cancer went into remission. Soon after he was pronounced cancer-free, his doctor suggested that Tham undergo BMT. According to the doctor with BMT he would live ten years longer. Tham declined after consulting me. The question I posed to Tham at that time was: “The aim of the doctor was to prolong his life for ten more years with BMT, but what was not taken into consideration was the risk of dying from BMT due to various complications.” It has been eleven years since Tham was diagnosed with cancer. He is very much alive and well today. Tham is still taking the herbs.

In the case of the lady above, fortunately she did not die from the BMT procedure, but it did not cure her either. Much money had been spent on medical expenses. I only have this to say: Your life is in your hands. Decide wisely!

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