H. Sidra yasin

Medical Biotechnology

Blood cancer

Pluripotent hematopoietic stem cells are common ancestral cells for all blood and immune cells.

• In blood cancer the blood cells produce abnormally and enormously, disturb the normal blood cells production and their normal function.

Types of blood cancer

• Leukemia • Lymphoma• Myeloma

The classification is according to cells which affect in a particular type of these cancers.

Leukemia

• Leukemia means ‘many white cells in the blood’

Types of Leukemia

• Lymphocytic– Acute– Chronic

• Myelogenous– Acute– ChronicAcute form of any disease progress rapidly and Chronic form progress slowly.

Acute Lymphocytic Leukemia

• Acute Lymphoblastic Leukemia.• In ALL unusually immature white blood

cells grow quickly and replace normal, healthy blood cells and prevent the production of these.

Prevalance

• It is more common type of leukemia of all blood cancers almost 25%, in children.

• Infants having ALL are 4 times and youth of 19 years old are 10 times more than children of ages of 2-3 among all children.

• It also affects adults. • There are almost 5,000 patients of ALL

appeared each other.

Causes

• Exposure to radiation: Prenatal exposure to x-ray, postnatal exposure to high radiation.

• Chromosomal problems: Chromosomal translocation in the cells at the time of birth causes ALL.

• Toxins: Like benzene.• Chemotherapeutic drugs.

Effects of these Environmental factors

• Formation of fusion genes• Dysregulation of proto-oncogene

Genetic Disorders

• Children having Down syndrome have an increased risk for both ALL and Acute Myeloid Leukemia.

• Associated with the diseases of Neurofibromatosis, Shwachman syndrome, Bloom syndrome and Ataxia telangiectasia.

Cytogenetic

• Chromosome translocation; between 9 and 22( Philadelphia chromosome, 4 and 11 in infants.

Diagnosis

• Blood test• Serological tests• DNA test

Symptoms• Breathlessness.• Pitting edema (swelling) in the lower limbs and abdomen.• Bone pain and joint pain because of the spread of blast cells to the

surface of bone or into the joint from the marrow cavity.• Patients of it also have easy bruising and bleeding from the different

parts of the body such as skin, gums, nose.• Fever.• Tiredness and weakness.• Less appetite and weight loss.• Petechia means tiny red spots or lines on the skin due to less in

platelets.• Swollen lymph glands (lymphadenopathy) of underarm, neck and

groin.• Night sweats.

Treatment• Chemotherapy: ALL can spread to the spinal cord

and brain so chemotherapeutics which are given through the vein cannot reach these parts of the body so we give chemotherapeutics directly to these areas.

• Radiotherapy: We also do radiotherapy in the brain and spinal column.

• Blood transfusion: Patient due to anaemia may need blood products transfusion like RBCs and platelets.

• Antibiotics: As patients of ALL have many infections so antibiotics are needed.

Bone marrow transplantation (Stem cell transplantation)

• If patients do not respond other treatments and experience again onset of ALL then usually patients are given stem cells transplantation or bone marrow transplantation.

Major interest of biotechnologists.

Prevention

• There is almost no known way to prevent it. • But we should avoid unnecessary exposure

to x-rays and toxins also • We should immediately consult the doctor if

having some kind of above mentioned symptoms.

• Also the people having family history of any kind of blood cancer have to be very careful and share their family medical history with the doctors.

Chronic Lymphocytoic Leukemia

• This type of Leukemia progress slowly. In it also white blood cells or lymphocytes are abnormally increase.

Prevalance

• It doesn't affect children.• The patients of 65 are found abundantly.• Under the age of 40 are very rare. • Common in men than women.• 15,000 new cases of CLL each year. 

Risk factors

• Exposure to toluene, benzene and x-ray• Having family history of any kind of blood

cancer• Chemotherapeutic drugs• Exposure to radiation: Prenatal exposure

to x-ray, postnatal exposure to high radiation.

Symptoms

• Fever.• Night sweats.• Repeated infections.• Tiredness and weakness.• Weight loss and appetite.• Enlarged lymph gland (which are painless)

especially in the neck, armpit and groin.• In some patients an enlarged spleen

found and it can cause pain.

Diagnosis

• Blood test• Serological tests• DNA test

Treatment

• When patients become anaemic or have many enlarged lymph glands. Then treatments is necessary.

• Chemotherapy:– Chlorambucil (leukerin) is usually given.– Fludarebine (Fludara) in late stage diseases.– In bone marrow failure steroid treatment

with Prednisolone (e.g., Deltacordril) – In Milder bone marrow failure repeated

blood transfusion.

Radiotherapy:• To cure swollen lymph nodes. In many small

repeated doses are given to the whole body. Surgical removal:• Sometimes spleen swells so much causing

pain and anaemia. So, surgical removal of spleen becomes must.

Antibiotics: • Repeated infections.

Bone marrow transplantation:

• Stem cell transplantation• In those patients who are under the age

of 45 and have severe form of CLL. Major interest of biotechnologists

Prevention

• As the causes of CLL is still unknown so there is no certain way to prevent it

• But avoidE the exposure to toluene benzene and x-rays

• Immediately consult the doctor • People having family history of any kind

of blood cancer have to be very careful and share their family medical history

Research in Pakistan

• Individually• In collaboration with the research

institutes in Canada, Germany, U.S, ChinaASH (American Society of Hematology)AACR (American Associates for Cancer

Research)

ReferencesWeb references:• www.ncbi.nlm.nih.gov/pubmedhealth• www.netdoctor.co.uk• www.medicinenet.com/leukemia/page3• www.hematology.org/patients/Blood-Disorders/Blood-Cancers/

5229.aspx• http://www.defence.pk/forums/current-events-social-issues/94389-

pakistani-scientist-s-research-leukemia-recognized-ash.htmlPrimary references:• www.medterms.com/script/main/art.asp?articlekey=13660• www.emedicine.medscape.com/article/207631-overview• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1988840/Book reference:• Klaus D. Elgert, Immunology understanding the immune system.

Second edition; A John Wiley and Sons, Inc., Publication 2009. Page 29.

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