Biology of Leukaemia

Intro

• Leukaemia is a cancer of the blood cells• It can be acute or chronic • There are many different forms of Leukaemia but there are four main

types• No specific know cause but there are several risk factors • Can cause a variety of symptoms • Diagnosed through blood bone marrow tests• Can be treated by chemotherapy and radiotherapy

Blood Basics

• Blood is made in the bone marrow • Each blood cell originates from a stem cell and becomes of three main

cells• White blood cells – fight infection• Red blood cells – carry oxygen around the body• Platelets – clot to prevent fluid loss through bleeding

(Farley, Hendry and Mclafferty 2012)

Image by Cancer Research UK (2013)

What is Leukaemia?

• Cancer occurs when the stem cells creating white blood cells rapidly multiply but do not differentiate into white cells correctly

• This leads to the accumulation of inadequate white blood cells • Therefore the blood is overcrowded and cannot function correctly,

leading to bone marrow failure• This normally occurs because of mutations to the DNA of the stem

cells

(Mckenna 2000)

Image by Powell (2013)

Types of Leukaemia

• Leukemia can be classified as acute or chronic

•Acute – Can occur over a short period of days to weeks

•Chronic – Occurs over months or years, eventually resulting in an accelerated phase which resembles acute leukemia and is often the terminal stage

(Cassidy et al. 2010)

Types of Leukaemia

• The disease may involve either the overproduction of lymphocytes or myelocytes.

• Leading to the classification of Lymphocytic or myelogenous leukaemia

Image by Cancer Research (2013)(Cassidy et al. 2010)

Types of Leukemia

• Acute lymphocytic leukemia (ALL)

•Acute myelogenous leukemia (AML)

(Cassidy et al. 2010)

• Chronic lymphocytic leukemia (CLL)

Chronic myelogenous leukemia (CML)

Symptoms

• Anaemia – tiredness, weakness and shortness of breath

• Repeated fever, infections and abscesses

• Bruising and bleeding

• Lymph node enlargement and symptoms related to enlargement of liver and spleen

• Chronic leukaemia may not present with symptoms until acceleration phase

(Kumar and Clark 2010) Image from diseasesymptomstreatment.com (2012)

Treatment

• Treatment is split into remission inducing and post remission therapy• Remission inducing treatment involves cycles of chemotherapy • The patient must stay in hospital for about 4 weeks due to risk of

infection and bleeding. • As well as other side effects of chemotherapy • Ie nausea and vomiting, diarrhoea and fatigue

(Kumar and Clark 2010)

Treatment

• Post remission treatment involves :• Further cycles of chemotherapy• Possibly using different drugs to used previously • This is creates further side effects for the patient• A bone marrow transplant may be required to replace damaged

marrow.

(Kumar and Clark 2010)

Prognosis

• Without treatment acute leukaemia will be fatal within a few months• Most adults will go into complete remission after treatment.• However about half of these patients will relapse in the future• A patients outlook will depend on many factors such as their age and

their genetic disposition

Relative Survival (%)

1 Year 5 Year 10 Year

Sex2005-2009 2005-2009 2007*

Male64.5 44 32.9

Female63.5 44.4 33.6

(Cancer Research UK 2012)

Summary

• Leukaemia is a cancer of the blood cells• Either the over production of lymphocytes or myelocytes. • It can be acute or chronic • Can cause a variety of symptoms involving the blood or infection• Treatment aims to force the cancer into remission then maintain this• Prognosis is relatively poor compared to other types of cancer

Any Questions?

References

• Cancer Research UK (2012). Leukaemia survival statistics. [online]. Last accessed 26th June 2013 2013 at: www.cancerresearchuk.org/cancer-info/cancerstats/types/leukaemia/survival/leukaemia-survival-statistics.

• Cancer Research UK (2013). Myeloproliferative neoplasms. [online]. Last accessed 21st June 2013 2013 at: www.cancerresearchuk.org/cancer-help/about-cancer/cancer-questions/what-are-myeloproliferative-neoplasms.

• CASSIDY, Jim, et al. (2010). Oxford handbook of oncology. 3rd ed., United States, Oxford University Press. • Disease Symptom Treatment (2012). Acquiring basic knowledge and prevention towards acute lymphoblastic

leukemia. [online]. Last accessed 26th June 2013 2013 at: www.diseasesymptomstreatment.com/acute-lymphoblastic-leukemia.html/.

• FARLEY, Alistair, HENDRY, Charles and MCLAFFERTY, Ella (2012). Blood components. Nursing standard, 27 (13). Article from EBSCOhost last accessed 26th June 2013 at: www.ebscohost.com.

• KUMAR, Parveen and CLARK, Micheal (2010). Clinical medicine. 7th ed., Edinburgh, Elsevier. • MCKENNA, Samuel J. (2000). Leukemia. Oral surgery, oral medicine, oral pathology, oral radiology, and

endodontology, 89 (2). Article from Science Direct last accessed 26th June 2013 at: www.sciencedirect.com. • POWELL, Meshell (2013). What is T-cell acute lymphoblastic leukemia?. [online]. Last accessed 26th June 2013

2013 at: www.wisegeek.com/what-is-t-cell-acute-lymphoblastic-leukemia.htm.