Acute lymphoblastic leukemia

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Acute Lymphoblastic Leukemia is an aggressive form of cancer of the white blood cells, it develops slowly but once symptoms show it rapidly becomes worse. It is a rare type of cancer as only 650 people in the UK on average are diagnosed with it each year. This type of leukemia is the most common type of childhood leukemia[1] .


Cause

Acute lymphoblastic leukemia is cause by a mutation the stem cells[1], causing them to produce too many immature white blood cells, called lymphoblasts. These lymphoblasts collect in the bone marrow meaning that the stem cells are unable to produce normal blood cells[2].  The cancer develops because the number of lymphoblasts increases, therefore the number of red blood cells and platelet cells decrease[1]. This means that there are fewer red blood cells carrying oxygen to muscles and respiring cells leading to the symptom of tiredness. The number of platelet cells being produced decreasing means that excessive bleeding can be an issue, as platelets aid the blood in clotting. 


Symptoms 

- Tiredness and breathlessness

- Frequent infections due to the lymphoblasts being less effective than normal white blood cells at fighting off infection

- Pale skin

- Frequent infections

- Nosebleeds

- Night sweats

- Bone and joint pain

- Weight loss 

- Abdominal pain due to the liver or the spleen swelling[1].


Risk factors

There are many risk factors that can increase your chance of developing Acute Lymphoblastic Leukemia. Hence for example if you have previously had chemotherapy then your chance of developing this type of cancer increases[1]. This is because the alkylating agents in the chemotherapy drugs can alter your cells DNA, meaning that mutations can occur more frequently[3]. Smoking can also increase the risk of developing leukemia as the smoke produced contains benzene and this can damage DNA, leading to a higher mutation rate[4]. Finally another risk factor is if you have HIV and AIDS[1] as this leads to you having a weaker immune system. 


Treatments

There are three stages to the treatment of Acute lymphoblastic leukemia:

1. Induction. This is where the leukemia cells in your bone marrow are destroyed, however it can destroy your normal bone marrow cells also, leading to a low blood count[5]

2. Consolidation. This aims to kill any leukemia cells in your CNS. This part of treatment is to try to help prevent a relapse[5]

3. Maintenance. This is where you have doses of chemotherapy tablets regularly to prevent leukemia returning[1].


References 

1. NHS. Acute Lymphoblastic Leukemia. 2016. cited 26/11/17. Avaliable from: https://www.nhs.uk/conditions/acute-lymphoblastic-leukaemia/

2. Leukemia Foundation. Acute lymphoblastic leukemia. 2017. cited 26/11/17. avaliable from: http://www.leukaemia.org.au/blood-cancers/leukaemias/acute-lymphoblastic-leukaemia-all

3. American Cancer Society. How does chemotherapy affect the risk of second cancer. 2017. cited 26/11/17. avaliable from: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/second-cancers-in-adults/chemotherapy.html

4. Cancer researcher UK. How smoking causes cancer. 2016. cited 26/11/17. Avaliable from: http://www.cancerresearchuk.org/causes-of-cancer/smoking-and-cancer/how-smoking-causes-cancer

5. American cancer society. Typical treatment of most types of acute myeloid leukemia. 2017. Avaliable from: https://www.cancer.org/cancer/acute-myeloid-leukemia/treating/typical-treatment-of-aml.html

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