LEUKEMIA

By Brian George

Is a disorder of cancer of the white blood cell and lymphoid tissue.
Leukaemia literally means White blood cells (WBC) disorder. It is a chronic maligned disorder of WBC precursors.
It is characterized by a replaced bone marrow by malignant immature WBC.
There is an abnormal immature circulating WBC.
Idiopathic (unknown)
Risk factors
Children (17) is the most common cause of childhood cancer.
Adult (50 years and above) is so because they have a low immune system.
More in male than female
Down syndrome (trisomy 21)
Cigarette smokers
Chemicals like benzene can lead to malignant leukaemia
People who have undergone treatment for cancer

Signs and Symptoms
Bleeding
Anaemia
Fatigue
Pain
Abdominal
Pallor
Decreased immune system leading to infection
Tachycardia
Dyspnea (difficulty in breathing)
Enlarged lymph nodes
Swollen gums
Enlarged in liver or spleen distension
Distension
Fever
Significant bruising
Bleeding
Persistent Infection can cause fever, night sweat, oral ulceration, frequent and recurrent respiratory, urinary, integumentary, or other system infections.
Increased bleeding due to thrombocytopenia which leads to bruising, petechiae (bleeding under the gum and also bleeding within specific organs and tissue).

Pathophysiology
The main cause of leukaemia remains unknown till date. It is caused by a lot of factors listed above.
Leukaemia starts with malignant transformation of blood cells which are usually formed in bone marrow by lymphoid precursor cells.
When there is now an abnormal proliferation of these precursor cells (blast cells) this results in overproduction of immature blast cells. Unfortunately, these blast cells have a longer life span than mature cells. So, they accumulate in the bone marrow and proliferate with normal cells.
When the erythrocyte and platelets producing cells are overcrowded, the patient begins to have severe anaemia, splenomegaly and other bleeding disorder.
After some time the leukaemic cells leave the bone marrow through the circulating system, infiltrating other body tissues such as the central nervous system, testes, skin, lymph node, liver and spleen and might eventually result in death due to internal haemorrhage and infection.

Diagnostic Measures

  1. History taking: The Doctor will obtain history about the onset of recurrent infection, occupation, personal lifestyle, family history, past medical history or had undergone any cancer treatment (chemotherapy/ radiotherapy).
  2. Physical examination: The Doctors look to observe signs of anaemia, abdomen for distension, spleen enlargement, conjunctiva for pallor, nose for bleeding. INVESTIGATIONS
    Full blood count (this is to indicate haematological conditions like pancytopenia, anaemia, thrombocytopenia, erythrogenic with a significant thrombocytosis.
    Bone marrow test. This is a procedure in which a sample of the bone marrow from the hipbone is being remove using a long, thin needle. This is sent to the laboratory to search for leukemic cells. This procedure also helps to determine the type of leukemia, the genetic makeup of leukaemic cells and gives information about the prognosis.
    Polymerase chain reaction (PCR) : Mostly done for people with chronic myeloid leukemia, it is a blood test to monitor their diseases.
    Scans or v-rays – it helps to view the lymph nodes, spleen and examine the lungs.

Management
The aim of management to include:-
To institute a proper management system
To relieve sign and symptom
The management to include:

  1. Chemotherapy: Is done to eradicate leukemia cells and producing remission. It is divided into two phases.
  • Induction phase
  • Post remission phase
    Induction phase: the drug doses are high to reduce leukemia cells from the bone marrow. The high doses damage stem cells and interfere with the production of normal blood cells.
    Post – remission phase: This continuously reduces additional leukaemic cells thereby preventing relapse and prolonged survival.
  1. Radiation therapy this is to damage cellular DNA while the cells continue to function. The damaged cell won’t be able to divide and multiply.
  2. Bone marrow transplant: Is recommended for chronic myeloid leukaemia used in conjunction with radio therapy or chemotherapy.
  3. Stem cell transplant
  4. Biological therapy
  5. Immunotherapy

Advances:
There are many advances and research ongoing worldwide into Leukaemia in both targeted therapies and immunotherapies. Leukaemia treatment has the potential to become more effective and less toxic.
Leukaemia treatment for adults have been chemotherapy, radiation therapy, and stem cell transplantation. Over the last two decades, targeted therapies have also become part of the standard of care for some types of leukaemia. Different types of leukaemia require different combinations of therapies. There are new drugs coming that reduce the toxicity of certain treatments. This is especially important for those who develop certain forms of this cancer in the older age groups.
At the last publication of data spread between 2015 through 2017, approximately 1.5 per cent of men and women will be diagnosed with leukaemia at some point during their lifetime.
Children:
With the proper treatment, the outlook for kids and teens with leukaemia is quite good. Most childhood leukaemias have high remission rates, up to 90% where doctors see no cancer cells in the body. Most kids are cured of the disease.
Alternative Spiritual Practices
This illness affects many emotions, especially where young children are concerned.
The writer is part of a group of energy healers who participate in weekly ritual blessings and distance healing procedures in conjunction with the Doctors at the special Kidwai, Kids Cancer Hospital in Samarpan, India.
The Doctors encourage the parents to join in a meditation group to affirm the blessings on their children and we have a group of Pranic Healers who volunteer to ‘adopt’ a kid for prayers and healing 3 times a week. The Doctors feel that this has a good effect and reduces the mental stresses also on the parents. When it was first introduced the management board at the hospital were sceptical about allowing this form of alternative treatment, but it was the Doctors who demanded that it be allowed. Many of the Doctors also practice Pranic Healing as an accompaniment to their traditional training and encourage parents to participate.
Forms of alternative treatments such as this are even offered in UK hospitals to cancer patients with Reiki Masters offering additional healing to patients after chemotherapy. These are ‘no touch’ therapies that theoretically re-align the energy flows in the body.
For particularly stressful diseases such as this, any additional relief and relaxation are surely welcome.

The UK Charity https://www.childrenwithcancer.org.uk/ are the leading charity dedicated to the fight against cancer in children.

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