Acute Myelogenous Leukemia | Acute Myeloid Leukemia | AML Symptoms, Diagnosis and Treatment
Acute Myelogenous Leukemia is not a common type of leukemia cancer. Acute Myelogenous is also known as Acute Myeloid Leukemia and abbreviated as AML. This rare type of cancer is mostly observed in adults. Acute refers to fact that AML has capacity to become fatal in very quick time. So it requires immediate treatment.
Leukemia is type of cancer which is caused by abnormal production of blood cells in bone marrow. Abnormal production means that bone marrow produces immature cells which can not perform regular functions. In Acute Myelogenous Leukemia, immature cells are produced at more rapid speed. Another problem with these immature cells is that these cells tend to remain in the body for longer time than normal cells. Normal blood cells die after about 120 days and new healthy cells replace old cells but leukemic cells do not die easily. With passage of time, AML cells replace most of the health cells in body. AML require immediate treatment than chronic type of leukemia cancer because growth of leukemic cells is very fast in Acute Myeloid Leukemia.
Why this type of cancer is called Acute Myeloid Leukemia? All blood cells in bone marrow are produced from two types of basic cells including Myeloid and Lymphoid cells. Blood cells in our body consist of tree main types including white blood cells, red blood cells and platelets. Of these three types, white blood cells are further categorized into five sub type. Few of these types are produced from myeloid cells and few are produced from lymphoid source. Red cells and platelets are grown up form of myeloid cells. Myelogenous leukemia starts with a problem in myeloid source. Main reason for leukemia is abnormal production of white cells. But as red cells and platelets are also produced from myeloid sources, AML may also start to produce immature red cells and platelets.
Acute Myelogenous Leukemia symptoms
As in all types of leukemia cancer, body loses normal blood cells, mostly white cells. So the few symptoms are common in all types of leukemia. Acute Myelogenous Leukemia symptoms are following,
- Spleen size may increase in AML
- In other types of leukemia, swelling of lymph nodes is usually seen. But it is not common symptom in Acute Myeloid Leukemia.
- Swelling in gums may be seen in some patients
- Sudden and unexplained bruising
- Solid looking tumor outside bone marrow.
- Shortness of breath
- In AML, as body also loses red blood cells. Red cells contain hemoglobin and are responsible for oxygen transportation in body. Lack of red cells lead to anemia and other such diseases.
Acute Myeloid Leukemia Diagnosis
Diagnosis of AML is done using following techniques,
- Complete blood count test is taken. Increased count of white cells and white cells blast indicates possibility of leukemia. AML may also result in lack of red cells and platelets.
- Optical microscopy and flow cytometry is used to examine bone marrow to find out leukemic cells. This technique is used to distinguish leukemia from other types of leukemia cancer. It is also used to find out sub type of AML.
AML Treatment
Treatment of Acute Myelogenous is usually done using chemotherapy and stem cells transplant. Chemotherapy is done in two phases, induction and consolidation.
The goal of induction phase is to achieve a phase where leukemic cells fall below detectable level. Consolidation therapy is then applied to kill all remaining immature cells. If induction therapy fails then stem cells transplantation option is used to treat AML. Stem cells transplantation is also used if the patient re-develops AML after successful induction therapy.
September 9, 2011
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Leukemia Treatment with Radiation Therapy (Radiotherapy) | Side Effects
Radiation therapy is also know as Radiotherapy. Radiation therapy is a treatment for cancer including leukemia which uses beams of radiation to kill cancerous cells. In this treatment, high energy beams of radiation are focused on cancer tissues. These radiations can penetrate deeper into the targeted tissues to kill or stop cancer cells from multiplying. The stoppage is done by damaging the genetic material of these cells.
Radiation therapy is a treatment option for leukemia, lymphoma, myeloma, myelodysplastic syndromes. Radiation therapy is also used in Total body irradiation (TBI). Total body irradiation is used to treat the severe cases of Leukemia. After TBI bone marrow may be transplanted.
Goal of Radiation therapy (Radiotherapy)
Basic goal of Radiation therapy are,
- To cure a disease like leukemia cancer.
- To destroy abnormal tissues.
- To control the disease symptoms, mainly to get relief from pain.
- To shrink the tumor before the surgery so that it can be removed easily.
- Radiation therapy is also used after surgery to destroy remaining tumors.
Types of Radiation therapy (Radiotherapy)
Mainly, there are three types of Radiation therapy,
- Radical Radiation therapy
- Prophylactic Radiation therapy
- Palliative Radiation therapy
Radical Radiation therapy
This therapy is used to get rid of all types of cancerous cells. Treatment is applied with low level of dosage usually five days a week, for five weeks.
Prophylactic Radiation therapy
This therapy is applied on the surgically operated organs to protect the re-development of cancer and to minimize the spread of cancer cells to other parts of body. The dose is given for five days a week, usually for many weeks.
Palliative Radiation therapy
This treatment is given when the disease reaches a stage where apparently it is not possible to cure it. It is usually given to control further growth of cancer tissues. It is given in single dose over a very short time period.
Method of Radiation therapy
Radiation therapy can be applied in following ways,
External Radiation therapy (Radiotherapy)
In this method, radiation comes from a machine which is outside of the body. It is the most common method. In this technique, machine emits high energy X-rays which are then applied on affected areas. Equipment of this Radiation therapy is advanced, specialized and large in size.
Planning of Treatment Course
This treatment is planned by radiographers. It is based on three factors,
- Type of cancer (type of leukemia).
- Size of cancer.
- Location of cancer.
The total dose of radiation which is required to treat the cancer is carefully calculated and divided into fractions.
Fraction
To minimize the side effects of total dose of radiation, the treatment is further divided into smaller dosage called fraction.
The patient is treated on all possible days in every week. Treatment finishes after the patient has received entries dosage.
Aims of Treatment Session
- Focus the radiation on the correct side of the cancer cells.
- Normal tissues should be carefully avoided from radiations to minimize the side effects.
CT scan technology is used to protect normal tissue. With the help of latest advancement in CT scan, exact location of tumor can be calculated and therapy is applied on right angels with high precision.
Procedure of Treatment
Before first session, the therapist carefully determines the exact direction and position of affected areas, patient lays on a special table and then radiations emit from machine. To ensure that during each treatment beams of radiation is focused on the same point the specialist may use permanent ink or permanent tattoo to make a spot on skin or some technique may also be used. After settlement, therapist goes out in a separate room to protect himself from the repeated exposure of radiation. The therapist observes the entire situation via TV monitor or through window where patient still be able to talk to them.
Each treatment session lasts for few minutes.
Internal Radiation therapy (Radiotherapy)
In this therapy, radiation comes from liquids which are inside the body like blood. Liquid can contain radioactive substance. This substance is absorbed into the blood stream and taken up by both normal and abnormal cells then radioactive substance pin points the cancerous cells and destroys them. They have little side effect on normal tissues in the body but this effect is temporary, sometimes it may become permanent.
Radio Immunotherapy
In this technique radiolabeled antibodies are used to deliver dose of radiation at correct position of cancer.Antibodies are highly specific protein which is developed by body immune system in response to the presence of antigen. Some tumor cells contain specific antigens that cause the body to start the production of tumor-specific antibodies. These types of antibodies can be prepared in a large quantity in the laboratory known as radio labeling. When anti-bodies developed using radio labeling are injected into the body, the antibodies actively find out the cancer cells which are then destroyed by the cell-killing action of radiation.
Role of Drugs in Radiation therapy
Two types of drugs are used in Radiation therapy,
Radiosensitizer: Used to kill cancerous cells.
Radioprotector: Used to protect normal cells
Good things about Radiation therapy
- Rays do not hurt, even patient don’t feel the radiation penetrating in the body.
- Rays are not hot.
Side effects of Radiation therapy (Radiotherapy)
- After starting treatment of external therapy, the area of skin from which the beams of radiation passes, becomes red, sore, itchy, and scary that may turn into painful wounds. Skin usually recovers its original look and feel in 2-4 weeks after the treatment finishes. Sometimes spots on skin become permanent and the affected part of skin become darker than the surrounding normal skin.
- Loss of hair.
- Cerebral oedema, which affects the neurological conditions causing restlessness, headache, hypertension, nausea, low rate of heart pulse and decrease in respiration.
- Change in taste sensing ability.
- Sore throat.
- May cause diarrhea and vomiting
- May cause sterility in men and women.
- May lead to tiredness, bruising and bleeding.
September 14, 2011
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Bone Marrow Transplant | Stem Cell Transplant | Leukemia Treatment
Bone marrow transplant is a process in which damaged bone marrow is replaced with healthy bone marrow stem cells. It is actually a new medical procedure which is used to treat that diseases which were incurable in past. Particularly it is used to treat patient suffering from Leukemia. Firstly this treatment was successfully used in 1968. Bone Marrow translation is abbreviated as BMT.
Bone marrow is soft fatty spongy tissue inside our body. The bone marrow of skull bone, hips, breast and spine contains stem cells. These cells mature and produce blood cells of the body including,
- White blood cells (leukocytes)
- Red blood cells (erythrocytes)
- Platelets
Visit following link to read more about blood cells,
Types of bone marrow transplant
Mainly there are three types of bone marrow transplantation,
Autologous Bone Marrow Transplantation
Auto means “self” . This BMT is used in conjunction with chemotherapy or radiation therapy treatment. Firstly, before applying high dose of chemotherapy or radiotherapy, stem cells are removed from affected bone marrow. Then after finishing treatment, stem cells are put back in body. This is also called “rescue” transplant.
Allogeneic Bone Marrow Transplantation
“Allo” means “others”. The person from which stem cells are removed is called donor. In Allogeneic bone marrow transplant, the genetic makeup of donor’s bone marrow must match the patient’s own genetic makeup as perfectly as possible. There are special blood tests for this which show whether the bone marrow of donor matches the patient’s bone marrow or not.
Umbilical Cord Blood Transplantation
In this transplantation stem cells are removed immediately from the umbilical cord of infant , after birth. For the transplant purpose, these stem cells are stored. Umbilical cord blood cells are less mature. So there is less concern that they will not match.
Procedure of Bone Marrow Transplantation
It consists of following steps,
Before BMT, chemotherapy or possibly radiotherapy is needed if leukemia is not in remission. Leukemia or cancerous cells should be at lowest possible level for effectiveness of BMT. This treatment takes several days.
Peripheral blood cell harvest is a procedure used to collect stem cells from donor. An injection of growth factor is given to patient over a 10 days period. This function controls and helps the bone marrow to make large number of stem cells and to make blood cells at faster rate. Then donor can recover from transplant more quickly. This harvesting of blood cells takes 3-4 hours .
In process of harvesting patient lie down on a bed and will have two blood bags, which are connected to each of his arms. Blood then moves from one arm to other via a machine called “cell separator.” This machine separates out the stem cells from other blood cells. This separator will only pick stem cells and other blood cells are returned to body blood stream through blood bag which is connected to other arm.
Problems which may occur during or after transplantation
Complications of bone marrow transplant depend on many things including,
- The disease which is under treatment.
- Intensity of radiotherapy and chemotherapy.
- Age of patient.
- Matching level of genetic makeup with donor.
- The type of bone marrow transplant.
These are major problems that may occur after bone marrow transplant.
Graft-Versus Host Disease: When patient receive bone marrow cells from a donor, it may cause complications. This happens when donors blood cells attack your body tissues. Medicines are provided by doctor to control this problem. It is mild but in some cases it can be serious.
Graft-Failure: It is very rare. In this problem, the new blood cells fed into the blood may not be able to make enough blood cells. If patient suffer from graft-failure then another transplant my be required.
Helplessness: It is also a common feeling among the bone marrow transplant patients, they have feeling of angriness .
Side Effects Of Bone Marrow Transplantation
- Level of blood cells will be very low.
- It may cause infections due to low level of white blood cells.
- May cause anemia, due to low level of hemoglobin.
- Bleeding due to low level of platelets.
- Fever
- Tiredness
- Patient may be too week, sleep more than normal.
- May cause headache.
- May cause nausea.
- May cause sore mouth.
October 14, 2011
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Posted in: Bone Marrow, Leukemia Treatment