The Journey and Courage Through Leukemia

Leukemia: Bone Marrow and Blood Formation

2013-11-10T16:09:00.000-08:00

Bones are not solid, but instead are made up of two distinct regions. The outter, weight bearing area, is hard, compact and calcium based. It surrounds a lattice work of fiberous bone known as cancellous tissue.
The inner region, or marrow, is one of the largest organs of the body, is located within the bones. It fills the shaft of the long bones, the trabeculae ( spaces within cancellous tissue ), and extends into the boney canals.
Bone marrow may contain fat cells, fluid, fibrous tissue, blood vessels and blood formimg (hematopoietic) cells. Marrow appears yellow in color when it holds many fat cells and red when it has more blood forming material. The marrow is the principle site for blood formation (hematopoiesis), which occurs primarily within the bones of the legs, arms, ribs, breastbone, and spine.

Stem Cells

Many of the blood cells that comprise the bloodstream within the arteries and veins are born and mature within the marrow. They are derived from hematopoietic cells that are called stem cells. Stem cells within the bone marrow continously divide to form new cells.

Some of the new cells remain unchanged as stem cells and have a lifelong capacity for self renewal. These cells are called pluripotential cells. Other unipotential stem cells have a limited capacity for self-renewal also known as progenitor cells. Unipotential cells become committed to forming only one type of blood cell line, eythrocytes (red blood cells), leukocytes (white blood cells) and platelets.

Colonies of progenitor cells provide offspring of increasing differentiation (maturity). They react to specific compounds known as protein. Proteins stimulate the progenitor cells until they transform into the appropriate young blood cell known as a " Blast Cell".

Although stem cells are few in number - composing no more than 3% to 5% of all cells in the marrow- they are the only cells capable of producing the progenitor cells that eventually form all of the blood elements. The number of blood cells that are formed every day is enormous. In adults, blood cell production amounts to about 2.5 billion erytthrocytes, 2.5 billion platlets, and 1.0 billion granulocytes ( granular leukocytes) per kilogram of body weight.

Getting ready for spring

2013-02-18T20:51:00.002-08:00

2011-10-01T15:00:00.000-07:00

Bone Cancer Symptoms

2010-12-17T21:55:00.001-08:00

Understanding Bone Pain

As cancer grows within the cartilage or bone tissue, a painful sensation may develop in the bones. Sometimes it is described as a "deep" pain that doesn't go away. As the cancer develops, the pain may grow to become constant throughout the day and may be accompanied by swelling. Occasionally, the tumor may cause the bone to weaken and fracture. Any unusual bone pain, the most common symptom of bone cancer, is a signal to talk to your doctor.

Other injuries or conditions, however, may have similar symptoms. Arthritis or osteoporosis are far more common ailments causing bone or joint pain in adults. Talk with your doctor if you are experiencing any bone pain. Your medical history and knowledge of previous accidents or injuries can help you doctor evaluate your condition.

Potential Bone Cancer Symptoms

Experiencing one or more of these symptoms does not mean you have bone cancer. However, you may be exhibiting symptoms of another condition or injury that may still require medical attention, so you should not ignore them.

The following are some potential symptoms of bone cancer:

•Bone Pain: Pain in the bones is usually noticeable as the tumor begins to grow. Early on, the pain may only occur at certain times of the day. As the cancer develops, the pain may become more persistent. Other conditions, like osteoporosis or arthritis, may also cause bone or joint pain.

•Swelling: The area where the pain is localized may begin to show signs of swelling.

•Fractures: Cancerous cells may weaken the bone. Sometimes this may result in fractures.

•Decreased Mobility: In some cases, if the location of the tumor is near a joint, it may make normal movements difficult or painful.

•Other Symptoms: Unintended weight loss and fatigue may accompany the bone pain. Other symptoms may develop if the cancer has spread to other organs.

NOTE: These symptoms may be attributed to a number of conditions other than cancer, such as an infection or other illness. It is important to consult with a medical professional for an accurate diagnosis.

Paget's Disease and Related Symptoms

Paget's disease is a rare condition resulting in abnormal bone growth. The breakdown of cartilage may lead to arthritis. Although the disease is non-cancerous, it does increase a person's likelihood of developing bone cancer.

Similar to the feeling of a pinched nerve, the pressure of the increased bone mass on the nerves may cause tingling and numbness in extremities. There may be a hereditary factor involved and certain tests are available for anyone who believes they may be at risk for Paget's disease.(Note: Paget’s disease of the breast, a rare form of breast cancer, is medically unrelated to Paget’s disease of the bone.)

Bone and joint pain can be extremely painful or inhibit mobility. These symptoms may be indicative of another injury or condition other than bone cancer. However, it is important to receive treatment for these symptoms as they arise. Let your doctor know if you have any of the bone cancer risk factors, such as Paget's disease or a history of radiation therapy.

Primary Risk Factors

2010-12-17T21:42:00.000-08:00

Understanding Primary Bone Cancer

Cancers are named for the site of origin. The naming of bone cancer depends on the type of tissue where the cancerous cells first arise. Primary bone cancer tumors, or sarcomas, originate in the bone tissue or cartilage and are relatively rare. Cancer that has spread (metastasized) from a different part of the body, such as the lung, is called secondary bone cancer.

This is an important distinction for understanding risk factors, diagnosis, and treatment because secondary bone cancer may behave differently. For example, cancer cells from the lung are different than those originating in the bladder, or the bone, and will respond differently to treatments.

Understanding Risk Factors for Bone Cancer

Scientists have not yet identified a cause for primary bone cancers, or sarcomas. Certain diseases and the treatment of other diseases may increase a person's likelihood for developing bone cancer.

Knowledge of risk factors may help with the diagnosis and treatment of the disease, but having one or more risk factors does not mean you will get bone cancer. Many factors are beyond our control. However, some risk factors, like exposure to high doses of radiation, can be managed to promote better overall health.

Note: Myeloma is cancer of the white blood cells. Sometimes these cells will collect within the bone marrow or on the outer part of the bone. Although the bones are involved, myeloma is not a bone cancer. You can learn more about multiple myeloma by visiting our Multiple Myeloma Center.

Bone Cancer Risk Factors

Primary bone cancer affects only about 2,500 people a year. Chondrosarcomas (originating in the cartilage) are the most common form, and are more likely to effect people over age 40. Osteosarcomas (originating in bone cells) are more common in younger adults. Ewing's sarcomas (found either in the bone or soft tissue) are rather rare, and occur more often in children.

Although there is not a clear cause of bone cancer, the factors that may affect a person's risk of developing the disease are as follows:

•Genetic Syndromes: Certain inherited conditions have been associated with an increased likelihood of developing the disease:

•Li-Fraumeni syndrome

•Rothmund-Thompson syndrome

•Inherited Retinoblastoma

•Multiple exostoses (multiple osteochondromas)

•Paget's Disease: Typically affecting adults over age 40, Paget's disease (or osteitis deformans) is a non-cancerous condition that deforms and weakens the bones and may increase the risk of developing osteosarcomas. (Note: Paget’s disease of the breast, a rare form of breast cancer, is medically unrelated to Paget’s disease of the bone.)

•Radiation Treatment: People who have undergone radiation therapy or chemotherapy for other conditions may be at an increased risk for developing bone cancer, particularly younger adults treated with high doses of radiation. Small sources of radiation, like a typical X-ray, do not pose a risk.

NOTE: Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer. Not having risk factors does not mean that you won't get cancer. If you think you may be at risk, you should discuss it with your doctor.

Assessing the Risk Factors of Bone Cancer

There is not a single identifiable cause of primary bone cancer. Having one or more of the risk factors only means that the probability of developing bone cancer may have increased.

For example, if you have received radiation therapy to treat another cancer, you may want to discuss what this means for your individual risk of developing bone cancer with your doctor. Or, if you have been diagnosed with Paget's disease, you and your doctor can work together to manage the risk factors associated with this condition. With knowledge and awareness, you can take charge of your risk factors.

What Is Bone Cancer?

2010-12-17T21:17:00.000-08:00

Bone cancer is a rare cancer that forms in the cells of bones. As the supporting framework of the body, the bones provide structure and shape to the body, act as braces for muscles to produce movement, and protect internal organs.

Most bones are hollow and consist of a hard outer portion (onto which calcium salts are deposited), a spongy inner tissue that contains bone marrow (which makes and stores blood cells), and cartilage at each end of the bone (which acts as a cushion between bones). The bone itself contains three types of cells: osteoblasts (which form new bone), osteocytes (which help maintain bone), and osteoclasts (which break down bone).

Cancer that begins in the bone (known as primary bone cancer) is not the same disease as cancer that starts in another part of the body and spreads (or metastasizes) to the bone (called secondary bone cancer). While it can occur in any of the bones of the body, primary bone cancer most often occurs in the long bones of the arms and legs.

According to the American Cancer Society, primary bone cancers account for less than 0.2 percent of all cancers, only about 2,300 new cases per year in the United States. More commonly, bones are the site of tumors that spread to the bone from another part of the body (bone metastases), such as the breasts, lungs, and prostate.

Types of Bone Cancer

Bone cancers can be primary (sarcomas), where the cancer forms in the cells of the bone. Or they can be secondary (bone metastasis) where the cancer has spread from another part of the body to the bone.

Primary bone cancers:

•Osteosarcoma - Also known as osteogenic sarcoma, osteosarcoma is the most common bone cancer and typically starts in the bones of the arms, legs, or pelvis of people between the ages of 10 and 30.

•Chondrosarcoma - This type of bone cancer forms in cartilage cells and is the second most common form of the disease. It rarely occurs in people under the age of 20, and the chances of developing it increases with age.

•Ewing tumor - Also known as Ewing sarcoma, this cancer starts in the bones, but can also start in other tissues and muscles. It is the third most common and typically forms in children and teenagers.

•Fibrosarcoma and malignant fibrous histiocytoma - Both of these bone cancers develop in the soft tissue around the bones and tend to occur in older adults. They most commonly affect the arms, legs or jaw.

•Giant cell tumor of bone - This type of bone cancer can have both benign and malignant forms, benign being the most common. It usually affects the arm or leg bones among young and middle aged adults without spreading. They commonly return after surgical removal and tend to spread to other parts of the body.

•Chordoma - Often found in adults 30 or older, this bone cancer affects the spine and the base of the skull. It is about twice as common for men than women and tends to grow more slowly without spreading. However after surgery, this bone cancer can return and usually spreads to the lungs, liver or lymph nodes.

Secondary bone cancer:

•Bone metastasis - Bone metastasis is a form of bone cancer that develops in another part of the body and spreads to the bones through the blood stream or lymph system. While this type of cancer can form in any part of the body it is most commonly found in the bones near the center, like the pelvis or spine.

Back to Basics for Children's Health

2010-12-09T19:15:00.000-08:00

Nutrition and fitness are the cornerstones of children's health.

To give your child a head start on lifelong fitness, consider children's sports and other kid-friendly physical activities. With your encouragement, chances are a few sports will spark your child's interest. And consider other classic tips from children's health experts, such as promoting activity — not exercise — and setting a good example yourself.

You can also promote children's health by encouraging your child to eat a variety of healthy foods and control portion sizes. Learn which nutrients are necessary, in what amounts, and how the guidelines change as a child grows older.

Of course, other children's health issues matter, too — such as vaccines, child safety and preventing child abuse. Share any concerns you may have about children's health with your child's doctor.

Staging

2010-06-02T18:43:00.000-07:00

Staging

Once the physician has diagnosed lymphoma, he or she will want to perform studies to establish the patient's stage—that is, to find out how far the patient's cancer has spread. Staging helps the physician to select appropriate treatment options and helps him/her to arrive at a prognosis, or estimate of disease outlook and survival. Clinical information is reviewed, including findings from the physical examination, blood tests, and imaging studies. The imaging studies most often employed are chest X-ray and computed tomographic (CT) scan of the chest, abdomen, and pelvis.

One of the hallmarks of HD is that it tends to spread from one lymph node set to the next, without "skipping" an area unless the disease has progressed very far. HD rarely invades single, nonlymphatic organs or sites, and it does not tend to spread to nearby organs. Because of these characteristics, HD is "staged" according to sites of involvement in relation to the diaphragm, the major muscle of the abdomen that is used for breathing.

If the patient has Hodgkin's Disease (HD), the physician may order additional tests such as a gallium scan and lymphangiography. In addition, a bone marrow biopsy may be obtained.

Tests

Gallium scanning—Gallium scanning is a nuclear medicine procedure. Radioactive gallium is injected into the patient's vein, and it is taken up by malignant lymphoma cells. A specialized camera then is used to produce a picture of the pooled gallium, which will identify the size and sites of cancerous areas. Gallium scanning is particularly useful when HD is located in the patient's chest; however, this procedure is used more often to help predict recurrence in patients with radiologic abnormalities that remain after therapy.

Chemotherapy Side Effects

2010-05-01T19:10:00.001-07:00

Not only feeling tired and depressed from Cancer,many people fear chemotherapy because they have heard that it can have uncomfortable side effects. But side-effect management has come a long way over the last few decades. Today, many side effects once associated with chemotherapy can be prevented or controlled. With some types of chemotherapy, you may experience only minimal side effects. And chemotherapy may be your best option for a successful outcome. You can help achieve a successful outcome by understanding how side effects can impact your treatment. Learn how best to manage chemotherapy side effects.
Chemotherapy is the general term for any treatment involving the use of chemical agents to stop cancer cells from growing. Chemotherapy can eliminate cancer cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.
More than half of all people diagnosed with cancer receive chemotherapy. For millions of people, chemotherapy helps treat their cancer effectively, enabling them to enjoy full, productive lives.
A chemotherapy regimen (a treatment plan and schedule) usually includes drugs to fight cancer plus drugs to help support completion of the cancer treatment.2-8 To get the most from chemotherapy, it's important to stick to a schedule of treatment.
How Chemotherapy Works :

Chemotherapy is designed to kill cancer cells. Chemotherapy can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill, depending on which drug is used.

Chemotherapy works by destroying cancer cells; unfortunately, it cannot tell the difference between a cancer cell and some healthy cells. So chemotherapy eliminates not only the fast-growing cancer cells but also other fast-growing cells in your body, including, hair and blood cells.

Some cancer cells grow slowly while others grow rapidly. As a result, different types of chemotherapy drugs target the growth patterns of specific types of cancer cells. Each drug has a different way of working and is effective at a specific time in the life cycle of the cell it targets. Your doctor will determine the chemotherapy drug that is right for you. To understand more about the different ways chemotherapy is given, read about how people receive chemotherapy.

Discussing the Effectiveness of Cancer Treatment :

Understand the goals and risks of each treatment option so you can work with your doctor to decide which treatment is best for you. Balance potential benefits against the risks of treatment.

Some risks of cancer treatments may include time away from family and friends, uncomfortable side effects, or long-term complications. Cancer treatment may be inconvenient, prolonged, or unavailable close to home. These are important considerations when evaluating treatment options, but they are not typically mentioned in medical journals reporting the results and benefits of new treatments.

Once you and your doctor have decided on a treatment plan, talk with your doctor about issues that could interrupt your treatment plan. You can make note of subjects to discuss and questions to ask by using Tools for Organizing Your Cancer Information.

Importance of Dose and Schedule :

Your doctor will develop a treatment plan scientifically designed for you, based on your type of cancer, its stage of advancement, and your overall health. It will consist of specific chemotherapy agents, at specific doses and intervals. These are called your scheduled cycles. Generally, treatments are given daily, weekly, or monthly. Your doctor will help you determine the most effective treatment schedule for you.

The goal is to make your chemotherapy as effective, timely, and problem-free as possible. But while your chemotherapy treatment works to fight your cancer, it also can cause side effects such as a lowered white blood cell count. A low white blood cell count means your immune system isn't as strong as it could be, which can increase your risk of infection. It also can require your doctor to change your dose or schedule of your chemotherapy.

A chemotherapy-induced low white blood cell count, caused by healthy cells lost during chemotherapy, is an expected side effect of many chemotherapy drugs. A low white blood cell count typically occurs after the administration of certain types of chemotherapy and may continue for several days. To help reduce side effects like low white blood cell count that may interfere with your treatment schedule, learn more about managing chemotherapy side effects.

Under certain circumstances, your doctor may decide your body is too weak to receive chemotherapy. A low white blood cell count can temporarily disrupt your cancer treatment or result in having your chemotherapy dose decreased.

Many doctors agree that it's important to stick to a schedule of treatment. Find out about chemotherapy cycles and schedules.

Chemotherapy Side Effects :

An undesirable consequence of chemotherapy affecting your body—not related to your cancer—is referred to as a complication of treatment, or a side effect. Some common side effects of chemotherapy are:

Low white blood cell count

Low red blood cell count

Low platelet count

Nausea

Vomiting

Hair loss

Fatigue

Some side effects may be temporary and uncomfortable. Some can cause dose reductions and treatment delays or even be life-threatening.
For example, one of the most serious potential side effects of chemotherapy is a low count of infection-fighting white blood cells—a condition called neutropenia (new-troh-PEE-nee-ah). Neutropenia can interrupt your chemotherapy schedule and put you at risk for infections that may require hospitalization and may even be life-threatening.
Fortunately, significant progress has been made in the development of "proactive" therapies that help you manage the side effects of chemotherapy—ideally, before they interrupt your treatment schedule.

Take an active role in managing side effects. Learn all you can, use your tools for organizing your cancer information to note any side effects you experience, and be sure to discuss them with your doctor. You can make note of subjects to discuss and questions to ask by using your Tools for Organizing Your Cancer Information.

Dose and Schedule:

Certain side effects may prevent doctors from delivering your full dose of chemotherapy on schedule.

Impact of Delaying Treatment or Reducing Doses:
Chemotherapy Side Effects

Scientists have made a great deal of progress in developing therapies to help prevent and manage the side effects of chemotherapy. Newer supportive care treatments have led to vast improvements in the management of symptoms associated with cancer treatment. Some people don't experience side effects at all, and you are unlikely to experience all the side effects you read about below. Although chemotherapy is designed to treat cancer cells, unfortunately, it often affects parts of your body not directly affected by the cancer itself. This undesired result is referred to as a complication of treatment, or a side effect.

Side effects may be acute (short-term), chronic (long-term), or permanent. Side effects may cause inconvenience, discomfort, and even death.

Additionally, certain side effects may prevent doctors from delivering the prescribed dose of chemotherapy at the specific time and schedule of the treatment plan.In certain cancers, the expected outcome from chemotherapy is based on delivering the full chemotherapy dose on schedule so it is important to understand chemotherapy cycles and schedules.
Side effects from chemotherapy can include pain, diarrhea, constipation, mouth sores, hair loss, nausea and vomiting, as well as blood-related side effects. In this section, you can learn more about the importance of diagnosing and monitoring blood-related side effects. These may include low infection fighting white blood cells count (neutropenia), low red blood cells count (anemia), and low platelets count (thrombocytopenia).

CBC and Related Side Effects :

The CBC, or complete blood count, helps your doctor look for side effects of chemotherapy, which may include changes in the three types of cells in your blood. Because chemotherapy kills fast-growing blood cells as well as cancer cells, side effects involving your blood are an expected result of chemotherapy. Your first step in understanding blood-related side effects is knowing CBC, or your complete blood count.

Side effects involving blood include the following:

Neutropenia

Neutropenia (new-troh-PEE-nee-ah) is the scientific name for a low infection-fighting white blood cell count. A low white blood cell count may leave your body vulnerable to infection and too weak to receive chemotherapy according to your doctors' treatment schedule.This could lead your doctor to delay your current treatment or reduce your doses until your count reaches sufficient levels. Infection can lead to hospitalization. To help reduce the risk of treatment delays due to blood-related side effects, find out more about the risks associated with low white cell blood count.

Anemia :

Anemia (ah-NEE-mee-ah) is the scientific name for a low red blood cell count. Because red blood cells carry oxygen, a low red blood cell count may mean there is not enough oxygen circulating in your body. This condition can be effectively managed with one of several treatments, including prescription medicines, and/or blood transfusions, if necessary.

Thrombocytopenia :

Thrombocytopenia (throm-boh-sy-toh-PEE-nee-ah) is the scientific name for a low platelet count. A low platelet count may cause you to experience bruising or excessive bleeding. Learn more about the risks of low platelet count.

All of these side effects may be related to your chemotherapy. All are diagnosed through your CBC test. You can manage them to help reduce the possibility that they will compromise your treatment. A journal provides a place for you to keep track of your blood counts throughout your chemotherapy, and is one of the Tools for Organizing Your Cancer Information.

In addition to blood-related side effects, chemotherapy can result in other side effects that can interfere with treatment if not managed properly. Learn more about other types of chemotherapy side effects.

Sometimes side effects signal a serious problem. Find out when to call your doctor about chemotherapy side effects.

Web Resources | Leukemia | Seattle Cancer Care Alliance

2010-04-24T16:04:00.000-07:00

Web Resources Leukemia Seattle Cancer Care Alliance

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2010-04-23T12:01:00.000-07:00

Treatment

Patients with ALL need to start chemotherapy right away. It is important to get medical care in a center where doctors are experienced in treating patients with ALL.

The goal of treatment for ALL is to cure the disease. Children with ALL are likely to be cured of their disease. The number of adult patients who have remissions has increased. The length of remissions in adults has improved.

There are two parts of treatment for ALL, called induction therapy and post-induction therapy. The aim of induction therapy is to:

Kill as many ALL cells as possible

Get blood counts back to normal

And to get rid of all signs of the disease for an extended period of time.

This is called a remission.

Some drugs used to treat ALL are given by mouth. Other drugs are given by placing a catheter in a vein - usually in the patient's upper chest. During induction therapy most patients are treated with more than one drug and they may be given several drugs in combination. Each drug type works in a different way to kill the cells. Combining drug types can strengthen the effects of the drugs. Some of the drugs used to treat ALL are clofarabine, cytarabine, daunorubicin, methotrexate, mitoxantrone, cyclophosphamide, vincristine, pegaspargase, imatinib mesylate, prednisone and dexamethasone.

Patients with ALL often have leukemic cells in the lining of the spinal cord and brain. The procedure used to check the spinal fluid for leukemic cells is called a spinal tap. The cells cannot always be found in an exam of the spinal fluid.

To prevent leukemia in the central nervous system (CNS) leukemia, all patients who are in remission have the lining of the spinal cord and brain treated. In some cases, treatment is needed for ALL that has already affected the lining of the spinal cord and brain (CNS leukemia) and is causing problems such as headache, nausea and vomiting, and blurred vision. Parts of the body that aren't easily reached with chemotherapy given by mouth or IV - such as the lining of the spinal cord and brain - are treated by injection into the spinal fluid. Drugs such as methotrexate or cytarabine are injected into the spinal fluid either to prevent or treat CNS leukemia.

When the treatment is for CNS leukemia, a spinal tap is done. Then spinal fluid is removed and chemotherapy is injected into the spinal canal.

Radiation therapy may be given to the spine or brain. Spinal taps are done from time to time to check if leukemic cells are being killed and to give more doses of chemotherapy. Sometimes both chemotherapy and radiation therapy are used.

Many ALL patients build up uric acid in their blood from their disease. Uric acid is a chemical made in the body. The use of chemotherapy also increases the uric acid. A high level of uric acid can cause kidney stones. Patients with high uric acid levels may be given a drug called allopurinol (Aloprim®, Zyloprim®) by mouth or IV. Another drug used to treat high uric acid levels is called rasburicase (Elitek®).

Post-Induction Therapy

More treatment is needed even after a patient with ALL is in remission. This is called post-induction therapy. It is given in cycles for two to three years. Post-induction therapy is given because some ALL cells remain that are not found by common blood or marrow tests. For most people, the postremission therapy drugs used are not the same drugs used during induction therapy. The doctor considers many things to decide the kind of post-induction therapy a patient needs, such as:

The patient's response to induction therapy.

Whether the patient has certain chromosomal abnormalities.

High-risk types of ALL - such as T-cell ALL, infant ALL and adult ALL - are usually treated with higher doses of drugs during induction and post-induction therapy. One treatment plan is to use higher doses of drugs and give them for a longer time. Allogeneic stem cell transplant may be a good treatment for some high-risk ALL patients.

Ph-Positive ALL-Induction/Post-Induction

About one out of five adults with ALL and a small number of children with ALL have a type called Ph-positive (or Philadelphia-positive) ALL.

Ph-positive ALL may be treated with imatinib mesylate, also called Gleevec® or with other related drugs, such as dasatinib (Sprycel®) or nilotinib (Tasigna®). These drugs are given with chemotherapy. Gleevec® (or Sprycel® or Tasigna®) is given by mouth. Doctors are studying how well this treatment works in patients with Ph-positive ALL.

During post-induction therapy, Gleevec® (or another related drug) is given with other drugs. Usually people with Ph-positive ALL stay on Gleevec® (or another related drug) after post-induction therapy is completed.

Allogeneic Stem Cell Transplant

Allogeneic stem cell transplant is a treatment used for some patients with ALL.

The main purpose of doing the transplant is to give strong doses of chemotherapy or radiation therapy to kill the ALL cells. This will also kill the healthy stem cells in the marrow. The transplanted donor stem cells help start a new supply of red cells, white cells and platelets.

Allogeneic stem cell transplant is a high-risk procedure. For this reason, it may not be a good treatment for some ALL patients. Allogeneic stem cell transplant may be a choice for adult ALL patients if:

They are not doing well with other treatments. The expected benefits of stem cell transplant exceed the risks. There is a donor.

Stem cell transplant is usually not considered for a child unless:

Doctors have determined that the child's type of ALL is not likely to respond well to chemotherapy.

Chemotherapy has not worked well.

The child has relapsed ALL.

Side Effects of Treatment

Not all patients have treatment side effects. Patients who experience side effects should speak to their treatment teams about how to manage their side effects.

Possible side effects of treatment for ALL include:

The number of red cells may decrease (called anemia). Transfusions of red cells (blood cells that are donated and given to the patient) may be needed to increase red cells.

Patients also may have a drop in the number of platelets. If a patient's platelet count is very low he or she may need a platelet transfusion to prevent bleeding.

A big drop in white cells may lead to an infection. Such infections are usually treated with antibiotics, until the white cell count goes up and the infection clears up. For adults, growth factors are sometimes given to increase white cells. G-CSF (Neulasta® or Neupogen®) and GM-CSF (Leukine®) are drugs that increase the number of white cells. The doctor may talk about the absolute neutrophil count or ANC, which is the number of neutrophils, a type of white cell a person has to fight an infection. Fever or chills may be the only signs of infection. Patients with an infection may also have:

Coughing

Sore throat

Pain when urinating

Frequent loose bowel movements.

To lower the risk of infection:

The patient, the patient's visitors and medical staff need to wash their hands well.

The patient's central line must be kept clean. Patients on chemotherapy should take good care of their teeth and gums.

Chemotherapy affects the parts of the body where new cells form quickly. This includes the inside of mouth and bowel, and the skin and hair. Some other chemotherapy side effects are:

Mouth sores

Diarrhea

Hair loss

Rashes

Nausea

Vomiting.

Drugs and other therapies can be given to prevent or treat nausea or vomiting.

Follow-up Visits

Patients who have finished all of their therapy still need to go to their doctors regularly for exams and tests. The doctor may recommend longer periods of time between follow-up visits if a patient continues to be disease free.

Treatment for ALL can cause long-term or late effects. Children should be checked for treatment effects on growth or learning that may not take place right away. It is important to identify problems early. Talk to the doctor about when your child's learning skills should be assessed. Some children will need special help with schoolwork during and after treatment.

Relapsed or Refractory ALL

Some patients have a remission after treatment but then ALL cells return later - this is called a relapse. Other patients with ALL may still have ALL cells in the marrow even after treatment (refractory leukemia).

For patients who relapse, the same or different drugs may be given, or be used. A drug called clofarabine (Clolar®) is being used to treat some children (ages 1 to 21) with relapsed and refractory ALL.

In refractory leukemia, drugs that were not used to treat the patient's ALL in the first round of treatment may be given. Allogeneic stem cell transplantation also may be used.

Clinical Trials

Clinical trials are used to study new drugs, new treatments or new uses for approved drugs or treatments. These are some of the types of trials under way:

Leukemia-specific therapy, based on a patient's specific type of leukemia - such as the type of chromosome changes - is being studied.

The ALL cells of some patients are not as easily killed by drugs as those of other patients. This is called drug resistance. Scientists are trying to understand why some ALL cells are resistant to the effects of chemotherapy. This will help them develop better treatments.

Scientists are studying ways to boost the body's natural defenses, called immunotherapy. The goal is to kill or prevent the growth of ALL cells.

Blood cell growth factors can be used to help restore normal blood cells during treatment.

Scientists are studying the exact genetic changes that cause a normal cell to become an ALL cell. This research is leading to the development of new treatments. These treatments could block the effects of cancer-causing genes called oncogenes.

Gene profiling will be used more in the future to design more specific treatments for the different types of leukemia. New targeted treatments are being developed for ALL.

Many therapies, such as nilotinib, are being studied in clinical trials for Ph-positive ALL and other high-risk types of ALL. T-cell ALL, infant ALL and adult ALL are other high-risk types of ALL.

Doctors are studying a type of stem cell transplant, called a nonmyeloablative stem cell transplant (also called a reduced-intensity transplant).

Talk to the Doctor

It may be helpful to write down questions to ask your doctor. You can also write down or record your doctor's answers and review them later. You may want to bring a family member or friend with you to the doctor. This person can listen, take notes and offer support. Some patients record information and listen to it at home.

Questions to Ask Your Doctor

Find Support

Get More Information

The Leukemia & Lymphoma Society offers ongoing education programs featuring leading leukemia specialists discussing the latest issues in the diagnosis and treatment of leukemia. Visit the Leukemia Education Series page to find out about upcoming and archived programs. These programs are offered at no charge.

Further details of treatment and supportive care and the beneficial and adverse effects of treatment may be obtained from the free LLS informational booklets Acute Lymphocytic Leukemia and Acute Lymphocytic Leukemia: A Guide for Patients and Caregivers.

Overview | Leukemia | Seattle Cancer Care Alliance

2010-04-10T03:19:00.000-07:00

Overview Leukemia Seattle Cancer Care Alliance

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2010-04-08T14:22:00.000-07:00

Wish of the Month:

"I wish for a beach in my house!"

- Kaya, 3

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Growing up in the nearly landlocked state of Indiana, little Kaya dreamed of spending a warm day at the beach. But with a schedule full of doctor’s visits and

surgeries to treat her congenital heart defects, a day of fun at the shore seemed like a world away. That is, until Make-A-Wish® stepped in and created a beach for Kaya—in her own bedroom! Now Kaya can enjoy some fun in the sun whenever she pleases.

The beach comes to Indiana for a spirited wish

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Three-year-old Kaya has had a life full of doctor’s visits and surgeries in her battle against congenital heart defects. With the support of family and friends, the Gaston, Indiana native has grown into an audacious little girl with a passion for the beach and all things warm!

When asked by Make-A-Wish® volunteers, “If you would have one wish, what would you wish for?”, she knew right away that she wanted her very own play room with a play set that looked ‘beachy’.

Wish volunteers got right to work, and on January 29, completed a beach-themed playroom in Kaya’s house, complete with beach accessories and toys!

"Kaya absolutely loves her new play room and had the BEST birthday party there. All of Kaya’s friends wore their swimsuits and loved the play house and slide. Kaya is now able to keep her heart healthy by exercising in her indoor playroom all year round. Thanks again for all you do and for making this wish for Kaya," wrote Kaya’s mom.

The beach comes to Indiana for a spirited wish

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Childhood Cancer

2010-03-12T23:48:00.000-08:00

Childhood Cancers? Every cell whithun our bodies is tightly regulated, with respect to growth, interaction with other cells, and even it's life span. Cancer occurs when the cells have lost these normal control mechanisms and continues to grow in a way that the body can no longer regulate. Different kinds of Cancers have different signs, symptoms, treatments, and outcomes, depending on the type of cell involved and the degree of uncontrolled cell growth.

what Is Cancer?

All kinds of Cancer, including childhood Cancer, have a common disease process - cells grow out of control, develope abnormal sizes and shapes, ignore their tpical boundries inside the body, destroy heir neighbor's cells, and can ultimately spread (or metastasize) to other organs and tissues. As cancer cells grow, they demand more and more of the body's nutrition. Cancer takes a child's strength, destroys organs and bones, and weakens the body's defenses against other illnesses.

Cancer affects only about 14 of every 100,000 children in the United States each year. Among all age groups, the most common childhood cancers are leukemia, lymphoma, and brain cancer. As children enter their teen years, there is also an increase in the incidence of osteosarcoma (bone cancer). The sites of cancer are different for each type, as are treatment and cure rates.

Typically, the factors that trigger cancer in children are usually not the same factors that may cause cancer in adults, such as smoking or exposure to environmental toxins. Rarely, there may be an increased risk of childhood cancer in kids who have a genetic condition, such as Down syndrome. Those who have had chemotherapy or radiation treatment for a prior cancer episode may also have an increased risk of cancer. In almost all cases, however, childhood cancers arise from noninherited mutations (or changes) in the genes of growing cells. Because these errors occur randomly and unpredictably, currently there is no effective way to prevent them.

Doernbechers, 2-26-2010

2010-03-01T05:31:00.000-08:00

Just a quick note to say Mckenzie's CBC " complete Blood Count " looked very good on Friday and the doctors are happy. Thank you Dr. Storke and everyone at the Children's Hospital.

Bone Marrow and Blood Formation

2010-02-20T20:42:00.000-08:00

     Bones are not solid but instead are made up of two distinct regions. The outter weight bearing area is hard compact and calcium based. It surrounds a lattice work of fibrous bone known as cancellous tissue. The inner region, or marrow,which is one of the largest organs in the body, is located inside the bones.It fills the shafts of the long bones and continues down to the boney canals that hold the blood vessels.

     Bone marrow may contain fat cells, fluid, fibrous material, blood vessels and blood forming cells. Marrow appears yellow in color when it holds many fat cells and red when it has more blood forming cells.
     The marrow is the principle site for blood formation which occurs primarily in the bones of the legs, arms, ribs, breastbone and spine.

Stem Cells

Many of the blood cells that comprise the bloodstream within the arteries and veins are born and mature within the bone marrow. They are derived from hematopoietic cells that are called stem cells.Stem cells within the bone marrow continuously divide to form new cells. Some of the new cells remain unchanged as stem cells and have a lifelong capacity for self-renewal. These cells are called pluripotential cells. Other unipotential have a limited capacity for self-renewal. Also known as progenitors cells, unipotential cells become committed to forming only one type of blood cell line - erythocytes ( redblood cells ), leukocytes ( whiteblood cells ), or platelets. Colonies of progenitor cells of increasing differentiation (maturity). They react to different specfic compounds known as protiens. Proteins stimulate the progenitor cells until they transform into the appropriate young blood cell known as a "Blast" cell.

Cancer Facts

2010-02-16T00:32:00.000-08:00

Who We Are

We are among the more than 800,000 persons in the United States living with Leukemia, Hodgkin's and Non-Hodgkin's Lymphomia, Myeloma and Myelodysplastics Syndromes. We share what are considered to be related cancers of the blood and marrow- they all arise from cells with a common origin and related functions, the Lymphohematopoietic Stem Cells. Our diseases usually result from an aquired genetic injury to the DNA of a single abnormal cell that begins to multiply continuously and interferes with the body's production of normal blood and immune cells. As a result, without treatment, we may develope severe anemia, be predisposed to bleed easily and/or have a decreased ability to fight infections.

Every five minutes a person will join us as a cancer patient. We will total about 135,000 new cases per year, or more than 9% of people with newly diagnosed cancer in the United States. Our deaths are estimated at over 50,000 per year - however, our likelihood of dying from most types of cancer of blood and marrow has decreased significantly in the past 10 years. We remain hopeful about the improved management of our disease with risk adapted therapy approaches, new anti-cancer drugs and advances in radiation therapy and stem cell transplantation techniques.

Can Radiotherapy Result in Second Cancers After Treatment?

2010-02-15T23:14:00.000-08:00

Radiation is a potient tool for killing Leukemia Cells. But radiation can also cause mutations in normal cells that may lead to development of second cancers later in life. It has been seen that young girls who were treated using radiation to the chest and neck for Hodgkin's Lymphoma had a higher chance of breast or lung cancer, compared with individuals who don't get treated with radiation. This has caused alot of concern among young patients and some doctors as well.
The truth is that the risk of developing second cancers, though increased, is still actually very small. The risk is somewhat higher in younger patients, but the bebefit to be gained by radiation therapy usually far outweighs the risks. In order to be carefull, radiaation therapy is often avoided in younger patients.if it is determined they can be treated equally as well with other forms of treatment. Oncologists are now well informed regarding risks of treatment, and can guide patients regarding their individual risks.The small chance of developing cancers in the future should not discourage an individual to refuse treatment that is essential for the present.

Facebook Causes

2010-02-10T16:30:00.000-08:00

St. Jude Children's Research Hospital Bulletin

Support your cause!

Hello everyone,
First of all, I'd jsut like to say thank you for your amazing support and donation for St. Jude's; this cause has had a marked impact. Unfortunately, my mother recently passed away and I have been thinking a long time about how I might honor her memory and it finally hit me that the answer is right in front of me. Her favorite charity by far was St. Jude's and she was a faithful contributor, no matter how hard times were, for many years of her life. Thus, I would just like to ask you all to help honor someone who was as passionate about St. Jude's as you all are by either donating or recruiting people to join the cause. If you can't or do not wish to donate at this time, please take two minutes and invite people you think would like to join our cause. We have really hit a stride with our membership and donations and the $200,000 and 1,000,000 member marks are not that far on the horizon. Thanks again for all you do and best wishes to you all.

How is Hodgkin's Lymphoma and the Non-Hodgkin's Lymphomas Different?

2010-02-02T14:52:00.000-08:00

Lymphomias are classified by the types of cells involved.Non-Hodgkin's lymphomias are marked by mutations of B Cells or T Cells. Hodgkin's Lymphomia is marked by the presents of a special type of cell, called a Reed-Sternberg cell. Buy there are many other differences between Hodgkin's and Non-Hodgkin's lymphomia: they involve, amoung other things, the treatment options, survival rate, incidence, and symptoms.

                                              AGE
     Hodgkin's Lymphomia typically occurs in younger patients, age 15 to 24 and older patients over 60.
Non-Hodgkins Lymphomia is rare in young patients. Most diagnoses are made in patients over 60 years old.

                                         Incidence
     Hodgkin's Lymphoma accounts for less than 1% of all Cancer concerns diagnosed in the U.S. per year. This represents about 15% of all Lymphomias.
     Non-Hodgkin's Lymphomia accounts for about 4% of all Cancers diagnosed in the U.S. per year. This represents around 85% of all Lymphomias.

Lymphoma - Cancer Overview - Greenebaum Cancer Center

2010-01-25T00:43:00.000-08:00

Lymphoma - Cancer Overview - Greenebaum Cancer Center

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Stem Cell Treatment for Leukemia Improved

2010-01-24T19:52:00.000-08:00

Stem Cell Treatment for Leukemia Improved

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This is a quick link to Webmd on updated Stem Cell news and treatment.

HODGKIN LYMPHOMA, OR NONHODGKIN LYMPHOMA

2010-01-24T14:13:00.000-08:00

Because of their uncontrolled growth, Lymphomas can encroach on and/or invade neighboring tissue or distant organs.In Lymphoma, abnormal Lymphocytes travel from one Lymph Node to the next, and sometimes to remote organs, via the Lymphatic System.
While Lymphomas are usually confined to the Lymph Nodes and other Lymphatic tissue,they can spread to other types of tissue almost anywhere in the body. Lymphomia development outside of Lymphatic tissue is called extranodal disease.

LYMPHOMA OVERVIEW

2010-01-23T19:20:00.000-08:00

     Lymphoma is a type of Cancer involving cells of the Immune System, called Lymphocytes. Just as Cancer represents many different diseases, Lymphoma represents many different Cancers of Lymphocytes - about 35 different subtypes,in fact.
     Lymphoma is a group of Cancers that effect the cells that play a role in the Immune System, and primarily represents cells involved in the Lymphatic system of the body.
     The Lymphatic System is part of the Immune System. It consists of a network of vessels that carry a fluid called Lymph, similar to the way that the network of blood vessels carry blood throughout the body. Lymph contains white blood cells called Lymphocytes. Lymphocytes attack a variety of infectious agents as well as many cells in the precancerous stages of development.
     Lymph Nodes are small collections of Lymph tissue that occur throughout the body. The Lymphatic System involves Lymphatic Channels that connect thousands of Lymph Nodes scattered throughout the body.Lymph flows through the Lymph Nodes, as well as through other Lymphatic Tissues including the spleen, the tonsils, the bone marrow, and the thymus gland.
     These Lymph Nodes filter the Lymph, which may carry bacteria, viruses or other microbes. The Lymph Nodes or glands as they may be called, filter the Lymph, which may on various occasions carry different microbial organisms.
     At infection sites, large numbers of these microbial organisms collect in the regional nodes and produce the tenderness and swelling typical of a localized infection. These enlarged and occasionally confluent collections of Lymph Nodes
( so called Lymphadenopathy) are often referred to as "swollen glands".
     Lymphocites recognize Pathogens (infection and abnormal cells) and destroy them. There are 2 major subtypes of Lymphocytes: B Lymphocytes and T Lymphocytes, also referred to as B cells and T cells.
     B Lymphocytes produce antibodies( proteins that circulates through the blood and lymph and attach to infectious organisms and abnormal cells). The combination attachment cell or antibody microbial organism essentially alerts other cells of the immune system to recognize and destroy these intruders, also known as pathogens.

     T - Cells, when activated, can kill pathogens directly. T-Cells also play a part in the mechanisms of Immunine System control to prevent the system from inappropriate overactivity or underactiviity.
     After fighting off an invader , some of the B and T Lymphocytes "remember" and are ready to fight it off if it returns.

     Cancer occurs when normal cells undergo a transformation whereby they grow and multiply uncontrollably. Lymphoma is a malignant transformation of lymphocytes B or T-cells or their subtypes.
     As normal cells multiply, they may collect in one or more lymph nodes or in other lymph tissues such as the spleen. As the cells continue to multiply they begin to form a mass often referred to as a Tumor.
     Tumors overwhelm surrounding tissues by invading their space, thereby depriving them of the necessary oxygen and neutrients needed to surive and function normally.

YOUR CHILD - THE INITIAL DIAGNOSIS

2010-01-23T03:59:00.000-08:00

    The initial diagnosis of Leukemia or Lymphoma may be one of the most challenging events for you, your child and your family. Your first concern may be, " What does this mean for my child?"
     Children, regardless of their age, are usually aware when their health is causing concern for their parents or medical staff. Your child may experience a variety of emotions in quick succession. Feelings such as anger, guilt, fear anxiety and sadness are all common reactions.
     Your childs treatment will involve new people and experiences that may sometimes be frightening.Treatment of children with Leukemia or Lymphoma usually takes place in medical centers' inpatient units and outpatient clinics. Your child will be admitted to the hospital almost as soon as the diagnosis is known. For some children this is the first time they have stayed away from home for a extended period of time.