Acute Lymphocytic Leukemia

Acute Lymphocytic Leukemia - Acute Lymphocytic Leukemia (LLA) is a fatal disease, in which cells that under normal circumstances develop into lymphocytes transformed into malignant and will soon replace normal cells in the bone marrow.

LLA is leukemia most often occurs in children. This type of leukemia is 25% of all cancers affecting children under 15 years of age. Most common in children aged between 3-5 years, but sometimes occur in teens and adults.

The cells are immature, which under normal circumstances develop into lymphocytes, transformed into malignant. This was covered in leukemic cells in the bone marrow, then destroy and replace cells that produce normal blood cells.

Cancer cells are then released into the bloodstream and migrated to the liver, spleen, lymph nodes, brain, kidneys and reproductive organs; where they continued its growth and splitting. Cancer cells can irritate the lining of the brain, causing meningitis and can lead to anemia, liver failure, kidney failure and damage to other organs.

CAUSE

Most cases appear to have no obvious cause. Radiation, toxic materials (such as benzene) and some chemotherapy drugs suspected to play a role in the occurrence of leukemia. Chromosomal abnormalities also plays a role in the occurrence of acute leukemia.

Risk factors for acute leukemia are:

Down syndrome
Have a brother / sister suffering from leukemia
Exposure to radiation (radiation), chemicals and medicine.

SYMPTOMS

The first symptoms usually occur because the bone marrow fails to produce red blood cells in adequate amounts, which are:

Weak and breathless, because anemia (too few red blood cells)
Infection and fever, reduced number of white blood cells
Bleeding, because the platelet count is too little.

In some patients, severe infections an early sign of leukemia; while in other patients the symptoms are milder, form weak, tired and looking pale.

Bleeding that occurs normally in the form of nosebleeds, bleeding gums, easy bruising and purplish blotches on the skin. Leukemia cells in the brain can cause headaches, vomiting and restlessness; whereas in the bone marrow causing bone and joint pain.

DIAGNOSIS

Routine blood tests (eg, complete blood count) may provide evidence that the person is suffering from leukemia. The total number of white blood cells can be reduced, normal or increased; but the number of red blood cells and platelets is almost always reduced.

White blood cells are immature (blast cells) seen in blood samples examined under a microscope. A bone marrow biopsy is almost always performed to confirm the diagnosis and determine the type of leukemia.

TREATMENT

The goal of treatment is to achieve complete cure by destroying leukemic cells so that the cells can grow back normal in the bone marrow. Patients undergoing chemotherapy need to be hospitalized for a few days or several weeks, depending on the response shown by the bone marrow.

Before the bone marrow returned to normal operation, the patient may require:
Red blood cell transfusions for anemia
Platelet transfusions to overcome the bleeding
Antibiotics to treat infections.

Some combinations of chemotherapy drugs are often used and the dose was repeated for several days or several weeks. A combination consists of prednisone per-orally (swallowed) and a weekly dose of vincristine with anthracycline or asparaginase intravenously. To overcome the leukemic cells in the brain, usually given an injection of methotrexate directly into the spinal fluid and radiation therapy to the brain.

A few weeks or a few months after the initial intensive treatment to destroy leukemic cells, are given additional treatment (consolidation chemotherapy) to destroy remaining leukemic cells. Treatment can last for 2-3 years.

Leukemic cells could re-emerge, often in the bone marrow, brain or testicles. Reappearance of leukemic cells in the bone marrow is a very serious problem. Patients must again undergo chemotherapy. Bone marrow transplant is a promising chance for recovery in this patient.

If the leukemic cells reappear in the brain, chemotherapy drugs injected into the spinal fluid as much as 1-2 times / week. Reappearance of leukemic cells in the testicles, are usually treated with chemotherapy and radiation therapy.

PROGNOSIS

Prior to the treatment for leukemia, the patient will die within four months after his illness was diagnosed. More than 90% of people with the disease can be controlled after undergoing initial chemotherapy.

Many patients who experience recurrence, but 50% of children do not show signs of leukemia within 5 years after treatment. Children aged 3-7 years have the best prognosis.

Children or adults who initially white blood cell count less than 25,000 cells / microliter of blood tend to have a better prognosis than patients who have a white blood cell count more.