Wednesday, September 9, 2009

How is chronic lymphocytic leukaemia treated?

Treatment is not always required and the patient may just be followed up as an outpatient on a regular basis, sometimes for many years, with no need for further action.
Older people with early stage CLL have a normal life expectancy. Treatment in the form of chemotherapy will be required for those who are unwell or who have many enlarged lymph glands, or who become significantly anaemic.
Chemotherapy is usually given in the form of tablets (usually a medicine called chlorambucil (Leukeran)). Other chemotherapy drugs such as fludarabine (Fludara) (may be used in late stage disease. General bone marrow production of blood cells can occur in more advanced CLL (bone marrow failure) in which steroid treatment with prednisolone (eg Deltacortril) usually allows the bone marrow to recover. Milder degrees of bone marrow failure might adequately be controlled by periodic blood transfusion.
X-ray treatment (radiotherapy) can be given locally, to swollen lymph nodes, or in small repeated doses to the whole body. Infections are more common in people with CLL and need to be diagnosed early and treated vigorously.
Sometimes the spleen, which is also part of the body’s immune system swells up so much in CLL that it gives rise to pain, or it causes a type of anaemia to develop in which the red cells of the blood (oxygen-carrying cells) become fragile, leading to further anaemia. These problems may justify the surgical removal of the spleen.
Bone marrow transplantation may be considered for those patients who are less than 45 years of age and who have an aggressive form of the disease.

How is chronic lymphocytic leukaemia diagnosed?

Often the condition is diagnosed by chance when blood tests are being performed for other reasons.
Although a blood test may give doctors the diagnosis, a bone marrow test is usually done to confirm the diagnosis. Special tests are performed on these samples to help classify the leukaemia as this will influence the kind of treatment required.
Scans and X-rays may also be performed in order to help doctors decide on the best treatment.

What are the symptoms of chronic lymphocytic leukaemia?

In addition to the symptoms mentioned above which are common to all forms of leukaemia, specific signs of the disease are:
painless enlargement of the lymph glands especially in the neck, armpits and groin.
lymph glands in deeper parts of the body may need special scans for diagnosis.
sometimes an enlarged spleen (located in the left upper quadrant of the abdomen) may cause discomfort or pain.

What is chronic lymphocytic leukaemia?

Chronic lymphocytic leukaemia (CLL) is the commonest type of leukaemia with 3000 to 4000 new cases diagnosed each year in the UK. It is a form of chronic leukaemia characterised by an increased number of lymphocytes, which make up one of the main sub-groups of white cells in the blood. Despite their increased numbers these lymphocytes lack the normal ability of responding to infection by the production of antibodies, so compromising the immune system of the affected person.
CLL is rarely found in people under the age of 40 - the peak age is 65. It is twice as common in men than in women. There are no obvious causes known for CLL.

What are the symptoms of chronic leukaemia?

It is possible to have chronic leukaemia for months or even years without knowing it.
The symptoms are varied, but many people notice:
tiredness (due to anaemia)
bruising easily (often without having had any blow or fall)
repeated infections
enlarged lymph glands
weight loss
night sweats
fever.

What is chronic leukaemia?

The white cells are part of the body’s immune system, and there are several sub-groups of white cells that have different sorts of roles in recognising and dealing with ‘invaders’ such as bacteria and viruses as well as other types of foreign protein.
All of the blood cells originate in the bone marrow and leukaemia (blood cancer) is a disease where the bone marrow produces large numbers of abnormal white cells. This means that the normal marrow is pushed into smaller and smaller areas. This results in fewer normal cells being produced and gives rise to some of the symptoms.
There are many types of leukaemia, each of which is classified according to the exact cell type affected by the disease.
Chronic leukaemia is a slowly progressive form of leukaemia and tends to involve more mature cell types. It may not need treatment immediately, but if treatment is required it is usually chemotherapy, given in the form of tablets.
The cause of leukaemia is not known.

What your doctor is looking for

Samples collected with cancer blood tests or other tests of urine, fluid or tissue are analyzed in a lab for signs of cancer. The samples may show cancer cells, proteins or other substances made by the cancer. Blood and urine tests can also give your doctor an idea of how well your organs are functioning and if they've been affected by cancer.
Examples of blood and urine tests used to diagnose cancer include:
Complete blood count (CBC). This common blood test measures the amount of various types of blood cells in a sample of your blood. Blood cancers may be detected using this test if too many or too few of a type of blood cell or abnormal cells are found. A bone marrow biopsy may help confirm a diagnosis of a blood cancer.
Urine cytology. Examining a urine sample under a microscope may reveal cancer cells that could come from the bladder, ureters or kidneys.
Blood protein testing. A test to examine various proteins in your blood (electrophoresis) can aid in detecting certain abnormal immune system proteins (immunoglobulins) that are sometimes elevated in people with multiple myeloma. Other tests, such as a bone marrow biopsy, are used to confirm a suspected diagnosis.
Tumor marker tests. Tumor markers are chemicals made by tumor cells that can be detected in your blood. But tumor makers are also produced by some normal cells in your body and levels may be significantly elevated in noncancerous conditions. This limits the potential for tumor marker tests to help in diagnosing cancer.
The best ways to use tumor markers in diagnosing cancer hasn't been determined. And the use of some tumor marker tests is controversial. Examples of tumor markers include prostate-specific antigen (PSA) for prostate cancer, cancer antigen 125 (CA 125) for ovarian cancer, calcitonin for medullary thyroid cancer, alpha-fetoprotein (AFP) for liver cancer and human chorionic gonadotropin (HCG) for germ cell tumors, such as testicular cancer and ovarian cancer.

Cancer blood tests: Lab tests used in cancer diagnosis

Cancer blood tests and other laboratory tests may help your doctor make a cancer diagnosis. Reduce your anxiety by learning about cancer blood tests and how they're used. By Mayo Clinic staff
Blood tests alone can rarely, if ever, show the presence or absence of cancer. If it's suspected that you have cancer, your doctor may order certain cancer blood tests or other laboratory tests, such as an analysis of your urine or a biopsy of a suspicious area, to help guide the diagnosis. While cancer blood tests generally can't absolutely tell whether you have cancer or some other noncancerous condition, they can give your doctor clues about what's going on inside your body.
Because your doctor has ordered cancer blood tests or other laboratory tests to look for signs of cancer doesn't mean that a cancer diagnosis has been made and you have cancer. Find out what your doctor might be looking for when cancer blood tests are done.

Do White Blood Cells Make Cancer Deadly?

Do White Blood Cells Make Cancer Deadly?
The ability to spread underlies the killing power of cancer. The process occurs, John Pawelek thinks, when tumor cells fuse with white blood cells—an idea that, if right, could yield new therapies

Steady Improvements Seen for Young Blood Cancer Patients

Steady Improvements Seen for Young Blood Cancer Patients
THURSDAY, Aug. 27 (HealthDay News) -- American teens and young adults newly diagnosed with blood-related cancers now live longer than they did in the 1980s, new research has found.
Researchers analyzed data from the Surveillance, Epidemiology and End Results (SEER) database, a population-based cancer registry in the United States. They compared data from 1981-1985 with data from 2001-2005 and found significant improvements in survival for patients with five blood-related cancers. Ten-year survival rates increased from 80.4 percent to 93.4 percent for Hodgkin's lymphoma, from 55.6 percent to 76.2 percent for non-Hodgkin's lymphoma, from 30.5 percent to 52.1 percent for acute lymphoblastic leukemia, from 15.2 percent to 45.1 percent for acute myeloblastic leukemia, and from 0 percent to 74.5 percent for chronic myelocytic leukemia.
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Further analysis showed that survival improved steadily over the past two decades for the lymphomas and chronic myelocytic leukemia, but has remained stable through the late 1990s and early 21st century for the acute leukemias.
The researchers also found that, with the exception of Hodgkin's lymphoma, survival in teens and young adults still lags behind survival in children. This remains a major challenge, the study authors noted.
The study appears online this week and in the Nov. 1 print issue of the journal Cancer.
"More research into how to treat these diseases and how to make sure that all patients have access to the best treatment is needed," study author Dr. Dianne Pulte, of the University of Medicine and Dentistry of New Jersey, said in a news release from the journal's publisher.