What is Leukemia?

What is Leukemia?

Today, one of the most dangerous and incurable condition seems to be cancer. It has no actual cure for mostly of the tissues it affects, especially when it reaches vital organs such as heart, lungs or blood. The blood tissue form of cancer is known as Leukemia and it represents a real life threat as it affects the blood circulation meant to supply the whole body with vital nutriments.

Blood is the connection tissue for all of the body's organs and tissue as it carries oxygen and other important elements for the cell life. This is the reason why leukemia is such dangerous and frightening disease. Blood has access to all vital organs like heart, lungs and brain and when Leukemia occurs, it will rapidly create a dysfunction of all the other organs by supplying them with unhealthy particles. Cancerous cells are quickly carried to all parts of the organism and the dissemination occurs in a very short period of time.

What is Leukemia ?

Leukemia is in fact the consequence of an abnormality occurred in the form and number of leukocytes, the blood white cells. Leucocytes are vital for the good functioning of the body as they have the role to fight against all potential aggressions from the outside. They are the key to a good protection against infections and when leukemia appears the cellular immunity decreases drastically leaving the body unable to protect against damaging factors of any nature.

The main pathological way of the disease is an increased production by the marrow of infected and abnormal white blood cells. The new leucocytes anatomically and functionally modified and interfere with all functions of the blood even hindering the normal oxygen transport. Modified white blood cells also damage the normal functioning of the red blood cells and lead to the occurrence of anemia. Cancerous cells impede the tissue supply with hemoglobin and the body cells suffer from the lack of iron.

When the cancerous cells reach the brain, other dangerous modifications appear such as headaches, night sweats and neuropsychical problems. Cancerous Leukemia cells can be easily detected under the microscope and the suspects of the disease are advised to undergo a bone marrow examination. The onset of Leukemia is pointed out by swollen lymph nodes through the whole body, especially around the neck and thigh.

What is Leukemia ?

Risk factors for Leukemia are especially radioactive radiations that produce cell mutations and damages to their activity. An overexposure to benzene, an industrial hydrocarbure, also increases the risk of developing Leukemia, as well as the Down syndrome.

The most effective but also painful treatment is chemotherapy when the patients need to swallow many drugs at once. Another possibility of treatment is radiotherapy and patients suffer from losing hair and skin texture.

Leukemia is curable if detected in time and treated right. A bone marrow transplant may be helpful to regain healthy white blood cells. For a good outcome, the patients especially need the support of the family.

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Learning To Live With A Leukemia Diagnosis

Learning To Live With A Leukemia Diagnosis

There are numerous symptoms of leukemia which you might notice after being diagnosed. Having said that, many people are not sure if they should be worried if they notice new symptoms.

It's generally recommended that you call your leukemia doctor when you notice things like frequent fevers, night sweats, as well as being tired for no reason and they persist for more than a couple of weeks.

Other issues you might notice happening for two weeks that should tell you to call your physician include swollen glands or new lumps in the neck, groin area, as well as under an arm.

If you notice you are starting to bruise quicker or start bleeding from your gums, then those are also signs.

Watchful waiting refers to a time period when a leukemia doctor regularly checks on a patient but is not doing anything to treat them. It can also be called surveillance as well as observation.

The point of the period is to figure out whether or not you will develop any symptoms. For older adults, it can be a choice for treatment.

During the period, medical and blood tests will be taken as well as scans during standard doctor appointments. In certain cases, watchful waiting can actually give better results than aggressive early stage treatment.

The truth is, many people that are suffering from chronic lymphocycic leukemia live for a reasonable amount of time with no treatment. When you are considering other leukemia types, watchful waiting will never be recommended.

Right after being diagnosed with leukemia, you may want to know who you can see about symptoms. Quite a few health professionals are capable, so you can go to any of them.

These people include nurse practitioners, family medicine physicians, physician assistants, internists, and also pediatricians. The leukemia doctor that will actually diagnose you will be a hematologist or a medical oncologist.

Dependent on the type of leukemia you could have, your choices can vary. Should you be dealing with chronic lymphocytic leukemia, you will likely go through a period known as watchful waiting.

In that time, the goal is usually to see what occurs with your symptoms. If you see things such as night sweats, frequent fevers, rapid weight loss, or swollen glands, you will need to call the doctor.

No matter whether you have currently been diagnosed with leukemia or you think you might have it, it's a good plan to find out who to see next.

For people who haven't been diagnosed, you will be referred to a specialist that will be able to conclusively detect whether or not you are dealing with it. These kind of professionals include medical oncologists and also hematologists.

Once you have been diagnosed, you will be able to get the help of others and won't be limited by just seeing a leukemia doctor. You'll be able to call a physician assistant, pediatrician, family medicine physician, or possibly a nurse in case you notice your signs and symptoms getting worse or lasting for over a couple of weeks.

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Morphology of Hairy Cell Leukemia

Morphology of Hairy Cell Leukemia

Accurate diagnosis of hairy cell leukemia rests upon the recognition of the cells in blood, bone marrow, or spleen.

Morphologic observation of these pathognomonic cells is more art than science.

This trenchant observation of Yam and colleagues is as relevant today as when it was written in 1972 and emphasizes that, despite the ever-growing battery of ancillary studies to assist the hematopathologist, the identification of cytologically characteristic cells remains the diagnostic sine qua non of HCL. Here we will spot the light on hairy cells in peripheral blood.

Hairy cells derive their name from the irregular fine cytoplasmic projections that extend for variable distances from the periphery. It is, however, a combination of characteristics that identifies the HC in Romanowsky preparations (e.g. Wright stain).

The eccentric nucleus with its fine chromatin condensation, the pale slate-blue cytoplasm and the fine surface projections all form part of the initial diagnostic impression.HC surface morphology is best appreciated by phase microscopy of a viable "wet" preparation of moving cells in suspension and here the typical villous nature of the HC are easily appreciated.

In Wright-stained preparations, the hairy cell is 1.5 to 2 times the size of a mature lymphocyte and the nucleus occupies one half to two thirds of the cell's area.

HCL tends to be a disease of monotonous cells with respect to cytologic characteristics and size. Hence, although there may be a moderate degree of cell size variation between patients, an individual patient usually displays a remarkably homogeneous population of hairy cells.

The nuclei can have several configurations, including round, oval, spindled, reniform, horseshoe-shaped, and bilobed. Although the hairy cells in an individual vary in nuclear contours, most patients have a preponderant nuclear shape, most commonly oval.

Despite variation in nuclear contour, there are several consistent nuclear characteristics of HCL that assist greatly in recognition.

Most important, the nuclear membrane is nearly always smooth, imparting a distinct demarcation from the surrounding cytoplasm and lacking the fine surface irregularities that typify many other lymphoproliferative disorders.

As well, the nuclear membrane usually appears thickened. The chromatin of HCL has a partially condensed appearance that is intermediate between a mature lymphocyte and a blast.

Additionally, the chromatin has a uniform granular appearance in contrast to the irregularly clumped chromatin of other disorders, particularly B-cell chronic lymphocytic leukemia (B-CLL) and splenic marginal zone lymphoma (SMZL).

Hairy cells have no evident nucleoli or a single nucleolus. Infrequently, cells with two nucleoli are present.

Generally, patients demonstrate a predominance of nucleolated or nonnucleolated cells.

The nucleoli are nearly always small, round, and without irregularities in contour.

Peripheral blood

The morphological presentation of HCL in the peripheral blood is variable. Some patients present with the appearance of leukaemic peripheral blood, including a moderate lymphocytosis composed of morphologically identifiable hairy cells.

In other cases, the peripheral blood smear is notable only for monocytopenia or neutropenia, with scant to absent circulating hairy cells.

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Types Of Acute Leukemia

Types Of Acute Leukemia

Leukemia is a disease of the bone marrow and blood that will affect our blood cell production. Normal blood cells have a limited life span and they need to be constantly replaced by fresh, young cells to resume their activity. There is a type of cell within the bone marrow (stem cell) that matures into the type of blood cells that the body needs.

In normal condition, these stem cells develop either into red blood cells, white blood cells or platelets, into a controlled way. Leukemia affects the normal development of blood cells and causes the accumulation of partially developed cells that are not able to fulfill their role inside the organism.

Judging by the speed of development and the persistence of the disorder, there are two types of leukemia:

i. Acute leukemia

ii. Chronic leukemia

Judging by the types of stem cells affected by the disorder, leukemia can either be:

i. Lymphocytic

ii. Myelogenous

Acute leukemia differs from chronic leukemia by the levels that stem cells are able to reach in their development (stem cells that present anomalies still manage to partially develop and either resemble immature cells or complete, normal white blood cells).

Inside the body of people who suffer from acute myelogenous leukemia, the bone marrow syntheses stem cells which form a kind of partially matured white blood cell called myeloblast. This form of blood cell does not reach a full maturity state and cannot carry out its intended role. Myelogenous cells tend to multiply very fast and exceed the numbers of healthy blood cells, facilitating the occurrence of anemia, infections and weakening the immune system of the body. The diseased cells can also spread to other places of the organism, such as organs.

As statistics indicate, there are lots of annual cases of the disease, acute leukemia of myelogenous form being the most basic type of leukemia. Although the disease is known to regress quickly when the appropriate treatment is administered, if left untreated it may cause the death of the affected person. This kind of leukemia tends to recidivate and it can redevelop with time.

Regardless of age and sex, many people are diagnosed with forms of leukemia. Children have respond better to some types of leukemia, while adults difficultly cope with the disease. The cases of acute leukemia exceed those of chronic leukemia by approximately 10 percent.

Older adults seem to be affected the most by acute leukemia. Around two thirds of acute leukemia cases seem to occur after the age of 60. Leukemia is a serious form of cancer and it needs immediate treatment. If treated correctly, especially in its incipient stages, leukemia can be successfully overcome.

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Promyelocytic Leukemia

Promyelocytic Leukemia

Promyelocytic Leukemia a growth of the bone marrow in which there is a deficit of mature blood cells in the myeloid line of cells and a surplus of immature cells called promyelocytes. Promyelocytic leukemia is due to a translocation between chromosomes 15 and 17 which is symbolized t(15;17).

This translocation is not a mere indicator of promyelocytic leukemia but the main cause. Promyelocytic leukemia generally comes under the acute form leukemia. It is also termed as acute promyelocytic leukemia (APL).

In 1957, promyelocytic leukemia was first accepted as an individual disease entity. It accounts for 5-10% of cases of acute myeloid leukemia (AML). The peak incidence of promyelocytic leukemia is amongst young adults. Promyelocytic leukemia is thought of as a type of AML and is classified as the M3 variant of AML.

Symptoms of promyelocytic leukemia are generally nonspecific and comprise of fatigue, minor infections, or hemorrhagic diathesis. There is usually pancytopenia with anemia, low levels of the granulocytes and monocytes, and low levels of platelets. Transfusion is thus an alternative that can be availed of.

Treatment of promyelocytic leukemia is different from that for all other forms of AML. Majority patients are now treated with all-trans-retinoic acid (ATRA). ATRA is a form of "differentiation therapy." It activates the retinoid receptor RAR and causes the promyeloctes to mature and this deters them from proliferating.

Even though ATRA cannot eliminate the leukemic clone it can stimulate a complete diminution in most patients suffering from promyelocytic leukemia by causing the promyelocytic leukemia -blasts to mature. ATRA is therefore used in combination with chemotherapy including an anthracycline drug.

Chances of survival are better with the combination of ATRA and chemotherapy than chemotherapy alone. This is because ATRA combined with chemotherapy accounts for a slightly higher rate of complete remissions while allowing significantly fewer relapses.

Maintenance cure with ATRA, and possibly with low-dose chemotherapy, further reduces the occurrence of relapse. The advent of ATRA therapy has revolutionized the treatment of promyelocytic leukemia and clearly enhanced the prognosis.

Promyelocytic leukemia is connected with a characteristic cellular picture classified as M3 in the French-American-British Classification and responds positively to treatments including retinoids, chemotherapy and, most recently, arsenicals.

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