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November 8, 2009
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Leukemia

Doctor to Patient

Evolution of Treatment for a Rare Type of Leukemia

Medical Author: Michael Lill, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD
Medical Revising Editor: Melissa Conrad Stöppler, MD

Two drugs have had a profound impact upon the treatment of acute promyelocytic leukemia.One of my more vivid memories from the early days of my training in hematology in Perth, Australia, is of the tragedy of a young girl with acute promyelocytic leukemia (APL). This disease is a very serious, rare type of acute leukemia (cancer of the white blood cells). I admitted her to our oncology floor in the hospital. A teenager, she had been completely well until one Sunday when she developed unusually heavy menstrual bleeding. She saw her doctor in her small country town on Monday, had a blood count done on Tuesday, and was flown up to us in Perth on Wednesday with a diagnosis of acute (rapid onset) leukemia. The next day, we performed a biopsy of the bone marrow that enabled us to confirm the diagnosis. We immediately started chemotherapy but that night she bled into her brain. Despite intensive medical efforts, including brain surgery, she died the next morning.

Doctor to Patient

What is leukemia?

Leukemia is cancer that starts in the tissue that forms blood. To understand cancer, it helps to know how normal blood cells form.

Normal Blood Cells

Most blood cells develop from cells in the bone marrow called stem cells. Bone marrow is the soft material in the center of most bones.

Stem cells mature into different kinds of blood cells. Each kind has a special job:

White Blood Cells
White blood cells help fight infection. There are several types of white blood cells.

Red Blood Cells
Red blood cells carry oxygen to tissues throughout the body.

Platelets
Platelets help form blood clots that control bleeding.

White blood cells, red blood cells, and platelets are made from stem cells as the body needs them. When cells grow old or get damaged, they die, and new cells take their place.

The picture below shows how stem cells can mature into different types of white blood cells. First, a stem cell matures into either a myeloid stem cell or a lymphoid stem cell:

  • A myeloid stem cell matures into a myeloid blast. The blast can form a red blood cell, platelets, or one of several types of white blood cells.


  • A lymphoid stem cell matures into a lymphoid blast. The blast can form one of several types of white blood cells, such as B cells or T cells.

The white blood cells that form from myeloid blasts are different from the white blood cells that form from lymphoid blasts.

Picture of Leukemia

Leukemia Cells

In a person with leukemia, the bone marrow makes abnormal white blood cells. The abnormal cells are leukemia cells.

Unlike normal blood cells, leukemia cells don't die when they should. They may crowd out normal white blood cells, red blood cells, and platelets. This makes it hard for normal blood cells to do their work.



Next: What are the types of leukemia? »

Leukemia - Symptoms Experienced

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Leukemia

What is pericarditis?

The hearts sits in the center of the chest and is surrounded by a sac called the pericardium. This sac has two layers, one that fits tightly onto the heart muscle and another looser layer surrounding the inner layer. Inflammation of these tissue layers surrounding the heart is referred to as pericarditis.

What causes pericarditis?

There are many causes of pericarditis. Most often the cause is unknown. Causes of pericarditis are listed below:

Idiopathic

  • The cause of the illness is not identified (although often it's the result of a minor viral illness or "cold")

Mechanical injury to the heart

  • Heart attack (myocardial infarction) and Dressler's syndrome
  • Heart surgery and post pericardiotomy syndrome
  • Trauma

Infection Bacterial

  • Viral
  • Fu...

Read the Pericarditis article »










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