Leukemia
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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
 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.
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What is leukemia?
Leukemia is a type of cancer. Cancer is a group of many
related diseases. All cancers begin in cells, which make up blood and other tissues.
Normally, cells grow and divide to form new cells as the body needs
them. When cells grow old, they die, and new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. Leukemia is cancer
that begins in blood cells.
Normal blood cells
Blood cells form in the bone marrow. Bone
marrow is the soft material in the
center of most bones.
Immature blood cells are called stem cells and blasts.
Most blood cells mature in the bone marrow and then move into the blood vessels.
Blood that flows through the blood vessels and heart is called the peripheral
blood.
The bone marrow makes different types of blood cells. Each type has a special
function:
White
blood cells help fight infection.
Red
blood cells carry oxygen to tissues throughout the body.
Platelets help form
blood clots that control bleeding.
Leukemia cells
In people with leukemia, the bone
marrow produces abnormal white blood
cells. The abnormal cells are leukemia cells. At first, leukemia cells
function almost normally. In time, they may crowd out normal white blood
cells, red blood cells, and platelets. This makes it hard for blood to
do its work.
Next: What are the types of leukemia? »
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Last Editorial Review: 10/4/2007
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