Stem cells found in the bone marrow are crucial for our health because they are needed to become new blood cells that sustain and protect our bodies. But when the transformation goes wrong, harmful mutations can cause the cells to start replicating without control -- a type of cancer known as leukemia. Danilo Allegra and Dania Puggioni explain how this happens and how certain treatments provide hope for those suffering from the disease.
What are the other Names for this Condition? (Also known as/Synonyms)
- Lymphoma and Leukemia
What is Leukemia and Lymphoma? (Definition/Background Information)
- All cancers are formed from normal cells in the body. Leukemia and Lymphoma are cancers that develop from the normal cells that are in one’s blood
- Cells are the smallest structural and functional component of the body. Different types of cells form different body parts. For instance, the skin is made up of specific types of cells, while the bones are made up of a set of completely different types of cells
Cancer of the blood: Leukemia or Lymphoma
- Cancers that are formed from the normal blood cells are of many different types
- However, doctors distinguish between different blood cancer types, by determining what the cancer cells should have been, if they had matured normally
Who gets Leukemia and Lymphoma? (Age and Sex Distribution)
There are many different types of Leukemia and Lymphoma. Depending on the type, they can be more common in young, old, male, or female individuals.
What are the Risk Factors for Leukemia and Lymphoma? (Predisposing Factors)
The risk factors of Leukemia and Lymphoma could include:
- DNA can be altered or damaged, which is what causes the cells to become malignant (cancerous). DNA damage causes the transformation of normal cells into cancer. Conditions that may cause damage to DNA include:
- Radiation (e.g. Ultraviolet light from the sun)
- Toxins/poisons (e.g. Some dyes used in tanning hides; chemicals used in industry; cigarette smoke)
- Even some types of infections
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Leukemia and Lymphoma? (Etiology)
- It is the genetic material (DNA) that gives instructions to the cell and directs it to mature into the type of cell that the body needs in each specific location/place
- However, DNA can be altered or damaged, which is what causes cells to become malignant (cancerous). DNA damage causes the transformation of normal cells into cancerous cells
- Conditions that can cause such a damage to the DNA include:
- Radiation, like the sun’s ultraviolet rays
- Certain toxins and poisons, such as some dyes used in tanning hides, industrial chemicals, and cigarette smoke
- Certain infection types
- Some individuals are even born with a preexisting abnormality in their DNA that allows the cancer to occur more easily in them, over other individuals in the general population
What are the Signs and Symptoms of Leukemia and Lymphoma?
The signs and symptoms of Leukemia and Lymphoma may include:
- Swollen glands (lymph nodes) that are not usually painful
- Easy bruising
- Sweating at night
- Unexplained weight loss
- Pale skin, due to lower levels of red blood cells
How is Leukemia and Lymphoma Diagnosed?
A diagnosis of Leukemia and Lymphoma would involve:
- Physical examination and medical history: The physician performs a physical exam and evaluates the signs and symptoms present, which may include:
- Pale skin
- Swollen organs (such as spleen and liver)
- Swollen lymph nodes (swollen glands)
- Blood examination under a microscope, which may show abnormal cells circulating in blood
- Biopsy: A portion of tissue is taken from a lymph node, organ, or bone marrow for examination. Bone marrow is where the cells in the blood are created and is usually taken from the pelvis (hip bone). The biopsy will then be studied under a microscope by a pathologist, to determine if any of the cells are cancerous
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Leukemia and Lymphoma?
The complications are dependent upon the type of Leukemia and Lymphoma that affects an individual.
How is Leukemia and Lymphoma Treated?
- The treatment measures depend upon the particular type of Leukemia and Lymphoma
- These measures may include radiation, chemotherapy (drugs), surgery, and/or bone marrow transplantation
How can Leukemia and Lymphoma be Prevented?
Currently, there are no specific methods or guidelines to prevent Leukemia and Lymphoma formation.
What is the Prognosis of Leukemia and Lymphoma? (Outcomes/Resolutions)
- The prognosis of Leukemia and Lymphoma varies significantly and is dependent upon the type of cancer
- Some types of the blood cancer have a good prognosis, and survival is greater than 90% after 5 years. Others have a very poor prognosis, with survival being less than 10%, at 5 years
Additional and Relevant Useful Information for Leukemia and Lymphoma:
A description of the components of blood is given below:
White blood cells (WBCs):
- All of the white cells in the peripheral blood, and, indeed, all of the cells in the entire body come from stem cells. Stem cells are cells that have the ability to turn into any of the different types of cells that the body can make. A similarity is drawn with the stem of a plant. From the plant stem arises different leaves and flowers; the same concept is applied to the human body cells
- Myeloid cells: The following cells are called “myeloid cells”, even though they have different functions, because they come from the same pathway or branch, very early after the stem cell starts to become committed to the development of blood cells. Since they all have the same ancestor, they are all related to each other
- Lymphocytes come from another early branch of the stem cell, and these are discussed below
- These types of cells are referred to as “granulocytes”, because they are full of granules (like little colored bubbles). The contents of the granules are used to destroy bacteria and other types of organisms that try to infect the body
- A familiar example is a facial pimple from acne. After the pimple forms a white head and ruptures, pus comes out. The pus is made up of neutrophils that have come together to attack the area and destroy foreign material and bacteria
- These cells are responsible for controlling the body’s response to infection. They also work to eat bacteria and other material that is foreign to the body
Red blood cells (RBCs):
- These cells carry oxygen to all the tissues in the body
- Although, they are referred to separately, they still come from a myeloid stem cell, just like the granulocytes and monocytes
- Platelets are responsible for the clotting of blood, when tissue and vessels are damaged. These are responsible for a large part of the scab formation, which forms over a scrape
- Platelets are small fragments of a larger cell that lives in the bone marrow, called a megakaryocyte
- The fragments break off from the megakaryocyte, and they circulate in the blood stream, looking for any damage
- Megakaryocytes are also derived from the same branch as the other myeloid cells
Neutrophils, basophils, eosinophils, monocytes, red blood cells, and megakaryocytes all come from the same very early branch of a stem cell. Once they have branched and committed themselves to be one of the cells listed above, they are then called “blasts.” In simple terms, a “blast” is a cell that is extremely young and has the ability to grow into multiple types of mature cells. However, the type of cell that it can become is much more limited than the “stem cell.” A “myeloid blast” must become one of the cells above.
- Lymphocytes come from a slightly different, very early branch of the stem cell. These very immature cells can only become one of several different types of lymphocytes. These early cells are called “lymphoid blasts”
- The function of lymphocytes includes the following:
- Responding to infection by creating antibodies: Think of antibodies as smart bullets! They are made by lymphocytes to specifically target a single type of foreign invader. The body makes different antibodies against every infection or invader that it encounters
- Lymphocytes regulate how the body will respond to each infection (e.g. fever)
- It informs other cells how to find and attack infections
- There are T and B lymphocytes, which are named based on where they were found to be made at the time of their discovery
- T cells are made in the thymus, an organ in an individual’s chest
- B cells are formed in the bone marrow. But, they are named after an organ in birds, called the bursa of Fabricius; this organ is only present in birds
- B cells make the antibodies; T cells help with regulation of the body’s attack against infections
The number of functions all of the blood cells above perform is incredible, and their real interactions are extremely complex. All of the cells work together as one intricate machine that acts to keep us healthy.
What are some Useful Resources for Additional Information?
Leukemia & Lymphoma Society (LLS)
3 International Drive – Suite 200 Rye Brook, NY 10573
Phone: (914) 949-5213
Toll-Free: (800) 955-4572
Fax: (914) 949-6691
National Cancer Institute (NCI)
U.S. National Institutes of Health
Public Inquiries Office
Building 31, Room 10A03
31 Center Drive, MSC 8322 Bethesda, MD 20892-2580
Phone: (301) 435-3848
Toll-Free: (800) 422-6237
TTY: (800) 332-8615
American Cancer Society (ACS)
1599 Clifton Road, NE Atlanta, GA 30329-4251
Toll-Free: (800) 227-2345
TTY: (866) 228-4327
References and Information Sources used for the Article:
http://www.cancer.org/cancer/cancercauses/othercarcinogens/generalinformationaboutcarcinogens/known-and-probable-human-carcinogens (accessed on 02/25/2014)
Helpful Peer-Reviewed Medical Articles:
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Foon, K. A. (1986). Immunologic classification of leukemia and lymphoma. Blood, 68(1), 1-31.
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PAGE, A. R., HANSEN, A. E., & GOOD, R. A. (1963). Occurrence of leukemia and lymphoma in patients with agammaglobulinemia. Blood, 21(2), 197-206.