The choice of topic for this paper results from the case of leukemia in my family. Leukemia was the cause of my grandfather’s death. Even though my grandfather was among lucky 5-year survivors of leukemia, he had to go through physical suffering as he contracted diabetes and lost 200 lbs of weight.
Leukemia is as a cancerous disorder of the tissues that are responsible for the formation of blood, such as lymphatics, bone marrow, spleen, and liver. Specialists distinguish between four commonly known leukemias: ALL (acute lymphocytic leukemia), CLL (chronic lymphocytic leukemia), AML (acute myeloid leukemia), CML (chronic myeloid leukemia) (Lewine, 2017). From the perspective of epidemiology, the incidence of this cancer in the United States is 13.7 per 100,000 persons per one year. As for the number of deaths, it is 6.8 per 100,000 persons per one year (National Cancer Institute, 2018). With reference to lifetime risk of leukemia development, it is 1.5 per cent of individuals that will be diagnosed with this cancer at some moment in their lives. Now, in terms of prevalence in our country, back in 2014, there were 387,728 individuals living with this disorder. Also, as many as 3,800 children are affected by this cancer in the U.S (Whitehead et al, 2016).
Whereas etiology remains unknown in most cases, scholars have managed to find out possible causes and risk factors associated with leukemia. Specifically, exposure to certain types of chemicals, Down syndrome and other chromosomal abnormalities, ionizing radiation exposure, use of specific drugs (for instance, alkylating agents prescribed in cancer treatment), as well as the infection with retroviruses (Lewine, 2017). It is suspected that all these agents cause mutations or other major disruptions that interfere with normal cell growth regulation and with how cells get divided in leukocytes. Other important risk factors include prenatal exposure to radiation as well as post-natal exposure to some toxins. Age is a risk factor, with chronic leukemias affecting primarily adults whereas acute leukemias affecting both. However, ALL as well as AML are found mostly in kids, and ALL is rare after the age of 25. CLL affects mostly adults aged between 35 and 80 and is most widespread in the 60s (Lewine, 2017). For CLL, sex and genetic factors are important, with men to women ration being 2:1 and with familial disposition being well-documented. Ethnicity is another risk factor, with East Asians, both living in Asia and in Western countries, being rarely affected. On the contrary, Hispanics living in the U.S. show a remarkably high frequency in comparison with Caucasians and other ethnicities (Ehsan et al., 2015).
With regard to pathophysiology, leukemia’s primary characteristic is the excessive production of mature or immature leukocytes in a disorganized way, when they crowd out red blood cells along with platelets. Leukemias are classified as myeloid or lymphocytic, depending on the affected leukocyte type (Lewine, 2017). In lymphocytic leukemias, immature lymphocytes as well as their progenitors are at work. First, they arise in human bone marrows; later, they infiltrate the spleen, CNS, lymph nodes, and other body tissues. As for myelogenous leukemias, they involve pluripotent myeloid stem cells, and, hence, they interfere with the process of granulocytes, thrombocytes, and erythrocytes maturation (Lewine, 2017). Based on pathophysiology, leukemias are classified as acute and chronic. In the former, the disease progresses rapidly and involves immature leukocytes whereas in the latter slower proliferation takes place, involving mature leukocytes. As for AML and ALL, they have courses and presentations that are similar to the chronic types (Lewine, 2017). Since leukemia is a cancerous disorder, the body is subject to its malignant processes.
Leukemia has its own clinical manifestations. These include persistent weakness and fatigue, chills or fever, losing weight even if one does not try to, easy bleeding or bruising, bone tenderness or pain, severe infections on a frequent basis, recurrent nosebleeds, swollen lymph nodes, headaches, spleen or liver larger than normal, skin rash, as well as too much sweating, especially during night (Lewine, 2017). In addition, the complications of leukemia include leukostasis resulting in hemorrhage, infection, tumor lysis syndrome, renal failure, and disseminating intravascular coagulation.
During physical examinations, doctors may discover swollen lymph nodes as well as see an enlarged liver or spleen. Also, abnormal results can be seen at routine blood tests, in particular with regard to blood cell counts. Tests that are used for diagnostics are bone marrow biopsy, blood tests that show abnormal cells, and genetic abnormalities tests, such as Philadelphia chromosome (Lewine, 2017).