Leukemia

Leukemia is cancer of the body’s blood-forming tissues, including the bone marrow and lymphatic system. Leukemia begins in a cell in the bone marrow, the spongy center inside of the bones where cells develop from stem cells into red cells, white cells or platelets. In leukemias, the cell mutates and becomes a type of leukemia cell classified by type of cell and by pattern of growth.

Lymphoid cells and Myeloid cells: the marrow forms myeloid cells which normally go on to form red cells. Myeloid leukemia can begin in these cells. The marrow also forms lymphocytes, the infection-fighting cells of the immune system. Lymphocytic leukemia can arise in these cells.

Acute and Chronic Leukemias: leukemias are also classified by how quickly they progress, in acute leukemia, immature white blood cells multiply rapidly in the bone marrow and are called blasts. Instead of functioning properly as the body’s infection fighters, these abnormal cells fill the blood, leaving little space for healthy cells. Acute leukemias progress rapidly without treatment. In chronic leukemia, the cancer develops more slowly, and is often diagnosed due to enlargement of the spleen.

The four main types of leukemias include:

• Acute myeloid leukemia (AML)
• Acute lymphocytic Leukemia (ALL)
• Chronic myelogenous leukemia (CML)
• Chronic lymphocytic leukemia (CLL)

Acute myeloid leukemia and acute lymphocytic leukemia-in these diseases, the acute leukemia cell multiplies to form a trillion more leukemia cells. Unlike healthy cells, these cells are called ‘nonfunctional’ because they do not function as normal and crowd out the normal cells in the marrow. With the resulting decrease in healthy red cell production, patients often experience anemia and increased bleeding and infection risks.

Chronic myeloid leukemia-the cell that begins this disease makes mature blood cells that function similar to normal cells. The number of red blood cells produced is usually less than normal, while the white blood cell count increases, which can result in severe anemia.

Chronic lymphocytic leukemia-the cell that begins this disease makes too many non- functioning lymphocytes. These cells interfere with the normal lymphocytes, causing a decrease in healthy red and white cell counts, and a weakened immune system. CLL is characterized by slow disease progression, often not requiring treatment for long periods of time.

The progress that has been made in treating leukemia gives patients and caregivers more hope than ever before. Treatments may include targeted drug therapy, chemotherapy, monoclonal antibody therapy, stem cell transplantation, and radiation therapy.

Acute Leukemia: treatments for patients with acute leukemias may include chemotherapy, targeted drug therapy and stem cell transplants. Treatment for both acute lymphoblastic leukemia (ACL), and acute myeloid leukemia (AML) usually need to start treatment soon after diagnosis. Treatment usually commences with a chemotherapy regime called induction therapy. Induction therapy kills leukemia in the blood and bone marrow to induce remission. If the specific genetic mutation called the Philadelphia chromosome is present, a tyrosine kinase inhibitor may be added to the treatment protocol. Induction therapy is often followed by consolidation therapy and may include stem cell transplantation. Follow up maintenance therapy may include lower doses of chemotherapy for up to three years.

Chronic myeloid leukemia (CML): treatment usually starts soon after diagnosis and is based on the genetics of the abnormal myeloid cells. Induction therapy kills leukemia in the blood and bone marrow to induce remission by chemotherapy treatment and may also include the approved targeted drugs for CML, Gleevec, Sprycel, or Tasigna. Post-remission therapy kills residual cancer cells and may include a stem cell transplant. Chemotherapy may be given in lower doses and frequency.

Chronic lymphocytic leukemia (CLL): Some CLL patients require only “watch and wait” observation after diagnosis. Patients who do need treatment may receive chemotherapy, targeted drug therapy/immunology therapy or combination therapy. Radiation therapy may be used to treat lymph node involvement.

Clinical Trials for Leukemia at MHOA
http://mhony.com/clinical-trials/

Leukemia & Lymphoma Society Clinical Trials
http://www.lls.org/diseaseinformation/managingyourcancer/clinicaltrials/

Leukemia Trials/ National Cancer Institute
http://www.cancer.gov/clinicaltrials/results/type/leukemia

American Cancer Society
http://www.cancer.org/cancer/leukemia-chronicmyelomonocyticcmml/detailedguide/leukemia-chronic-myelomonocytic-treating-clinical-trials

CenterWatch Trials: Acute Myelogenous Leukemia
https://www.centerwatch.com/clinical-trials/listings/condition/660/acute-myelogenous-leukemia-aml

CenterWatch: Leukemia Trials
https://www.centerwatch.com/clinical-trials/listings/condition/92/leukemia

Cancer Care Educational Resource for Leukemia
http://www.cancercare.org/diagnosis/leukemia

Leukemia & Lymphoma Society Resource Center
http://www.lls.org/resourcecenter/

Leukemia Research Foundation
http://www.leukemia-research.org/additional-resources

American Cancer Society Resources for Acute Lymphocytic Leukemia
http://www.cancer.org/cancer/leukemia-acutelymphocyticallinadults/detailedguide/leukemia-acute-lymphocytic-additional

National Cancer Institute
http://www.cancer.gov/cancertopics/types/leukemia

ACOR.org Association of Cancer Online Resources
http://www.acor.org/

Oncolink: Cancer resources for patients and healthcare professionals
http://oncolink.org/types/types.cfm?c=8

CRISPR-Based System Identifies Important New Drug Targets in a Deadly Leukemia-Cold Spring Harbor Laboratory March 8, 2018 https://medicalxpress.com/news/2018-03-crispr-based-important-drug-deadly-leukemia.html

New Therapies for Acute Leukemia
March, 2018
http://www.onclive.com/web-exclusives/expert-highlights-gamechanging-therapies-for-acute-leukemia

New Drug target for leukemia identified
Medical News Today
July 31, 2014
http://www.medicalnewstoday.com/articles/280440.phpLiver Cancer

European Commission Approves Roche Leukemia Treatment
The Wall Street Journal
July 29, 2014
http://online.wsj.com/articles/european-commission-approves-roche-leukemia-treatment-1406614865

FDA expands approved use of Imbruvica for chronic lymphocytic leukemia
FDA News Release
July 28, 2014
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm406916.htm

FDA approves idelalisib for three leukemia and lymphoma indications
The Oncology Report
July 23, 2014
http://www.oncologypractice.com/oncologyreport/home/article/fda-approves-idelalisib-for-three-leukemia-and-lymphoma-indications/1e0c726a08e9781744ddd696e94b58ce.html

Novartis Wins ‘Breakthrough’ Status for New Leukemia treatment
The Wall Street Journal
July 7, 2014
http://online.wsj.com/articles/novartis-wins-breakthrough-status-for-new-leukemia-treatment-1404758105

Now Enrolling Patients for AML and CLL Clinical Trials at Manhattan Hematology Oncology Associates.

Leukemia & Lymphoma Society Support groups
http://www.lls.org/diseaseinformation/getinformationsupport/supportgroups/

Acute Myelogenous Leukemia AML Support Group
http://www.dailystrength.org/c/Acute-Myelogenous-Leukemia-AML/support-group

Acute Lymphocytic Leukemia ALL Support Group
http://www.dailystrength.org/c/Acute-Lymphocytic-Leukemia-ALL/support-group

MD Junction Acute Myelogenous Leukemia Support Group
http://www.mdjunction.com/acute-myelogenous-leukemia

ACOR Association of Cancer Online Resources
http://www.acor.org/

Caring4Cancer Support Groups
https://www.caring4cancer.com/go/all/wellbeing

The National CML Society
http://www.nationalcmlsociety.org/

Inspire Support Groups
https://www.inspire.com/groups/bladder-cancer-advocacy-network/

Imerman Angels (to connect directly with another survivor or caregiver through an organization that creates personal, one-on-one connections among patients, survivors, and caregivers)
http://www.imermanangels.org

Fighting Chance- free counseling service for cancer patients and caregivers
http://fightingchance.org/resourceGuide.shtml