What is T Leukemia?

It is a type of lukemia where the Tcells or T lymphocytes-cells of the lymphoid system are malignant. Normal T cells can fight virus, cancerous cells and foreign cells. T cell lukemia is an adult lukemia.ATL is an aggressive Non- Hodgkin’s lymphoma. Evidence shows that HTLV-1(Human T cell lukemia/lymphotrophic virus type 1) is the cause of ATL.Infection of the HTLV-1 is established when the antibody against it is found present in the serum.

Signs and Symptoms

Signs of acute T cell Lukemia include Hypercalcemia, Lytic bone lesions, Skin lesions, Enlarged lymph nodes, liver and spleen and frequent infections. The signs and symptoms of chronic adult T cell lukemia are infections, weight loss, tiredness, fever and swollen lymph nodes. Symptoms of Adult Lukemia include Lymphadenopathy, Fever, Fatigue, Anorexia, Pruritis and Night Sweats.

Diagnosis

After a physical examination a complete blood count test is done to find out blood cell count. Abnormal levels of white blood cells indicate possibility of T cell lukemia. Biopsy is done to extract bone marrow and test it for leukemia cells. The type of leukemia is confirmed by Immunophenotyping -checking the surface of the leukemia cells for antigens providing immunity. The presence of chromosomal abnormalities is tested using cytogenetics tests. A CT (Computed Tomography) scan reveals abnormalities and tumors inside the body. Skin biopsy is done wherein skin tissue samples are checked for Tcells.

Treatment

Initially the patient’s blood count is monitored with routine blood tests. When the lukemia advances and the patient feels fatigue, swollen lymph nodes, low blood counts and night sweats, active treatment is started. Chemotherapy is administered on the patient via the bloodstream to kill can cancer cells. External beam radiation therapy uses high energy rays for the same purpose. Surgery is sometimes performed to remove the enlarged spleen that generates white blood cells. Stem cell transplantation is a treatment that involves replacing the maligned bone marrow with specialized cells called hematopoietic stem cells. Immunotherapy / biological therapy uses recombinant interferon alpha (Alferon N, Roferon-A, Intron A) to boost the body’s natural immunity against cancer. Monoclonal antibodies are administered on the patient to kill leukemia cells when they attach to their antigens.

Prognosis

The disease whether of chronic or acute nature, is not very responsive to treatment. Usually patients die within a year. The complications that ensue from it are the same as its symptoms.

Prevention

Though Tcell lukemia can’t be prevented as such, some precautionary measures can be taken to prevent transmission of the HTLV 1 virus that causes it. Carrier mothers should not breast feed their baby as the HTLV 1 is passed on to the baby through breast milk.HTLV-1 also passes through sexual contact between males and females and through blood transfusion. So, donated blood must always be tested before use.

T cell lukemia is a fatal disease and by taking due precautions one can reduce chances of its occurrence to a great extent.

What is AML Leukemia?

Acute myelogenous leukemia progresses fast. If not treated quickly it can prove fatal.AML begins in the stem cells of the bone marrow that would grow into white blood cells other than lymphocytes, red blood cells or platelet forming cells (early forms of myeloid cells).From the bone marrow it spreads to the blood and then to other body parts such as the lymph nodes, liver, spleen, testes, spinal cord and brain.

Signs and Symptoms

Acute AML lukemia causes anemia due to decline in red blood cells as well as fatigue, breathlessness and paleness. The patient suffers infections frequently with or without fever due to lack enough white blood cells to fight diseases. The condition of Thrombocytopenia (low platelet level) causes bleeding and bruising quickly and skin rashes. Enlarged spleen and liver cause a feel of fullness and abdominal swelling. Bone and joint pain are felt. Leukemia cutis or chloromas which are painless purple spots on the eye, neck, underarm and stomach are signs of AML.

Diagnosis

A physical examination reveals swelling of lymph nodes, neck, spleen, groin and arm pits. A complete blood count test helps find abnormalities. A biopsy is done to extract and test some bone marrow to find the lukemia type. Immunophenotyping and peroxi-dase stains studies will help to diagnose the AML subtype.Cytogenetics-a chromosome test is also done.

Treatment

The first phase of AML treatment is Induction chemotherapy. Medications include daunorubicin chemotherapy and ARA-C.Supportive care such as antibiotics, anti nausea medication, anti diarhheals, eye drops for stopping irritation, nutritive beverages and transfusions are also given to the patient. While transfusions keep the blood count normal antibiotics help fight infections. G-CSF (Neupogen) is administered to raise white blood cells count. At the end of this therapy remission levels are checked with a bone marrow biopsy. The second treatment cycle is consolidation chemotherapy. It includes intensive chemotherapy. Bone marrow transplant may be made from the patient’s own bone marrow (autologous transplant) or from a donor’s bone marrow (allogeneic transplant). Chemotherapy drug provided is drug ARA-C (cytarabine).Supportive care is required.

Prognosis

The 5 year survival rate for AML child patients in the US is around 30%.Ratio of AML related deaths to AML incidence is 75% approximately.Complications of AML include death and diseases like disseminated intravascular coagulation, Neutrophilia, Hypokalaemia, Neutrophil Nuclear Hyper segmentation and Megaloblastic anemia.

Prevention

There are no known means of preventing AML lukemia. By quitting smoking and avoiding cancer creating industrial chemicals like benzene one can reduce the risk of getting AML leukemia. Cancer treatments like chemotherapy and radiation also cause AML lukemia.