Chronic leukemia is a disease that often has no obvious symptoms.
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What is chronic leukemia?
Chronic leukemia is a disease related to white blood cells . Specifically, this condition is characterized by the accumulation of mature B lymphocytes in the blood and in some organs. It usually affects the lymph nodes and the spleen (peripheral lymphoid organs), but can also occasionally affect the bone marrow and other organs.
It is a blood cancer in which there is an abnormal multiplication of this type of lymphocytes. It all starts with a first cell that begins to duplicate itself uncontrollably, producing dysfunctional clones that cannot protect the body, but rather cause internal inflammation and other types of problems.
It is for this reason that this disease, commonly known as chronic leukemia, is medically called chronic lymphocytic leukemia . It may also be called chronic lymphocytic leukemia or B-cell chronic lymphocytic leukemia .
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Causes
The exact causes of chronic leukemia are still not entirely clear . In other types of leukemia, a more direct relationship between the underlying causes of the disease and the disease has been established, but in chronic leukemia it is not possible to attribute the causes so clearly.
However, it is known that this disease is largely generated by epigenetic factors. This means that different environmental conditions in a person’s life can modify their genetic profile, leading to the expression of the disease.
This is actually how many tumors appear (and not so much by chance). In fact, a significant example is that a relationship has been observed between people who have developed agricultural activities in which they have used pesticides.
On the other hand, from the biological point of view, mutations of the B cells and the activation of certain enzymes are investigated, since the studies also confirm the genetic cause of the disease. Family members who have relatives with this pathology have a higher risk of developing it than the rest of the population, as well as other lymphoproliferative disorders.
The truth is that several genetic alterations capable of favoring the abnormal replication of B lymphocytes, as well as drug resistance, have been identified. However, these mechanisms are complex and are still being studied, so the initial genetic lesion from which the disease develops is unknown.
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Symptoms
It may take years for the first symptoms of this cancer to appear . It is a disease with a very slow course, and sometimes the damage is asymptomatic or goes unnoticed until it is diagnosed.
One of the most common symptoms is that the lymph nodes are enlarged, although it is difficult to see and they do not cause pain. The spleen or liver are other organs that can increase in size, but it is often something that goes unnoticed.
As in other leukemias, it is common for the patient to feel fatigue and have pale skin and even a certain tachycardia. They are symptoms related to the anemia that occurs, and it is that the red blood cells can be affected. Also the number of platelets can be reduced and promote bleeding if injuries occur.
On the other hand, the deterioration of the immune system is one of the most significant symptoms. Immunosuppression leads to more risk of infections, especially in the case of bacteria. Although autoimmune conditions are the ones that can bring more complications, because in this case the attack of the body’s own cells occurs.
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Treatment
Chronic leukemia is a disease that requires personalized treatment , since it is a complex condition and the therapeutic strategy to follow is not always obvious. The main treatments currently used to combat this chronic disease are shown below.
The treatment of chronic leukemia is adapted according to the patient’s symptoms, the phase in which the disease is found and the prognosis that is given.
1. Observation
In many cases there is no recommended intervention other than regular observation despite how surprising it may seem. As described above, the development of the disease may be so slow that the progression of the disease may not be significant for years.
It is therefore a situation corresponding to the early stages of the disease. There is no treatment capable of reversing the progression of this condition at first. It is thus concluded that the best thing for the well-being of the person is not to subject her body to the stress of certain interventions, which may be useful in the future.
2. Chemoimmunotherapy
Currently, chemoimmunotherapy represents the preferred treatment in cases where intervention is necessary. It is about combining therapy with monoclonal antibodies and chemotherapy, being the most common way to intervene in chronic leukemia.
Monoclonal antibodies are proteins that are produced artificially. They are administered intravenously or subcutaneously, and have the ability to selectively attack cancer cells.
On the other hand, chemotherapy complements the action of monoclonal antibodies. This dual intervention produces a good clinical response rate due to its great synergistic effect.
3. Hematopoietic stem cell transplant
Chemoimmunotherapy represents a great therapeutic advance in recent years, but there is still another possibility to combat this condition. It is used in the most aggressive cases of the disease, and its results so far are promising.
This is hematopoietic stem cell transplantation through a bone marrow transplant . This type of intervention is based on the role played by the donor’s hematopoietic stem cells. In any case, it is a procedure in which the patient’s conditions and the possible associated risks and benefits must be carefully analyzed.
This treatment is an example of the great advances made by science compared to just a few decades ago. Still, researchers still need to know much more about this chronic disease.
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Bibliographic references
- Harris, N.L., Jaffe, E.S., Diebold, J., et al. (1999). World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House. Virginia. J. Clin. Oncol., 17 (12), 3835-3849.
- Kipps, T.J. Stevenson, F.K., Wu, C.J., Croce, C.M., Packham, G., Wierda, W.G., O’Brien, S., Gribben, J. y Rai, K. (2017). Chronic lymphocytic leukaemia. Nature Reviews. Disease Primers, 3, 16096.
- Lehmann , S. , Ogawa , S. , Raynaud , SD , Sanada , M. , Nannya , Y. , Ticchioni , M. , Bastard , C. , Kawamata , N. and Koeffler , HP (2008). Molecular allelokaryotyping of early-stage, untreated chronic lymphocytic leukemia. Cancer, 112(6), 1296–1305 .
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.