Leukemia is a disease of blood cells where bone marrow is replaced by menacing leukemia cells. This may degenerate into chronic myeloproliferative disorder that is characteristic of neutrophilic leukocytosis that is manifested in some places in India and across the world. Treatment choice of Chronic myelogenous leukemia is mostly determined by age and other related heath factors. Before the discovery of Imanitib most of anti-cancer drugs were used for prevention and treatment. In order to diagnose the treatment of the disease it is paramount for physicians to comprehensively diagnose the right type of leukemia. It is worth pointing out that leukemia can be chronic and acute where the former can be established through conducting regular check-up to the extent of production of leukemia cells in abundance (Hehlmann, 2016). On the other hand, the latter leukemia cells increase speedily and patient’s condition deteriorates.
Causes and Symptoms
Studies have comprehensively established that cause of the disease is not known but there are risk factors that may potentially increase the chances of acquiring the disease (Bozzone, 2009). Such risk factors include radiations emanating from atomic and others myriad radiations. Moreover, radiation therapies like CT-scans and x-rays have been known to increase chances of the disease on humans. Plus, behavioral habits such as smoking may also increase chances of occurrence while benzene exposure, chemotherapy, Down’s syndrome and inheritance may also instigate the occurrence of the disease.
Clinicians have established that Chronic myelogenous leukemia is the most common type seen in different countries across the world (Bozzone, 2009). It is a myeloproliferative disorder that manifests itself by amplified propagation of the granulocytic cell line without the loss of their capability to distinguish. Subsequently, the outlying blood cell silhouette demonstrates an amplified quantity of granulocytes and their undeveloped forerunners, including irregular blast cells.
Clinical symptoms heavily depend on the quantity of leukemia cells produced and the exact location where they are likely to affect. As pointed out earlier, chronic leukemia does not show prominent symptoms and signs as identified by physicians during routine check-up. Patients suffering from acute chronic myelogenous leukemia may experience sickness, headache, confusion and loss of muscle agility. Other prominent symptoms may be occasioned by kidney failure, lungs and digestive system malfunctioning. Research has established that common symptoms include swollen lymph glands, fever, profuse sweating at night, recurrent infections, feeling tired and weak (Bozzone, 2009). In addition, a patient may show signs of bleeding, swelling of the abdomen, weight loss, disjointed and paining bones and joints.
Phases of Chronic Myelogenous Leukemia
Medical professionals have revealed that the disease goes through different phases and comprise chronic, accelerated and blastic phases (Estey & Appelbaum, 2012). Fundamentally, chronic phase is characterized by less than 5 percent of blast witnessed in blood and bone marrow and may potentially last for several years. Meanwhile, the accelerated phase may demonstrate between 5 and 30 percent of visible blasts in blood and bone marrow, they potentially grow faster while blastic phase may be occasioned by more than 30 percent of blasts and may develop into acute leukemia. This may prompt a patient to have symptoms including recurrent fever, enlarged spleen, and unprecedented weight loss. Evidence from studies has avowed that relapsing of the disease may occasion progression from stable remission that may be characterized by increased myeloid or blast cells (Estey & Appelbaum, 2012).
Incidences and Pathogenesis
According to data from WHO, this disease is rare and potentially affect less than 150,000 people in the United States. Medical institutions have often listed the disease among rare disease because it occurs on 1 to persons in 100,000 (Hehlmann, 2016). It affects people of all ages but it is most common among middle-aged individuals and children, and it is more prominent on males rather than on females. Surveys have established that 1 in 2000 people is affected with annual cases ranging between 5000 and 6000 people in the United States (Hehlmann, 2016). Patients who have been diagnosed with chronic myelogenous leukemia may live for 5 years making the prevalence rate to be about 5 times its survival rate.
The disease is characterized by the presence of Philadelphia chromosome that alters the genetic compositions of chromosome 9 to 12. Alterations of genetic materials may occasion deletion of adjacent chromosomes to the breakpoint on the derivative chromosome nine. The presence of ABL proteins is significant in promoting cell growth and transduction of signals, however, abnormalities in the proteins may facilitate the leukemogenic transformation of BCR to ABL which results to fusion of proteins to elevate kinase activities. It has been established that BCR and ABL proteins prevent apoptosis thus leading to accumulation of cells that eventually blast (Faderl & Kantarjian, 2013). Moreover, combination of the proteins blocks the normal functioning of body cells and reduces adhesive capability of a cell to reinforce stromal elements of the cells and body organs (Faderl & Kantarjian, 2013). Molecular abnormalities are comprehensively associated with myeloid transformation while abnormalities of RBI are associated with lymphoid transformation.
Patients must be systematically diagnosed before actually taking treatment plans as this will help identify phase of the disease. Moreover, the factors to be considered when choosing a diagnostic test include examination of age, condition, type of leukemia, severity of symptoms and previous test data. Tests for diagnosis include blood tests, biopsy of blood marrow and cytogenetics; these may be instrumental in establishing treatment and future prevention of the disease.
Treatment of chronic myelogenous leukemia is dependent on the phase of the disease and may vary from chemotherapy, surgery and immunotherapy to bone marrow transplantation. Significantly, there are several drugs that can be used in treatment of the disease and include Fowler solution which is recognized as the first treatment. Consequently, it has been revealed that radiotherapy was used to control the disease up to 1950 when Busurfan was discovered and immediately replaced the former (Finn & Peterson, 2004). Later in 1972, Hydroxyurea was introduced as a form of therapy and because of its toxicity it became a better agent of treatment. Subsequently, it has been opined that in 1980 Interferon was discovered to be effective in treating patients with the disease (Finn & Peterson, 2004). Today, INFA2 and 2b are used in treatment of CML because it acts by induction of FAS and its ligand on CML progenitor. In the process, the event induces cell death especially those of leukemia while INF has been known to prolong survival by effectively delaying cell blasting. Notably, studies have revealed that INF a with cytosine arabinoside that together improve cytogenic response and thus improve survival (Popat, 2011). Major developments have been realized on chemotherapy and may prove to be crucial in future; coupled with the introduction of second-generation thyrokinase inhibition it may help patients to show some improvement.
Chronic myelogenous leukemia is a disease that affects many people across the world; this means that comprehensive diagnosis should be conducted to identify its presence in the human body. This may make it possible for physicians to identify effective treatment plans. In conclusion, current treatment may show improvement but due to evolution of the disease it is paramount for physicians to incorporate therapies now and in the foreseeable future.
Bozzone, D. M. (2009). Leukemia. New York, NY: Chelsea House.
Estey, E. H., & Appelbaum, F. R. (2012). Leukemia and related disorders: integrated treatment
approaches. New York: Humana Press.
Faderl, S., & Kantarjian, H. (2013). Leukemias: principles and practice of therapy. New York,
NY: John Wiley & Sons.
Finn, W. G., & Peterson, L. A. C. (2004). Hematopathology in oncology. Boston: Kluwer
Hehlmann, R. (2016). Chronic myeloid leukemia. Switzerland: Springer, 2016.
Popat, U. R. (2011). Leukemia. New York, NY: Demos Medical Publication.