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Leukemia   Cancer is the uncontrolled growth of abnormal cells that can spread throughout the body. These cells start out as normal but change, become abnormal and keep dividing and forming more cells without control or order. These cancer cells live beyond their normal lifecycle and do not function normally.

Cancer is not just one disease. They are a group of more than 100 different diseases. All organs of the body are made up of cells. Normally, cells divide to produce more cells only when the body needs them. If cells divide when new ones are not needed, they form a mass of excess tissue, called a tumor. Tumors can be benign (not cancer) or malignant (cancer). Depending on where the cancer begins determines the type of cancer. For example, cancer that first effect brain tissue can form a brain tumor.

The cells in malignant tumors can invade and damage nearby tissues and organs. Cancer cells can also break away from a malignant tumor and travel through the bloodstream or the lymphatic system to form new tumors in other parts of the body. The spread of cancer is called metastasis.

Leukemia is a cancer of the blood, and does not form a tumor. The white blood cells (or leukocytes or WBC) are produced in the bone marrow in very large numbers and become abnormal. These cancer cells interfere with the body's production of other types of blood cells, specifically the red blood cells (RBC) and platelets. Red cells carry oxygen to the body and a decreased number of RBC result in anemia and fatigue. Platelets help blood vessels clot and a decreased number of platelets result in bleeding problems, such as easy bruising. The WBC helps fight infection and when they are abnormal there is an increased risk of infection.

Leukemia is the most common cancer among children and is the leading cause of death from disease in children under fifteen. Leukemia is divided into two types, acute (rapid developing) and chronic (slowly developing) forms. The acute type, which accounts for 98% of all childhood leukemia, is further divided, depending on the type of WBC involved. The types are acute lymphocytic leukemia (ALL) or acute non-lymphocytic leukemia (ANLL), also called acute myelogenous leukemia (AML). ALL usually occurs in children between ages 2 and 8 years. The exact cause of leukemia is unknown but most are believed to result from non-inherited mutations in the genes of growing blood cells.

As indicated earlier, symptoms of this disease result from the changes in blood cells. Fewer RBC results in paleness (anemia) and children may become abnormally tired (fatigued) and short of breath while playing. Fewer platelets may result in easy bruising and frequent, prolonged bleeding. Abnormal WBC result in decreased ability to combat infection. Since blood cells are made in the marrow of bones, there may be pain in the bones and joints. Poor appetite and swollen glands (or lymph nodes) are additional symptoms.

The diagnosis of leukemia is made through the history of symptoms, physical examination to check for signs of infection, abnormal bleeding, anemia and swollen lymph nodes and confirmatory lab tests. These lab tests include a complete blood count (CBC), which measure the number and type of cells in the blood. Further evaluation may include a bone marrow biopsy, lymph node biopsy and sometimes a spinal tap. Other tests include X-rays, CT scans and MRI's.

Depending on the type and extent of the leukemia determines the type of therapy. Therapy usually includes multiple chemotherapeutic drugs and/or radiation therapy.

More people are being cured of leukemia now then in the past. The overall five-year survival rate has tripled in the past 40 years. In 1960, the rate of survival was only 14 percent. By 1970, 5-year survival reached 35 percent and today the overall five-year survival rate is 44 percent. The rate of cure is better for children. The leukemia death rate for children in the United States has declined 61 percent over the last three decades. The overall five-year survival rate for children with acute lymphocytic leukemia is 81 percent. The rate is 43 percent for acute myelogenous leukemia. Despite the improved statistics, leukemia is still the leading cause of cancer death in children less then fifteen years old. For more information, visit The Leukemia & Lymphoma Society on the WEB.

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