Professor Khwaja explains what leukaemia is and how the various types of leukaemia differ in their presentation, treatment and outcome.
He is an expert in the diagnosis and treatment of haematological malignancies especially acute leukaemia's. There is acute leukaemia and chronic leukaemia. And the definition of acute leukaemia comes from the fact that it normally is a very rapidly growing cancer and if left untreated would result in relatively survival of the patient, but with effective treatment that can be reversed.
And also sometimes you get bruising or inappropriate bleeding because the blood cells that Asim khwaja wife sexual dysfunction you doing that, platelets, are also reduced in number. Chronic leukaemias are normally much more slow growing. And in fact before we had treatments for leukaemias people could have certain types of chronic leukaemia for many, many years without requiring any treatment or coming to any harm from it.
So there are, in the acute leukaemias there are two types, the myeloid type and the lymphoblastic type. And similarly in the chronic leukaemias there is a myeloid and a lymphoid type.
Asim khwaja wife sexual dysfunction difference between these two is that they develop from slightly different types of white blood cells. So normally in our circulation we have white blood cells called neutrophils, which are the myeloid type of cells. These are very important in fighting bacterial infection in particular. And then the other main type of white blood cell we have is the lymphocyte, and this is important, especially important in fighting viral infections.
So in chronic or acute myeloid leukaemia the cancer is developed in a cell that would normally have become a neutrophil, it would have become a normal myeloid cell but has become damaged in some way and is now growing out of control. So typically what this means is the patient usually is anaemic and needs regular red blood cells transfused to them.
And sometimes there can be a reduction in the other blood cells as well, the platelets and the white blood cells. So the treatment in most instances requires regular transfusions and chemotherapy type treatments are not commonly used.
In other individuals the myelodysplastic syndrome can convert to an acute myeloid leukaemia, and at that stage it would require treatment with chemotherapy.
So with acute leukaemias the growth of the cancer cells is very rapid and therefore we need to get treatment started urgently, normally in a matter of days. And the treatment consists of chemotherapy. So these are drugs that damage the leukaemia cells and we hope cause them to die. We need to give chemotherapy drugs that travel throughout the blood stream.
So there are combinations of drugs. You normally get at least two, sometimes three, and these are given daily over of a period of about a week to ten days.
This sort of treatment needs to be given in hospital because one of the consequences of the chemotherapy is that there is damage to normal blood cells and normal bone marrow cells, and temporarily the patient has very low levels of these cells.
So we have to support them through that period. So this is a period when because of low immunity and the patient is very susceptible to getting serious infections and has to spend time in hospital. So once the first course of treatment is completed, which normally for acute leukaemias takes about a month to six weeks, you usually have a short break of a week to two weeks, and then have further courses of treatment.
And for acute myeloid leukaemia that normally takes about four courses of intensive chemotherapy which, with the intervals in between, requires about a six month period to complete your treatment. So for chronic myeloid leukaemia the treatment now involves most commonly taking a new type of drug which has become available over the last few years, and this is a drug called imatinib or Glivec. You Asim khwaja wife sexual dysfunction talking about the chromosomal abnormality in CML.
Asim khwaja wife sexual dysfunction that the Philadelphia chromosome? Is that unique to CML? Not in other cells in the body but purely in the leukaemia cells. So the Glivec, the imatinib is also being used for treatment of those types of ALL where the Philadelphia chromosome may be present.
But for those conditions it needs to be combined with intensive chemotherapy to get a remission, whereas in CML the Glivec alone is sufficient usually to induce the remission. And in many cases no treatment is required initially so that one can just watch and wait until treatment becomes necessary.
In some people this may never happen or it may take many years to happen. The sorts of treatment you need for CLL are again chemotherapy type drugs but these are of a relatively low intensity type so that they can be delivered as an outpatient.
And there are some newer treatments coming through which are being incorporated also with monoclonal antibodies that, again, are more specifically targeted to the CLL cells. So what determines when someone with CLL needs treatment? There may be a number of things. It depends if the patient has significant symptoms.
Sometimes with CLL this can also make the lymph glands in the body enlarge because the CLL cells can track their way into the lymph glands.
So sometimes there are symptoms from having very large lymph glands that people can find uncomfortable or painful.
CLL can affect the normal bone marrow function if the level of the leukaemia rises, so that the patient may become anaemic or start to get a lower platelet count than normal. And that would be another reason to start treatment, to reverse that balance, to try and restore some normality to the bone marrow. Also sometimes the CLL can get to a stage where the patient may be losing weight or has fevers or is generally becoming more poorly, and again that would be a reason to start treatment.
So one of the complications that can occur with an allogeneic stem cell transplant is this condition called graft-versus-host-disease. And this arises because when the new stem cells seed and take root in the patient a new immune system develops. And this can give complications such as liver damage, problems with the gut and with the skin. This is a complication that can be treated but it requires further immune suppression drugs to be given.
So the new immune system recognises the leukaemia cells as not belonging to them and therefore can attack them and kill them. And in some kinds of leukaemia, for example for chronic myeloid leukaemia, this is a very powerful effect and it is sometimes called graft-versus-leukaemia-effect.
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UK Biobank Urinary catheter. Young people and weight loss Young People Young people: Advice and tips for Asim khwaja wife sexual dysfunction people Sexual Health. Previous Person Pat - Interview Professor Khwaja explains the differences between the four main types of leukaemia.
Professor Khwaja explains myelodysplastic syndrome and how it is related to leukaemia. Professor Khwaja explains that treatment for acute leukaemias needs to be started promptly and consists of intensive chemotherapy.
Professor Khwaja explains that treatment for chronic myeloid leukaemia nowadays involves daily doses of a drug called imatinib or Glivec.
Professor Khwaja explains that for most chronic lymphocytic leukaemias a watch and wait policy is adopted until symptoms develop that would benefit from treatment with mild tablets. Feedback Make a donation. Leave this field blank. Send to a friend Simply fill out this form and we'll send them an email.
Acute myeloid leukaemia (AML) is a malignant disorder characterized by Asim Khwaja1, Magnus Bjorkholm2, Rosemary E. Gale1, Ross L. Levine3, Craig T. Jordan4. Gerhard. people in the general population mostly regarding sex, Linch, D. C., Hills, R. K., Burnett, A. K., Khwaja, A. & Gale, R. E.