Mbak Ratna,
Saya ikut prihatin dengan kondisi Andre, ini ada
artikel tentang leukemia untuk anak, seperti harapan
hidup masih lebih tinggi dibanding dengan dewasa,
semoga bisa disembuhkan ya.
Mamanya Dafi
What is it?
The leukemias are cancers that affect the
blood-forming system of the body,including the
lymphatic system and the bone marrow. Leukemias are
classified as either acute or chronic, with subtypes
identified according to the microscopic appearance of
leukemia cells and their behavior. In general acute
leukemias tend to affect children, while chronic
leukemias are more common in adults.
Acute Leukemia
In the acute leukemias, under-developed (immature)
blood cells reproduce quickly in the bone marrow,
eventually crowding out healthy cells. These
abnormal cells may also spread to other organs,
ultimately leading to disruption of organ function.
The main types of acute leukemias are differentiated
based on the specific types of blood cells that fail
to mature:
Acute lymphoid leukemias (ALL) - These occur when
primitive blood-forming cells called lymphoblasts
("blasts") proliferate without developing into normal
blood cells. These lymphoblasts crowd out healthy
blood cells, and frequently collect in the lymph nodes
to cause swelling. ALL is the most common kind of
childhood cancer, accounting for 80% of leukemia cases
in children under 15 years old. Although adults may
sometimes develop ALL, the illness is rare in persons
over age 50.
Acute myeloid leukemias (AML) - These occur when
primitive blood-forming cells called myeloblasts
("blasts") proliferate without developing into normal
blood cells. Immature blast cells crowd the bone
marrow and interfere with the production of sufficient
numbers of healthy normal cells. The result is anemia
(due to low levels of red blood cells) and frequent
infections (due to low levels of protective white
blood cells). AML accounts for 50% of leukemia
diagnosed in teenagers and persons in their 20s, and
80% of all acute leukemia
cases in adults.
Chronic Leukemia
The chronic leukemias involve overproduction of blood
cells that appear to be mature, but that actually lack
the normal functions of mature blood cells. There are
two main groups of chronic leukemia:
Chronic lymphoid leukemias (CLL) - These are
characterized by the production of too many apparently
"mature" lymphocytes in the bone marrow. These
abnormal cells appear to be fully-developed
lymphocytes, but they cannot fight infection as well
as normal lymphocytes can. In CLL, cancerous cells are
found in the bone marrow, blood, and lymph nodes
(where they produce the swelling which appears as
"swollen glands"). CLL accounts for about 30% of all
leukemias. It is rare in persons under 30, but its
frequency increases with age, so that the greatest
number of CLL cases occur in those between the ages of
60 and 70.
Chronic myeloid leukemias (CML) - These are
characterized by the overproduction of
mature-appearing but defective myeloid cells (white
blood cells that have granules inside them), to the
point where almost no healthy cells remain. Persons
with CML often develop a chromosomal abnormality
called the "Philadelphia chromosome." CML accounts for
20% to 30% of all adult leukemias and most frequently
affects persons aged 25 to 60. As a group, the
leukemias currently account for about 2% of all
cancers, and they strike 9 out of every 100,000
Americans annually. Males are more likely
to develop leukemia than females, and whites more than
other racial or ethnic groups. Adults are 10 times
more likely to be diagnosed with leukemia than
children, with the greatest risk in the elderly. Among
children, the incidence is greatest in those under age
4.
There is evidence that at least part of the risk for
leukemia may be inherited, since some forms of
leukemia (especially CLL) tend to strike close
relatives in
the same family. Certain genetic abnormalities (such
as Down syndrome ) have also been linked to the
development of specific forms of leukemia. However, as
research stands today, the possibility of a definite
inherited risk for leukemia is still being
investigated. In cases of myeloid leukemia, an
increased risk for the illness has been linked to
excessive exposure to ionizing radiation and to heavy
exposure to the chemical benzene (found in unleaded
gasoline).
Symptoms
Early symptoms of leukemia are often overlooked, since
they may resemble symptoms of the flu or other common
diseases. Symptoms include:
Fever
Fatigue
Aches in bones or joints
Headaches
Skin rashes
Swollen lymph nodes ("swollen glands")
Frequent infections
Unexplained weight loss
Bleeding of gums or nose
An enlarged spleen or liver, or a feeling of abdominal
fullness
Slow-healing cuts or frequent bruises
What your doctor looks for
Your doctor may ask about any of the symptoms listed
above, especially frequent infections, abnormal
bruising or bleeding, and swollen lymph nodes.
Diagnosis
Even your doctor may not initially suspect leukemia
based on your symptoms alone. However, during your
physical examination, he or she may discover
that you have swollen lymph nodes, or an enlarged
liver or spleen. The diagnosis may become clearer when
routine blood tests (especially blood cell counts)
show abnormal results. These blood tests will be
followed by further diagnostic procedures, including:
a bone marrow biopsy (removal of a sample of bone
marrow for laboratory examination); specialized blood
tests to detect the presence of abnormal cell surface
proteins; and (sometimes) tests for genetic
abnormalities, such as the Philadelphia chromosome.
Expected duration
In general, the chronic leukemias progress more slowly
than the acute leukemias. Patients with CML typically
have several years of stability before developing a
picture more like AML.
Prevention
There is currently no way to prevent most forms of
leukemia. In the future, genetic testing may play a
larger role in identifying patients who are at an
increased risk for the illness. Until then, close
relatives of leukemia patients should follow a normal
schedule of routine physical exams, unless suspicious
symptoms develop.
Treatment
Acute Leukemias
There is no "staging" (determination of how far cancer
has spread) for acute leukemias, so treatment is not
dependent on how far the disease has advanced.
Treatment for acute leukemias depends on the patient's
condition, and on whether the patient is newly
diagnosed, continuing treatment, in remission (the
disease is controlled), or in relapse after a
remission.
In ALL, treatment generally occurs in phases, although
not all phases may be used for all patients:
Phase 1, called "induction therapy" - Here
chemotherapy is administered in the hospital with the
goal of getting the patient into remission.
Phase 2, called "consolidation " - This is a
continuation of the same drugs used in Phase 1, but on
an outpatient basis — to keep the patient in
remission.
Phase 3, called "prophylaxis" - In this phase, there
is chemotherapy using different drugs, perhaps
combined with radiation, to prevent the leukemia from
entering the brain and central nervous system.
Phase 4, the "maintenance" stage - After the leukemia
has been treated, you will have frequent visits with
your physician. You will need regular physical
examinations and laboratory tests to be sure that the
cancer has not recurred.
Recurrent leukemia: Some patients will have a relapse
(recurrence)of their disease. When relapse occurs,
patients are given further doses of various
chemotherapy drugs in different dosages to maintain
the
remission. Several years of chemotherapy may be needed
to keep a patient in remission. Allogenic bone marrow
transplant may be appropriate for some patients.
Treatment for patients with AML generally depends on
the type of AML, as well as the patient's age and
overall health. Usually patients receive induction
therapy in an effort to send the leukemia into
remission. Consolidation and maintenance therapies may
also be used, but their effectiveness for AML is
less than for ALL.
Chronic Leukemias
For CLL, the next step after diagnosis is "staging" to
determine the extent of the cancer. There are 4 stages
of CLL:
Stage 0: There are too many lymphocytes in the blood.
Generally, there are no other symptoms of leukemia.
Stage I: Lymph nodes are swollen due to lymphocytes in
the blood.
Stage II: Lymph nodes, spleen and liver are swollen
due to overabundance of lymphocytes.
Stage III: Anemia has developed because there are too
few red blood cells in the blood.
Stage IV: There are too few platelets in the blood.
Lymph nodes, spleen and liver may be swollen. Anemia
may be present.
Treatment of CLL will depend on the stage of the
disease, as well as the patient's age and overall
health. In the earliest stage, Stage 0, no treatment
may be offered, and the patient's health will be
closely monitored. In Stage I or II, either
observation or chemotherapy is the usual treatment,
while more
intensive or multiple-drug chemotherapies may be used
in Stage III or IV. Selected patients may also be
treated with bone marrow transplantation (BMT).
For CML, bone marrow transplantation has become the
most common treatment. Certain medications have also
been used to manage the disease.
When to call your doctor
If you are an adult, see your doctor for an annual
physical examination. Otherwise call your doctor if
you have frequent infections, abnormal bruising or
bleeding, swollen glands, unexplained weight loss,
persistent fatigue, or any other symptoms of leukemia.
Prognosis
The 5-year survival rate for all leukemia patients is
about 42%, but it varies greatly depending on the type
of leukemia:
ALL - In general, children with ALL have a 90% chance
of obtaining a complete remission, with a 80% 5-year
survival rate. The adult prognosis is not quite as
good, with only 25%-35% of adult patients surviving
for 5 years.
AML - With proper treatment, 70%-75% of those with AML
can expect to go into remission. About 80% of patients
who go into remission will do so within one month of
induction therapy.In some of these patients, however,
the disease will return, lowering the cure rate to
40%-60%.
CLL - The average survival of patients with CLL is 9
years, although survival of up to 35 years has been
recorded. In Stage I or II, remission occurs in about
70% of patients treated with chemotherapy.
CML - The median survival time for CML patients
depends on the age of the patient, the extent of the
disease, and the treatments undergone. For example,
younger patients (under age 40) with mild symptoms
have a 3-year survival rate of 50%-60% following
treatment
with bone marrow transplantation. However, only
15%-25% of patients without a transplant live longer
than 5 years. A few rare patients have lived up to 20
years.
----end----
--- Ratna Manulang <[EMAIL PROTECTED]>
wrote:
>
>
> > -----Original Message-----
> > From: Ratna Manulang
> > Sent: Thursday, October 26, 2000 11:37 AM
> > To: '[EMAIL PROTECTED]'
> > Subject: leukimia
> >
> > dear Netters,
> >
> >
> > Adakah diantara rekan-rekan yang masih mempunyai
> artikel ttg leukimia..
> > soalnya anggota keluargaku, anak Oom ku (Andrew,
> 11 th) divonis terkena
> > Leukimia.. dan akan di bawa ke Belanda dalam
> minggu ini.. gejalanya
> > baru ketahuan minggu kemarin setelah cek lab.
> Andrew masih kecil tapi
> > kok bisa kena leukimia ya...
> >
> > Tolong artikelnya baik sebab / penanggulangannya
> bagaimana ??
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