The Types of Leukemia - Dr. Gary Dahl
My name is Gary Dahl; I'm a professor of pediatric hematology/oncology at Stanford University and I've been involved with treating children with cancer for many many years. When I started, the cure rate was very low and at the present time we're curing almost 80% of children with cancer. At the time when I was starting taking care patients with leukemia, it was just called acute lymphoblastic leukemia and over the years these different subgroups have been identified with different characteristics in the cell that tell us which cell type they come from, and it's important because it subtypes the Leukemia and the therapies are different and more effective in different types of acute lymphoblastic leukemia. There's also another cohort of patients, 20% of the leukemic population, which consists of acute myeloid leukemia, chronic myeloid leukemia, and juvenile myelomonocytic leukemia These are very rare when compared with acute lymphoblastic leukemia. The incidence of acute lymphoblastic leukemia is three to four per hundred thousand children under the age of 15 and that peak incidence of this disease is between the ages of 2-5 What causes leukemia? Every patient, every parent wants to know, why did this happen to me? Let me show you what a bone marrow looks like in someone with leukemia This is a picture of a bone marrow biopsy and you can see the pink line is bone and the dark blue circles are leukemia cells so a normal bone marrow would be full from normal precursors of regular cells: white cells, red cells, and platelets called precursors, called magacariocytes and so would be a real nice growing garden normal cells developing into the blood cells that make you able to fight infection and breathe and stop bleeding. So usually when a child presents to the doctor with acute lymphoblastic leukemia they have problems with number red cells, number of white cells, number of platelet so they can have problems with bleeding, being an anemic, or they can have problems with bleeding: having extensive nosebleeds that won't stop or little red spots all over their body called petechia and low numbers of normal white cells that fight infection and the bone marrow's replaced by these cells and when we make the diagnosis of leukemia you have over 10 billion leukemia cells in your body so the normal cells have been completely replaced by these cells. So our chemotherapy is given to empty the bone marrow of these abnormal cells and allow the body to repopulate the marrow with the normal precursors: red cells white cells, and platelets. So thats kind of summary of acute leukemia in pediatrics.
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