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Leukemias, Acute


Overview :

The cells that make up blood are produced in the bone marrow and the lymph system. The bone marrow is the spongy tissue found in the large bones of the body. The lymph system includes the spleen (an organ in the upper abdomen), the thymus (a small organ beneath the breastbone), and the tonsils (an organ in the throat). In addition, the lymph vessels (tiny tubes that branch like blood vessels into all parts of the body) and lymph nodes (pea-shaped organs that are found along the network of lymph vessels) are also part of the lymph system. The lymph is a milky fluid that contains cells. Clusters of lymph nodes are found in the neck, underarm, pelvis, abdomen, and chest.

The cells found in the blood are the red blood cells (RBCs), which carry oxygen and other materials to all tissues of the body; white blood cells (WBCs) that fight infection; and the platelets, which play a part in the clotting of the blood. The white blood cells can be further subdivided into three main types: granulocytes, monocytes, and lymphocytes.

The granulocytes, as their name suggests, have particles (granules) inside them. These granules contain special proteins (enzymes) and several other substances that can break down chemicals and destroy microorganisms, such as bacteria. Monocytes are the second type of white blood cell. They are also important in defending the body against pathogens.

The lymphocytes form the third type of white blood cell. There are two main types of lymphocytes: T lymphocytes and B lymphocytes. They have different functions within the immune system. The B cells protect the body by making "antibodies." Antibodies are proteins that can attach to the surfaces of bacteria and viruses. This "attachment" sends signals to many other cell types to come and destroy the antibodycoated organism. The T cells protect the body against viruses. When a virus enters a cell, it produces certain proteins that are projected onto the surface of the infected cell. The T cells recognize these proteins and make certain chemicals that are capable of destroying the virus-infected cells. In addition, the T cells can destroy some types of cancer cells.

The bone marrow makes stem cells, which are the precursors of the different blood cells. These stem cells mature through stages into either RBCs, WBCs, or platelets. In acute leukemias, the maturation process of the white blood cells is interrupted. The immature cells (or "blasts") proliferate rapidly and begin to accumulate in various organs and tissues, thereby affecting their normal function. This uncontrolled proliferation of the immature cells in the bone marrow affects the production of the normal red blood cells and platelets as well.

Acute leukemias are of two types: acute lymphocytic leukemia and acute myelogenous leukemia. Different types of white blood cells are involved in the two leukemias. In acute lymphocytic leukemia (ALL), it is the T or the B lymphocytes that become cancerous. The B cell leukemias are more common than T cell leukemias. Acute myelogenous leukemia, also known as acute nonlymphocytic leukemia (ANLL), is a cancer of the monocytes and/or granulocytes.

CHARLOTTE FRIEND (1921–1987)

Charlotte Friend was born to Russian immigrants, Morris Friend and Cecilia (Wolpin), on March 11, 1921, in New York City. At three years of age, her father died of a heart condition. Friend's decision to pursue a career in medicine may well have been influenced by her father's death and by her mother's occupation as a pharmacist. As a child, Friend read books about bacteriologists and, by age ten, she knew that she wanted to study bacteriology. She attended Hunter College, enlisting in the U.S. Navy after her graduation in 1944.

Friend attended Yale University, earning her Ph.D. in bacteriology in 1950. After working for the Memorial Sloan-Kettering Institute for Cancer Research, she became an associate professor at Cornell University in 1952. Friend began researching cancer and became particularly interested in leukemia and its cause. She believed that a virus caused the disease and confirmed this theory by using an electron microscope to photograph the virus in mice. Her findings were initially met with much skepticism but she was able to develop a vaccine that was used successfully with mice, which added credibility to her theory. Her breakthroughs have led medical researchers to new methods of treating cancer and to a greater understanding of the disease.

Friend was a prolific writer who published 113 original papers, 49 abstracts, book chapters, and reviews, many of which she completed individually. She was diagnosed with lymphoma and died on January 13, 1987.

Leukemias account for 2% of all cancers. Because leukemia is the most common form of childhood cancer, it is often regarded as a disease of childhood. However, leukemias affect nine times as many adults as children. Half of the cases occur in people who are 60 years of age or older. The incidence of acute and chronic leukemias is about the same. According to the estimates of the American Cancer Society (ACS), approximately 29,000 new cases of leukemia were diagnosed in 1998.




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