Hematological Disorder-Leukemia

Leukaemia is a general term used to describe blood cell cancer. It is the most common type of cancer in children under the age of 15 years. However, the majority of leukaemia cases are always reported in adults older than 55 years. The types of leukaemia vary depending on the type of blood cell attack. There are four main types of leukaemia: acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL), and chronic myeloid leukaemia (CML). Currently, the exact cause of leukaemia is unknown. However, its risk factors are chemotherapy, radiation exposure, some chemicals such as benzene, smoking, and familial history of leukaemia (Bassan et al ., 2018).

Usually, leukaemia treatment aims to ensure the patients turn to good health by bringing about complete remission. The treatment of leukaemia continuously varies depending on the type of leukaemia. The three treatment strategies for leukaemia are chemotherapy, Targeted therapy, and bone marrow transplant. The primary form of leukaemia treatment is chemotherapy. This is where drug treatment is combined with chemicals to kill leukaemia cells. The type of drug (single or combined drug dose) always depends on the type of leukaemia. For ALL and AML, chemotherapy should always be initiated immediately after the diagnosis. Leukaemia chemotherapy incorporates induction therapy, post-recession therapy (which consists of intensification therapy), and maintenance therapy. In targeted therapy, targeted drug treatment focuses on a specific abnormality within the cancerous cells (Hallek, 2015).

To help re-establish healthy stem cells, bone marrow transplant/stem cell transplant is always the treatment of choice. This treatment involves the replacement of unhealthy bone marrow with cells that are leukaemia-free. However, in CLL, the wait-and-watch approach is always used after diagnosis.

The treatment mentioned above, among others, has resulted in a good prognosis in leukaemia patients. However, these treatment options and the provision of care to leukaemia patient is still faced with numerous challenges. This includes infections, cancer relapse, graft versus host disease, drug resistance, difficulties in targeting cancer cells, lack of cancer epigenetic profiling, difficulties in diagnosis, and metastasis. Multiple numbers of genetic and chromosomal abnormalities always make stem cell therapy more challenging, especially in adults. This is because their abnormalities always increase with an increase in age. Therefore, a more detailed study is needed to clarify the molecular changes associated with genetical and chromosomal aberrations in leukaemia (Chakraborty and Rahman, 2017)

References

Bassan, R., Bourquin, J. P., DeAngelo, D. J., & Chiaretti, S. (2018). New approaches to the management of adult acute lymphoblastic leukaemia. J Clin Oncol, 36(36), 3504-19. https://clf1.medpagetoday.com/content/pdf/reading-room/asco/JCO.HM.Bassan(1).pdf

Chakraborty, S., & Rahman, T. (2017). The difficulties in cancer treatment. Cancer medical science, 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024849/

Hallek, M. (2015). Chronic lymphocytic leukaemia: 2015 Update on diagnosis, risk stratification, and treatment. American journal of haematology, 90(5), 446-460. https://onlinelibrary.wiley.com/doi/abs/10.1002/ajh.23979

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Hematological Disorder-Leukemia

Pick one haematological disorder covered in this module. For this disorder, identify and describe three treatment strategies for the disease.

What challenges could arise in carrying out these strategies and providing care to the patient?