LEUKEMIA

Dr DEEPAN P SHAH (MD)

Abnormal proliferation of blood cells due to defective medullary heamatopoetic stem cells is called leukemia.

In Layman terms, defective bone-marrow causes uncontrolled multiplication and abnormal growth of cells that are components of blood causing blood cancer.

TYPES AND CLASSIFICATION

Based on speed of progression and maturity level of most cells, most of the Leukemia can be categorised into

  • Acute – Fast progressing, takes weeks to few months, most of the cells are blast cells (immature cells), requires immediate treatment, commonly seen in children.
  • Chronic – Relatively slow progressing, takes months to years, has relatively mature cells, patient usually under observation before commencing any aggressive treatment, Common in elderly people.

There are some leukemias which do not follow fixed pattern, even the presentation of symptom may vary in different individual, also there are cases where in they change the classical course and speed of progression.

Based on types of cells involved, most of the Leukemia can be categorised into

  • Lymphoid (Lymphocytic) – Precursors of Lymphocytes are involved. It is further classified as per which lymphocytes are involved wether B-cells or T-cells.
  • Myeloid(Non-Lymphocytic) – Precursors of RBC, Non-Lymphocyte WBC and Platelets are involved.

A Lymphoid or Myeloid leukemia can Either Acute or Chronic as described below

  1. Acute – Lymphoblastic(ALL)
  2. Chronic – Lymphocytic (CLL)
  3. Acute – Myeloid (AML)
  4. Chronic – Myeloid (CML)

ACUTE

Acute Lymphoblastic Leukemia (ALL) –

When there are multiple mutations in the locus that controls cell proliferation, cell maturation and cell death of precursor cells of Lymphocytes, called Lymphoblast, then this results in ALL. ALL can be of T cell type or B cell type.

Genes associated with ALL –

  • KMT2A – Infant ALL – onset before 10yr of age
  • ARID5B
  • CKDN2A
  • CKDN2B
  • TP53
  • GATA3
  • PIP4K2A
  • IKZF1
  • CEBPE
  • PAX5 – Inherant Autosomal Dominant
  • ETV6 – Inherant Autosomal Dominant

Certain syndromes that increases risk of ALL

  • Down’s Syndrome
  • Bloom Syndrome
  • Fanconi Anaemia
  • X-Linked agamaglobulinaemia
  • Neurofibromatosis Type 1
  • Li-Fraumani Syndrome
  • Paroxysmal Nocturnal Heamoglobinuria
  • Severa Combined Immunodeficiency
  • Costmann Syndrome
  • Ataxia Telangiectasia
  • Schwachmann Daimond Syndrome

SUBTYPES OF ALL

  • Precursor B-cell ALL
  • Precursor T-cell ALL
  • Mature B-cell ALL (also called Burkitts Leukemia due to its similarity with Burkitts Lymphoma)
  • Acute Biphenotypic Leukemia.

Acute Myeloid Leukemia (AML)

It is an Acute Non-Lymphocytic type of malignanacy that involves myeloblast cells(precursor of monocytes and granulocytes).

In AML, there are mutations in genes responsible for maturation and differentiation of the myeloblast cell, so the cell freezes in undifferentiated and immature state. When this type of mutations are combined with mutations in genes controlling proliferation in same cell, it results in clonning of immature undifferentiated cells resulting in AML.

Genes associated with AML

Subtypes of AML

Subtypes of AML are classified based on staging of maturation i.e. at which stage the msturation of the cell is arrested and how is the general behaviour of cells and which genes are involved.

  • Undifferentiated Acute Myeloblastic Leukemia
  • Acute Myeloblastic Leukemia with Minimal Maturation
  • Acute Myeloblastic Leukemia with Maturation
  • Acute Pro-Myelocytic Leukemia (APL)
  • Acute Myelomonocytic Leukemia
  • Acute Myelomonocytic Leukemia with Eosinophilia
  • Acute Monocytic Leukemia
  • Acute Erythroid Leukemia
  • Acute Megakaryoblastic Leukemia

Adult T-Cell Leukemia

Blast Crisis of CML

CHRONIC

Chronic Lymphocytic Leukemia (CLL)

  • B-cell Pro-Lymphocytic Leukemia(B-PLL)
  • T-Cell Pro-Lymphocytic Leukemia(T-PLL), T-PLL doesnt completely fit into this category.

Hairy-Cell Leukemia(HCL)

Large Granular Lymphocytic Leukemia(LGLL)

Chronic Myeloid Leukemia (CML)

  • Chronic Granulocytic Leukemia
  • Juvenile CML
  • Chronic Neutrophillic Leukemia
  • Chronic Myelo-Monocytic Leukemia(CMML)
  • Atypical CML (aCML)

Chronic Eosinophillic Leukemia

Few other types, preleukemias and syndromes that cannot be classified in above category

  • Clonal Eosinophilia
  • Other Myelodysplastic Syndromes
  • Other Myeloproliferative Syndromes

CAUSES

Leukemia is caused due to mutations in genes that are associated with proliferation, differentiation, growth, maturation and cell death of blood cells. With different types of mutations responsible for different types of leukemia.

These genetic mutations can be inherited or acquired due to multiple reasons of which few known risk factors are

  • Exposure to certain chemicals (e.g. benzene, petrochemicals, hair-dyes, agent orange herbicide, certain insecticides)
  • Radiation – ionising radiations and doubtedly non-ionising radiations too.
  • Smoking and tobacco use.
  • Prior alkylating chemotherapy for some other form of malignancy.
  • Viruses – Human T-cell Lymphotropic Virus – 1 HTLV-1 is associated with Adult T-cell Leukemia and Hepatitis C is associated with CLL
  • Diseases and Syndromes – Down’s Syndrome, Kline Felter syndrome, Fanconi Anaemi, Ataxia-Telangiectasia or Louis-Bar Syndrome, Myelodysplastic syndrom, Myeloproliferation syndrome.

Few of these factor are seen responsible for specific type of cancer (eg HTLV1 causes Adult T-cell Leukemia, Tobacco and Down’s Syndrome increases risk of AML).

SIGNS AND SYMPTOMS

Symptoms may vary in different types of leukemia, different individuals and different stages of disease.

  • Tired feeling
  • Paleness due to anaemia
  • Shortness of breath
  • Headache, lethargy, stiffness of neck
  • Loss of appetite
  • Weight loss
  • Tendency to catch infection too frequently
  • Fever usually due to secondary infections
  • Painful long bones
  • (Heamorrhagic diathesis) easily bleeds and frequent ecchymosis and petechiae (bruises).
  • Painless lymphomegaly (Enlarged lymphnodes)
  • Hepatospleenomegaly – can easily palpate liver and spleen due to its increased size.
  • Fibrosis of bone marrow
  • Chloroma or Leukemia Cutis or myeloid sarcoma or granular sarcoma or extramedullary myeloid tumour
  • Swollen painfull and bleeding gums
  • Sweet’s Syndrome
  • Pitting Oedema
  • Enlarged Testis
  • Mediastinal mass
  • Cranial nerve Paralysis if CNS is involved
  • Increased blood cell count , WBC or RBC or Platelets, depending on type with most if the cells immature and lacking differentiation.

DIAGNOSIS

  • Complete Blood Count
  • Bone Marrow Biopsy
  • Lymph Node Biopsy

HOMEOPATHIC TREATMENT WITH INDICATED HOMEOPATHIC MEDICINES

  • Arsenicum Album
  • Phosphorus
  • Hekla lava
  • Lachesis
  • Benzinum
  • Carica Papaya
  • Cinchonna Officinalis
  • X-ray
  • Thuja Occidentalis
  • Syphillinum
  • Baryta Carbonica
  • Calcarea Phosphorica
  • Ruta Graveolens
  • Calcarea Fluorica
  • Calcarea Carbonica
  • Symphytum Officinalis
  • Hyocyamus Niger
  • Medhorrhinum

UNDER CONSTRUCTION

19 thoughts on “LEUKEMIA”

  1. I am suffering from CML since 2011. Taking allopathic treatment since then but results are not that good. WBC keep fluctuating. Do you have any help to offer to keep my cell counts normal ?

  2. I have CLL/SLL. What Homeopathic remedies are effective for this condition?
    I grew up with a MD/Homeopathic Physician, and I know the amazing effectiveness of Homeopathy.
    Any assistance would be greatly appreciated.
    I am also a Family Physician for 34 years, now retired.
    Thank you.

  3. My mother has been diagnosed with CMML (Chronic Mylomonocytic Leukemia ). Do we have any treatment available in Homeopathy to control fever associated with CMML in old Age?

    1. Homeopathy has effective treatment for CMML, we treat such cases at Dr. Shah’s Homeopathy, for more details contact us no number provided.

  4. My daughter has AML M2, she did not respond to 1st Chemo induction therapy. Can you please guide homeopathic treatment can cure this disease

  5. Sir, my mother is suffering from pneumonia (xray), but blood test shows total WBC count 2.64 lacs/cmm, lymphocyte 52%, Myelocyte 8%, Myeloblast 10%, Pro lymphocyte 15%, lymphoblast 5%, Hb 7.9, platelet 84000/cmm;

    can you suggest if homeopathic treatment is possible or, not; and possible treatment, please?

  6. Patient is 43 years old having AML intermediate prognosis.. One chemo done.. Can homeopathy help further so that BMT can be avoided

  7. Hello Sir , my brother is suffering from blood cancer (AML) , his bone marrow transplant(haplo stem cell transplant ) is done but his disease relapsed and now cancer cells are increasing rapidly
    So please give us any suggestions .. No chemotherapy is working on the disease
    I don’t have your contact number please need your suggestionS

  8. I was diagnosed with cLL in 2018 and currently in wait and watch. TLC value slowly increased to approx 100 now with hemoglobin around 12 and platelet count 120 to 150

  9. My daughter jigyasa Srivastava suffering from B-ALL repeat and last stage blood cancer.plesse help

  10. Hi my father have detected MDS RAEB 1 with 8% blast in Oct 2023 and now in Dec first Chemo has started i.e. Azacitidine but after the treatment blood transfusion increased that previous so any action in Homeopath to avoid or to control to Shift from MDS to AML.

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