Aadit

Gautam

XII - C

Roll No -
Biology
Project
 Blood
Cancer
(Leukaemia)
 Certificate
This is to certify that the biology project titled “Blood
Cancer (Leukaemia)”has been successfully completed
by Aadit Gautam of class XII in Central Board of
Secondary Education (CBSE) leading to the award of
the year 2025-2026

Acknowledgemen
t
In the accomplishment of this successfully, many
people have best owned upon me their blessings and
the heart utilizing to thank are primarily I would
Thank god for making me able to complete this project
Then I would like to thank my principal and my biology
teacher Mrs. Aradhna Bedi whose valuable guidance
has been the ones that help me patch up this project
and make it fully successful.
Leukemia (also spelled leukaemia; pronounced /luː
ˈkiːmiːə/[1] loo-KEE-mee-ə) is a group of blood
cancers that usually begin in the bone marrow and
produce high numbers of abnormal blood cells.[9] These
blood cells are not fully developed and are
called blasts or leukemia cells.[2] Symptoms may include
bleeding and bruising, bone pain, fatigue, fever, and an
increased risk of infections.[2] These symptoms occur
due to a lack of normal blood cells.[2] Diagnosis is
typically made by blood tests or bone marrow biopsy.[2]
The exact cause of leukemia is unknown.[5] A
combination of genetic factors and environmental
(non-inherited) factors are believed to play a role.
[5]
Risk factors include smoking, ionizing radiation,
petrochemicals (such as benzene), prior chemotherapy,
and Down syndrome.[5][3] People with a family history of
leukemia are also at higher risk.[3] There are four main
types of leukemia—acute lymphoblastic
leukemia (ALL), acute myeloid leukemia (AML), chronic
lymphocytic leukemia (CLL) and chronic myeloid
leukemia (CML)—and a number of less common types.
[3][10]
Leukemias and lymphomas both belong to a
broader group of tumors that affect the blood, bone
marrow, and lymphoid system, known as tumors of the
hematopoietic and lymphoid tissues.[11][12]
Treatment may involve some combination
of chemotherapy, radiation therapy, targeted therapy,
and bone marrow transplant,
with supportive and palliative care provided as needed.
[3][6]
Certain types of leukemia may be managed
with watchful waiting.[3] The success of treatment
depends on the type of leukemia and the age of the
person. Outcomes have improved in the developed
world.[10] Five-year survival rate was 67% in the United
States in the period from 2014 to 2020.[4] In children
under 15 in first-world countries, the five-year survival
rate is greater than 60% or even 90%, depending on
the type of leukemia. For infants (those diagnosed
under the age of 1), the survival rate is around 40%.
[13]
In children who are cancer-free five years after
diagnosis of acute leukemia, the cancer is unlikely to
return.[13]
In 2015, leukemia was present in 2.3 million people
worldwide and caused 353,500 deaths.[7][8] In 2012, it
had newly developed in 352,000 people.[10] It is the
most common type of cancer in children, with three-
quarters of leukemia cases in children being the acute
lymphoblastic type.[3] However, over 90% of all
leukemias are diagnosed in adults, CLL and AML being
most common.[3] It occurs more commonly in
the developed world.
Classification
[edit]
Four major kinds of leukemia
Cell type Acute Chronic
Lymphocytic Acute Chronic
leukemia lymphoblastic lymphocytic
(or leukemia leukemia
"lymphoblastic") (ALL) (CLL)
Acute
Myelogenous Chronic
myelogenous
leukemia myelogenous
leukemia
("myeloid" or leukemia
(AML or
"nonlymphocytic") (CML)
myeloblastic)
Duration: 9 minutes and 51 seconds.9:51An
explanation of acute leukemia
General classification
[edit]
Clinically and pathologically, leukemia is subdivided
into a variety of large groups. The first division is
between its acute and chronic forms:[15]
 Acute leukemia is characterized by a rapid increase
in the number of immature blood cells. The
 crowding that results from such cells makes the
bone marrow unable to produce healthy blood
cells resulting in low hemoglobin and low platelets.
Immediate treatment is required in acute leukemia
because of the rapid progression and accumulation
of the malignant cells, which then spill over into
the bloodstream and spread to other organs of the
body. Acute forms of leukemia are the most
common forms of leukemia in children.
 Chronic leukemia is characterized by the excessive
buildup of relatively mature, but still
abnormal, white blood cells (or, more rarely, red
blood cells). Typically taking months or years to
progress, the cells are produced at a much higher
rate than normal, resulting in many abnormal
white blood cells. Whereas acute leukemia must
be treated immediately, chronic forms are
sometimes monitored for some time before
treatment to ensure maximum effectiveness of
therapy. Chronic leukemia mostly occurs in older
people but can occur in any age group.
Additionally, the diseases are subdivided according to
which kind of blood cell is affected. This divides
leukemias into lymphoblastic or lymphocytic
leukemias and myeloid or myelogenous leukemias:[15]
  In lymphoblastic or lymphocytic leukemias, the
cancerous change takes place in a type of marrow
cell that normally goes on to form lymphocytes,
which are infection-fighting immune system cells.
Most lymphocytic leukemias involve a specific
subtype of lymphocyte, the B cell.
 In myeloid or myelogenous leukemias, the
cancerous change takes place in a type of marrow
cell that normally goes on to form red blood cells,
some other types of white cells, and platelets.
Combining these two classifications provides a total of
four main categories. Within each of these main
categories, there are typically several subcategories.
Finally, some rarer types are usually considered to be
outside of this classification scheme.[15][16]
Specific types
[edit]
 Acute lymphoblastic leukemia (ALL) is the most
common type of leukemia in young children. It also
affects adults, especially those 65 and older.
Standard treatments
involve chemotherapy and radiotherapy. Subtypes
include precursor B acute lymphoblastic
leukemia, precursor T acute lymphoblastic
leukemia, Burkitt's leukemia, and acute
 biphenotypic leukemia. While most cases of ALL
occur in children, 80% of deaths from ALL occur in
adults.[17]
 Chronic lymphocytic leukemia (CLL) most often
affects adults over the age of 55. It sometimes
occurs in younger adults, but it almost never
affects children. Two-thirds of affected people are
men. The five-year survival rate is 85%.[18] It is
incurable, but there are many effective treatments.
One subtype is B-cell prolymphocytic leukemia, a
more aggressive disease.
 Acute myelogenous leukemia (AML) occurs far
more commonly in adults than in children, and
more commonly in men than women. It is treated
with chemotherapy. The five-year survival rate is
20%.[19] Subtypes of AML include acute
promyelocytic leukemia, acute myeloblastic
leukemia, and acute megakaryoblastic leukemia.
 Chronic myelogenous leukemia (CML) occurs
mainly in adults; a very small number of children
also develop this disease. It is treated
with imatinib (Gleevec in United States, Glivec in
Europe) or other drugs.[20] The five-year survival
rate is 90%.[21][22] One subtype is chronic
myelomonocytic leukemia.
 Hairy cell leukemia (HCL) is sometimes considered
a subset of chronic lymphocytic leukemia, but does
not fit neatly into this category. About 80% of
affected people are adult men. No cases in
children have been reported. HCL is incurable but
easily treatable. Survival is 96% to 100% at ten
years.[23]
 T-cell prolymphocytic leukemia (T-PLL) is a very
rare and aggressive leukemia affecting adults;
somewhat more men than women are diagnosed
with this disease.[24] Despite its overall rarity, it is
the most common type of mature T cell leukemia;
[25]
nearly all other leukemias involve B cells. It is
difficult to treat, and the median survival is
measured in months.
 Large granular lymphocytic leukemia may involve
either T-cells or NK cells; like hairy cell leukemia,
which involves solely B cells, it is a rare
and indolent (not aggressive) leukemia.[26]
 Adult T-cell leukemia is caused by human T-
lymphotropic virus (HTLV), a virus similar to HIV.
Like HIV, HTLV infects CD4+ T-cells and replicates
within them; however, unlike HIV, it does not
destroy them. Instead, HTLV "immortalizes" the
infected T-cells, giving them the ability to
 proliferate abnormally. Human T-cell lymphotropic
virus types I and II (HTLV-I/II) are endemic in
certain areas of the world.[citation needed]
 Clonal eosinophilias (also called clonal
hypereosinophilias) are a group of blood disorders
characterized by the growth of eosinophils in
the bone marrow, blood, and/or other tissues.
They may be pre-cancerous or cancerous. Clonal
eosinophilias involve a "clone" of eosinophils, i.e.,
a group of genetically identical eosinophils that all
grew from the same mutated ancestor cell.
[27]
These disorders may evolve into chronic
eosinophilic leukemia or may be associated with
various forms
of myeloid neoplasms, lymphoid neoplasms, myelo
fibrosis, or the myelodysplastic syndrome.[28][29][27]
Pre-leukemia
[edit]
 Transient myeloproliferative disease, also termed
transient leukemia, involves the abnormal
proliferation of a clone of non-
cancerous megakaryoblasts. The disease is
restricted to individuals with Down syndrome or
genetic changes similar to those in Down
syndrome, develops in a baby during pregnancy or
 shortly after birth, and resolves within 3 months
or, in ~10% of cases, progresses to acute
megakaryoblastic leukemia. Transient myeloid
leukemia is a pre-leukemic condition.[30][31][32]
 Clonal hematopoiesis is a common age-related
phenomenon with a low risk of progression
to myelodysplastic syndrome (MDS) and leukemia.
[33]
Once MDS has developed, the risk of
progression to acute leukemia can be assessed
using the International Prognostic Scoring System
(IPSS).
 Monoclonal B-cell lymphocytosis has a low risk of
progression to B-cell leukemia.
Signs and symptoms
[edit]

Common symptoms of
chronic or acute leukemia[34]
The most common symptoms in children are
easy bruising, pale skin, fever, and an enlarged
spleen or liver.[35]
Damage to the bone marrow, by way of displacing the
normal bone marrow cells with higher numbers of
immature white blood cells, results in a lack of
blood platelets, which are important in the blood
clotting process. This means people with leukemia may
easily become bruised, bleed excessively, or develop
pinprick bleeds (petechiae).[36]
White blood cells, which are involved in
fighting pathogens, may be suppressed or
dysfunctional. This could cause the person's immune
system to be unable to fight off a simple infection or to
start attacking other body cells. Because leukemia
prevents the immune system from working normally,
some people experience frequent infection, ranging
from infected tonsils, sores in the mouth, or diarrhea to
life-threatening pneumonia or opportunistic infections.
[37]

Finally, the red blood cell deficiency leads to anemia,

which may cause dyspnea and pallor.[38]
Some people experience other symptoms, such as
fevers, chills, night sweats, weakness in the limbs,
feeling fatigued and other common flu-like symptoms.
Some people experience nausea or a feeling of fullness
due to an enlarged liver and spleen; this can result in
unintentional weight loss. Blasts affected by the
disease may come together and become swollen in the
liver or in the lymph nodes causing pain and leading to
nausea.[39]
If the leukemic cells invade the central nervous system,
then neurological symptoms (notably headaches) can
occur. Uncommon neurological symptoms
like migraines, seizures, or coma can occur as a result
of brain stem pressure. All symptoms associated with
leukemia can be attributed to other diseases.
Consequently, leukemia is always diagnosed
through medical tests.
The word leukemia, which means 'white blood', is
derived from the characteristic high white blood cell
count that presents in most affected people before
treatment. The high number of white blood cells is
apparent when a blood sample is viewed under a
microscope, with the extra white blood cells frequently
being immature or dysfunctional. The excessive
number of cells can also interfere with the level of
other cells, causing further harmful imbalance in the
blood count.[40]
Some people diagnosed with leukemia do not have
high white blood cell counts visible during a regular
blood count. This less-common condition is
called aleukemia. The bone marrow still contains
cancerous white blood cells that disrupt the normal
production of blood cells, but they remain in the
marrow instead of entering the bloodstream, where
they would be visible in a blood test. For a person with
aleukemia, the white blood cell counts in the
bloodstream can be normal or low. Aleukemia can
occur in any of the four major types of leukemia, and is
particularly common in hairy cell leukemia.[41]
Causes
[edit]
Studies in 2009 and 2010 have shown a positive
correlation between exposure to formaldehyde and the
development of leukemia, particularly myeloid
leukemia.[42][43] The different leukemias likely have
different causes.[44]
Leukemia, like other cancers, results from mutations in
the DNA. Certain mutations can trigger leukemia by
activating oncogenes or deactivating tumor suppressor
genes, and thereby disrupting the regulation of cell
death, differentiation or division. These mutations may
occur spontaneously or as a result of exposure
to radiation or carcinogenic substances.[45]
Among adults, the known causes are natural and
artificial ionizing radiation and petrochemicals,
notably benzene and alkylating chemotherapy agents
for previous malignancies.[46][47][48] Use of tobacco is
associated with a small increase in the risk of
developing acute myeloid leukemia in adults.[46] Cohort
and case-control studies have linked exposure to
some petrochemicals and hair dyes to the
development of some forms of leukemia. Diet has very
limited or no effect, although eating more vegetables
may confer a small protective benefit.[49]
Viruses have also been linked to some forms of
leukemia. For example, human T-lymphotropic
virus (HTLV-1) causes adult T-cell leukemia.[50]
A few cases of maternal-fetal transmission (a baby
acquires leukemia because its mother had leukemia
during the pregnancy) have been reported.[46] Children
born to mothers who use fertility drugs to induce
ovulation are more than twice as likely to develop
leukemia during their childhoods than other children.
[51]

In a recent systematic review and meta-analysis of any

type of leukemia in neonates using phototherapy,
typically to treat neonatal jaundice, a statistically
significant association was detected between using
phototherapy and myeloid leukemia. However, it is still
questionable whether phototherapy is genuinely the
cause of cancer or simply a result of the same
underlying factors that gave rise to cancer.[52]
Radiation
[edit]
Large doses of Sr-90 (called a bone
seeking radioisotope) from nuclear reactor accidents,
increases the risk of bone cancer and leukemia in
animals and is presumed to do so in people.[53]
Genetic conditions
[edit]
Some people have a genetic predisposition towards
developing leukemia. This predisposition is
demonstrated by family histories and twin studies.
[46]
The affected people may have a single gene or
multiple genes in common. In some cases, families
tend to develop the same kinds of leukemia as other
members; in other families, affected people may
develop different forms of leukemia or related blood
cancers.[46]
In addition to these genetic issues, people with
chromosomal abnormalities or certain other genetic
conditions have a greater risk of leukemia.[47] For
example, people with Down syndrome have a
significantly increased risk of developing forms of acute
leukemia (especially acute myeloid leukemia),
and Fanconi anemia is a risk factor for developing acute
myeloid leukemia.[46] Mutation in SPRED1 gene has
been associated with a predisposition to childhood
leukemia.[54]
Inherited bone marrow failure syndromes represent a
kind of premature aging of the bone marrow. In people
with these syndromes and in older adults, mutations
associated with clonal hematopoiesis may arise as an
adaptive response to a progressively deteriorating
hematopoietic niche, i.e., a depleting pool
of Hematopoietic stem cells. The mutated stem cells
then acquire a self-renewal advantage.[55]
Chronic myelogenous leukemia is associated with a
genetic abnormality called the Philadelphia
translocation; 95% of people with CML carry the
Philadelphia mutation, although this is not exclusive to
CML and can be observed in people with other types of
leukemia.[56][57][58][59]
Non-ionizing radiation
[edit]
Whether or not non-ionizing radiation causes leukemia
has been studied for several decades. The International
Agency for Research on Cancer expert working group
undertook a detailed review of all data on static
and extremely low frequency electromagnetic energy,
which occurs naturally and in association with the
generation, transmission, and use of electrical power.
[60]
They concluded that there is limited evidence that
high levels of ELF magnetic (but not electric) fields
might cause some cases of childhood leukemia.[60] No
evidence for a relationship to leukemia or another form
of malignancy in adults has been demonstrated.
[60]
Since exposure to such levels of ELFs is relatively
uncommon, the World Health Organization concludes
that ELF exposure, if later proven to be causative,
would account for just 100 to 2400 cases worldwide
each year, representing 0.2 to 4.9% of the total
incidence of childhood leukemia for that year (about
0.03 to 0.9% of all leukemias).[61]
Diagnosis
[edit]
 The increase in white blood
cells in leukemia
Diagnosis is usually based on repeated complete blood
counts and a bone marrow examination following
observations of the symptoms. Sometimes, blood tests
may not show that a person has leukemia, especially in
the early stages of the disease or during remission.
A lymph node biopsy can be performed to diagnose
certain types of leukemia in certain situations.[62]
Following diagnosis, blood chemistry tests can be used
to determine the degree of liver and kidney damage or
the effects of chemotherapy on the person. When
concerns arise about other damages due to leukemia,
doctors may use an X-ray, MRI, or ultrasound. These
can potentially show leukemia's effects on such body
parts as bones (X-ray), the brain (MRI), or the kidneys,
spleen, and liver (ultrasound). CT scans can be used to
check lymph nodes in the chest, though this is
uncommon.[63]
Despite the use of these methods to diagnose whether
or not a person has leukemia, many people have not
been diagnosed because many of the symptoms are
vague, non-specific, and can refer to other diseases.
For this reason, the American Cancer Society estimates
that at least one-fifth of the people with leukemia have
not yet been diagnosed.[41]
Treatment
[edit]
Most forms of leukemia are treated with
pharmaceutical medication, typically combined into a
multi-drug chemotherapy regimen. Some are also
treated with radiation therapy. In some cases, a bone
marrow transplant is effective.
Acute lymphoblastic
[edit]
Further information: Acute lymphoblastic leukemia
§ Treatment
Management of ALL is directed towards control of bone
marrow and systemic (whole-body) disease.
Additionally, treatment must prevent leukemic cells
from spreading to other sites, particularly the central
nervous system (CNS); periodic lumbar punctures are
used for diagnostic purposes and to administer
intrathecal prophylactic methotrexate.[64] In general,
ALL treatment is divided into several phases:
 Induction chemotherapy to bring about bone
marrow remission. For adults, standard induction
plans include prednisone, vincristine, and
an anthracycline drug; other drug plans may
include L-asparaginase or cyclophosphamide. For
children with low-risk ALL, standard therapy
usually consists of three drugs (prednisone, L-
asparaginase, and vincristine) for the first month of
treatment.
 Consolidation therapy or intensification therapy to
eliminate any remaining leukemia cells. There are
many different approaches to consolidation, but it
is typically a high-dose, multi-drug treatment that
is undertaken for a few months. People with low-
to average-risk ALL receive therapy
with antimetabolite drugs such
as methotrexate and 6-mercaptopurine (6-MP).
People who are high-risk receive higher drug doses
of these drugs, plus additional drugs.
 CNS prophylaxis (preventive therapy) to stop
cancer from spreading to the brain and nervous
system in high-risk people.
Standard prophylaxis may include radiation of the
head and/or drugs delivered directly into the
spine.
  Maintenance treatments with chemotherapeutic
drugs to prevent disease recurrence once
remission has been achieved. Maintenance
therapy usually involves lower drug doses and may
continue for up to three years.
 Alternatively, allogeneic bone marrow
transplantation may be appropriate for high-risk or
relapsed people.[65]
Chronic lymphocytic
[edit]
Further information: Chronic lymphocytic leukemia
§ Treatment
Decision to treat
Hematologists base CLL treatment on both the stage
and symptoms of the individual person. A large group
of people with CLL have low-grade disease, which does
not benefit from treatment. Individuals with CLL-
related complications or more advanced disease often
benefit from treatment. In general, the indications for
treatment are:
 Falling hemoglobin or platelet count
 Progression to a later stage of disease
  Painful, disease-related overgrowth of lymph
nodes or spleen
 An increase in the rate
of lymphocyte production[66]
Treatment approach
[edit]
Most CLL cases are incurable by present treatments, so
treatment is directed towards suppressing the disease
for many years, rather than curing it. The primary
chemotherapeutic plan is combination chemotherapy
with chlorambucil or cyclophosphamide, plus
a corticosteroid such as prednisone or prednisolone.
The use of a corticosteroid has the additional benefit of
suppressing some related autoimmune diseases, such
as immunohemolytic anemia or immune-mediated
thrombocytopenia. In resistant cases, single-
agent treatments with nucleoside drugs such
as fludarabine,[67] pentostatin, or cladribine may be
successful. Younger and healthier people may
choose allogeneic or autologous bone marrow
transplantation in the hope of a permanent cure.[68]
Acute myelogenous
[edit]
Further information: Acute myeloid leukemia
§ Treatment
Many different anti-cancer drugs are effective for the
treatment of AML. Treatments vary somewhat
according to the age of the person and according to the
specific subtype of AML. Overall, the strategy is to
control bone marrow and systemic (whole-body)
disease, while offering specific treatment for the
central nervous system (CNS), if involved.[69]
In general, most oncologists rely on combinations of
drugs for the initial, induction phase of chemotherapy.
Such combination chemotherapy usually offers the
benefits of early remission and a lower risk of disease
resistance. Consolidation and maintenance treatments
are intended to prevent disease recurrence.
Consolidation treatment often entails a repetition of
induction chemotherapy or the intensification of
chemotherapy with additional drugs. By contrast,
maintenance treatment involves drug doses that are
lower than those administered during the induction
phase.[70]
Chronic myelogenous
[edit]
Further information: Chronic myelogenous leukemia
§ Treatment
There are many possible treatments for CML, but the
standard of care for newly diagnosed people
is imatinib (Gleevec) therapy.[71] Compared to most
anti-cancer drugs, it has relatively few side effects and
can be taken orally at home. With this drug, more than
90% of people will be able to keep the disease in check
for at least five years,[71] so that CML becomes a
chronic, manageable condition.
In a more advanced, uncontrolled state, when the
person cannot tolerate imatinib, or if the person wishes
to attempt a permanent cure, then an allogeneic bone
marrow transplantation may be performed. This
procedure involves high-dose chemotherapy and
radiation followed by infusion of bone marrow from a
compatible donor. Approximately 30% of people die
from this procedure.[71]
Hairy cell
[edit]
Further information: Hairy cell leukemia § Treatment
Decision to treat
People with hairy cell leukemia who are symptom-free
typically do not receive immediate treatment.
Treatment is generally considered necessary when the
person shows signs and symptoms such as low blood
cell counts (e.g., infection-fighting neutrophil count
below 1.0 K/μL), frequent infections, unexplained
bruises, anemia, or fatigue that is significant enough to
disrupt the person's everyday life.[72]
Typical treatment approach
People who need treatment usually receive either one
week of cladribine, given daily by intravenous infusion
or a simple injection under the skin, or six months
of pentostatin, given every four weeks by intravenous
infusion. In most cases, one round of treatment will
produce a prolonged remission.[73]
Other treatments include rituximab infusion or self-
injection with Interferon-alpha. In limited cases, the
person may benefit from splenectomy (removal of
the spleen). These treatments are not typically given as
the first treatment because their success rates are
lower than cladribine or pentostatin.[74]
T-cell prolymphocytic
[edit]
Further information: T-cell prolymphocytic leukemia
§ Treatment
Most people with T-cell prolymphocytic leukemia, a
rare and aggressive leukemia with a median survival of
less than one year, require immediate treatment.[75]
T-cell prolymphocytic leukemia is difficult to treat, and
it does not respond to most available
chemotherapeutic drugs.[75] Many different treatments
have been attempted, with limited success in certain
people: purine analogues (pentostatin, fludarabine,
cladribine), chlorambucil, and various forms of
combination chemotherapy (cyclophosphamide,
doxorubicin, vincristine, prednisone CHOP,
cyclophosphamide, vincristine, prednisone [COP],
vincristine, doxorubicin, prednisone, etoposide,
cyclophosphamide, bleomycin VAPEC-
B). Alemtuzumab (Campath), a monoclonal
antibody that attacks white blood cells, has been used
in treatment with greater success than previous
options.[75]
Some people who successfully respond to treatment
also undergo stem cell transplantation to consolidate
the response.[75]
Juvenile myelomonocytic
[edit]
Treatment for juvenile myelomonocytic leukemia can
include splenectomy, chemotherapy, and bone marrow
transplantation.[76]
Prognosis
[edit]
The success of treatment depends on the type of
leukemia and the age of the person. Outcomes have
improved in the developed world.[10] The average five-
year survival rate is 65% in the United States.[4] In
children under 15, the five-year survival rate is greater
(60 to 85%), depending on the type of leukemia.[13] In
children with acute leukemia who are cancer-free after
five years, the cancer is unlikely to return.[13]
Outcomes depend on whether it is acute or chronic,
the specific abnormal white blood cell type, the
presence and severity of anemia or thrombocytopenia,
the degree of tissue abnormality, the presence
of metastasis and lymph node and bone
marrow infiltration, the availability of therapies and the
skills of the health care team. Treatment outcomes may
be better when people are treated at larger centers
with greater experience.[77]
Epidemiology
[edit]

Deaths due to leukemia per

million persons in 2012:
 0–7
8–13
14–22
23–29
30–34
35–39
40–46
47–64
65–85
86–132
In 2010, globally, approximately 281,500 people died of
leukemia.[78] In 2000, approximately 256,000 children
and adults around the world developed a form of
leukemia, and 209,000 died from it.[79] This represents
about 3% of the almost seven million deaths due to
cancer that year, and about 0.35% of all deaths from
any cause.[79] Of the sixteen separate sites the body
compared, leukemia was the 12th most common class
of neoplastic disease and the 11th most common cause
of cancer-related death.[79] Leukemia occurs more
commonly in the developed world.[10]
United States
[edit]
About 245,000 people in the United States are affected
with some form of leukemia, including those that have
achieved remission or cure. Rates from 1975 to 2011
have increased by 0.7% per year among children.
[80]
Approximately 44,270 new cases of leukemia were
diagnosed in the year 2008 in the US.[81] This represents
2.9% of all cancers (excluding simple basal cell and
squamous cell skin cancers) in the United States, and
30.4% of all blood cancers.[82]
Among children with some form of cancer, about a
third have a type of leukemia, most commonly acute
lymphoblastic leukemia.[81] A type of leukemia is the
second most common form of cancer in infants (under
the age of 12 months) and the most common form of
cancer in older children.[83] Boys are somewhat more
likely to develop leukemia than girls, and white
American children are almost twice as likely to develop
leukemia than black American children.[83] Only about
3% cancer diagnoses among adults are for leukemias,
but because cancer is much more common among
adults, more than 90% of all leukemias are diagnosed
in adults.[81]
Race is a risk factor in the United States. Hispanics,
especially those under the age of 20, are at the highest
risk for leukemia, while whites, Native Americans, Asian
Americans, and Alaska Natives are at higher risk
than African Americans.[84]
More men than women are diagnosed with leukemia
and die from the disease. Around 30 percent more men
than women have leukemia.[85]
Australia
[edit]
In Australia, leukemia is the eleventh most common
cancer.[86] In 2014–2018, Australians diagnosed with
leukemia had a 64% chance (65% for males and 64% for
females) of surviving for five years compared to the
rest of the Australian population–there was a 21%
increase in survival rates between 1989–1993.[86]
UK
[edit]
Overall, leukemia is the eleventh most common cancer
in the UK (around 8,600 people were diagnosed with
the disease in 2011), and it is the ninth most common
cause of cancer death (around 4,800 people died in
2012).[87]
History
[edit]
 Rudolf Virchow
Leukemia was first described by anatomist and
surgeon Alfred-Armand-Louis-Marie Velpeau in 1827. A
more complete description was given by
pathologist Rudolf Virchow in 1845. Around ten years
after Virchow's findings, pathologist Franz Ernst
Christian Neumann found that the bone marrow of a
deceased person with leukemia was colored "dirty
green-yellow" as opposed to the normal red. This
finding allowed Neumann to conclude that a bone
marrow problem was responsible for the abnormal
blood of people with leukemia.[88]
By 1900, leukemia was viewed as a family of diseases
as opposed to a single disease. By 1947, Boston
pathologist Sidney Farber believed from past
experiments that aminopterin, a folic acid mimic, could
potentially cure leukemia in children. The majority of
the children with ALL who were tested showed signs of
improvement in their bone marrow, but none of them
were actually cured. Nevertheless, this result did lead
to further experiments.[89]
In 1962, researchers Emil J. Freireich, Jr. and Emil Frei III
used combination chemotherapy to attempt to cure
leukemia. The tests were successful with some people
surviving long after the tests.[90]
Etymology
[edit]
Observing an abnormally large number of white blood
cells in a blood sample from a person, Virchow called
the condition Leukämie in German, which he formed
from the two Greek words leukos (λευκός), meaning
'white', and haima (αἷμα), meaning 'blood'.[91] It was
formerly also called leucemia.[92]
Society and culture
[edit]
According to Susan Sontag, leukemia was often
romanticized in 20th-century fiction, portrayed as a joy-
ending, clean disease whose fair, innocent and gentle
victims die young or at the wrong time. As such, it was
the cultural successor to tuberculosis, which held this
cultural position until it was discovered to be an
infectious disease.[93] The 1970 romance novel Love
Story is an example of this romanticization of leukemia.
[94]

In the United States, around $5.4 billion is spent on

treatment a year.[95]
Research directions
[edit]
Significant research into the causes, prevalence,
diagnosis, treatment, and prognosis of leukemia is
being performed. Hundreds of clinical trials are being
planned or conducted at any given time.[96] Studies may
focus on effective means of treatment, better ways of
treating the disease, improving the quality of life for
people, or appropriate care in remission or after cures.
[97]

In general, there are two types of leukemia research:

clinical or translational research and basic research.
Clinical/translational research focuses on studying the
disease in a defined and generally immediately
applicable way, such as testing a new drug in people. By
contrast, basic science research studies the disease
process at a distance, such as seeing whether a
suspected carcinogen can cause leukemic changes in
isolated cells in the laboratory or how the DNA changes
inside leukemia cells as the disease progresses. The
results from basic research studies are generally less
immediately useful to people with the disease.[98]
Treatment through gene therapy is currently being
pursued. One such approach used genetically
modified T cells, known as chimeric antigen receptor T
cells (CAR-T cells), to attack cancer cells. In 2011, a year
after treatment, two of the three people with advanced
chronic lymphocytic leukemia were reported to be
cancer-free[99] and in 2013, three of five subjects who
had acute lymphocytic leukemia were reported to be in
remission for five months to two years.[100] Subsequent
studies with a variety of CAR-T types continue to be
promising.[101] As of 2018, two CAR-T therapies have
been approved by the Food and Drug Administration.
CAR-T treatment has significant side effects,[102] and
loss of the antigen targeted by the CAR-T cells is a
common mechanism for relapse.[101] The stem cells that
cause different types of leukemia are also being
researched.[103]
Pregnancy
[edit]
Leukemia is rarely associated with pregnancy, affecting
only about 1 in 10,000 pregnant women.[104] How it is
handled depends primarily on the type of leukemia.
Nearly all leukemias appearing in pregnant women are
acute leukemias.[105] Acute leukemias normally require
prompt, aggressive treatment, despite significant risks
of pregnancy loss and birth defects, especially if
chemotherapy is given during the developmentally
sensitive first trimester.[104] Chronic myelogenous
leukemia can be treated with relative safety at any time
during pregnancy with Interferon-alpha hormones.
[104]
Treatment for chronic lymphocytic leukemias,
which are rare in pregnant women, can often be
postponed until after the end of the pregnancy.[104][105]
See also
[edit]
 Acute erythroid leukemia
 Antileukemic drugs, medications used to kill
leukemia cells
 Cancer-related fatigue
 Hematologic diseases, the large class of blood-
related disorders, including leukemia
 Multiple myeloma
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