Thursday, November 4, 2010

Next Steps to Understanding Blood Cancer

Last week, we started talking about the different types of blood cancer: leukemia, lymphoma and myeloma and the importance of research into them. I hope you are gaining an understanding of some of the distinguishing characteristics.

Hang on, though; we're not done yet! We saw last week that the different blood cancers can be distinguished partly based on the type of cell involved, myeloid or lymphoid. In addition, leukemia is broken down by growth characteristics. There is fast-growing leukemia, called acute leukemia, or slower-growing leukemia, called chronic leukemia. This means the general classifications of leukemia are:
  • acute myeloid leukemia (AML)
  • acute lymphoid leukemia (ALL)
  • chronic myeloid leukemia (CML)
  • chronic lymphoid leukemia (CLL)

Furthermore, lymphomas are classified as Hodgkin lymphoma and non-Hodgkin lymphoma.
  • Hodgkin lymphoma is defined by the presence of a certain type of large, malignant (cancerous) cell, called a Reed-Sternberg cell, in the lymphoma tissue.
  • Non-Hodgkin lymphoma is a diverse group of cancers containing the remaining types of lymphoma.
Here’s a cheat sheet:

I only go through all this because, as I mentioned last week, these are each very distinct diseases.
  • Hodgkin lymphoma is more common in children and young adults. In contrast, the risk for developing non-Hodgkin lymphoma increases with age and typically appears between the ages of 40 and 70.
  • The median age of a myeloma patient is 70-years-old, and it rarely occurs in anyone under the age of 45.
  • Of the leukemias, children most often develop ALL, whereas adults most often develop AML.
  • Gleevec is a successful treatment for CML patients with a particular mutation, called BCR-Abl, but it is not used to treat CLL.
  • The five-year survival rates for each type of leukemia are dramatically different:
  • AML: 24.2%
  • ALL: 66.4%
  • CML: 54.6%
  • CLL: 79.7%
There is still a lot of work to be done so that we can understand all the differences among these diseases.

One area under investigation is understanding the different genetic changes that cause the cancer. The next step would be to identify which genetic change, or mutation, each patient has, and then they can receive the best treatment for their disease, called personalized medicine.

For instance, a patient with the BCR-Abl mutation can be given Gleevec, and a patient who does not have that mutation can be given a different treatment, because Gleevec won't work for them.

Researchers are working hard to identify cancer-causing mutations as well as therapies targeted to those mutations. This type of innovative research will help increase the five-year survival rates for all cancers.

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