Leukaemia
What's leukaemia and why did my mother get it?
The word Leukemia comes from the Greek leukos which means "white" and aima which means "blood". It is cancer of the blood or bone marrow (which produces blood cells). A person who has leukemia suffers from an abnormal production of blood cells, generally leukocytes (white blood cells).
The DNA of immature blood cells, mainly white cells, becomes damaged in some way. This abnormality causes the blood cells to grow and divide chaotically. Normal blood cells die after a while and are replaced by new cells which are produced in the bone marrow. The abnormal blood cells do not die so easily, and accumulate, occupying more and more space. As more and more space is occupied by these faulty blood cells there is less and less space for the normal cells - and the sufferer becomes ill. Quite simply, the bad cells crowd out the good cells in the blood.
So why does this happen? Why did my mother get it?
Acute lymphoblastic leukaemia is the only form of leukaemia that is commonest in childhood (under 15 years of age). Adult ALL is most common between the ages of 15 to 25 and in those over 75 years. ALL is slightly more common in males than in females at all ages.
SO.... either children under 25 or in old people, mostly male, over 75.
So why did a 44 year old otherwise healthy female get it?
The cause(s) of ALL are unknown in most instances. The only clearly identified risk factor for adults is exposure to very high radiation levels such as those seen after the atom bomb explosions in Japan in 1945. Very few people in the Western world are exposed to levels of radiation high enough to increase the risk of leukaemia. No other chemical or physical exposure has been clearly shown to increase the risk of adult ALL.
Radiation? The only clearly unidentified factor for adults? Was my mother near any radiation? We did live in the capitals of China and Malaysia for the 10 years before her death...but I'm not sure she was exposed to very high radiation levels there.
She wove in platelet colours of yellows and reds,
knitting love and hope into rugs and hangings
Picking lichen from trees,
Collecting colours of the Earth
Dyeing the wool in pans.
Her friend brought some red (skimpy) knickers.
(I don't know if she ever wore them)
Encouraging the little red platelets to grow strong
The jolly red mantra to get Mama better.
SYMPTOMS:
Anaemia (lack of red blood cells). This causes fatigue, breathlessness, and a low platelet count, which causes bruising, bleeding of mucus membranes and the gut, and low normal blood cells causing fever and persistant infections. Signs? Fatigue, night sweats, weight loss, itching, breathlessness, bruising, recurrent infections, bone pain, enlarged lymph glands persisting for six weeks...
And all before you've started taking all the chemotherapy drugs. And before your body has really begun to break down.
LIFE EXPECTANCY?
Acute lymphoblastic leukaemia is rapidly fatal without effective treatment.
Today, more than 70% of children and an increasing proportion of adults can be cured.
A high proportion of patients will achieve remission (clearance of leukaemia cells from blood and bone marrow.
Although adult ALL is a very serious disease which is almost uniformly fatal if not treated, it is potentially curable with standard chemotherapy, with or without stem cell transplantation. About eight out of ten patients will achieve a remission but overall cure rates are between 20% and 40%. The difference between remission and cure rates is accounted for mainly by patients who experience relapse of their original disease.
Apparently they gave her weeks to live. I don't know when that was. I can't remember anything about those early days of her illness. Apart from - I had to walk home from school all the time but it was ok because I went past the newsagent and bought a bright pink Wham bar.
She was going to fight it, though. We just all had to think RED all the time.
When I went off to boarding school, she hardly put anything in my suitcase, and forgot the new t-shirts she'd just bought me. I unpacked, and exclaimed "Oh, I'm JOLLY cross with my mother!" and my friends teased me about my use of the word "jolly". I still use it, but apparently it's square.
A couple of years (?) later, she was supposed to have been in remission - at least I think she was getting better for a few months. The platelet count went up. There are photos of her with us all at the Asquith's for lunch.
But then a horrible day. In the kitchen in Estelle Road. The way Papa was hugging her. I felt my stomach lurch with fear. Something about lymph nodes grown bigger ...in her stomach? I no longer remember...
Unfortunately, although as many as eight out of ten adults with ALL will achieve a remission this does not necessarily mean that they are cured. Many patients will relapse, which means their disease will return. Relapse often occurs because the leukaemia cells have become resistant to drug treatment. This drug resistance is often not specific to a particular drug. It may affect all, or virtually all anti-leukaemia drugs, this is known as Multi-Drug Resistance (MDR)
Chemotherapy is pretty barbaric..
So is it hereditory? Perhaps her own mother, Zizzie, was exposed to radiation or pesticides when pregnant with my mother, Cairo 1943.
They still don't even know what causes it. It was only recognised in the 50's when it was very rare.
A genetic variation that may indicate a patient's risk of developing a potentially life-threatening blood disorder if exposed to certain pharmaceutical therapies or chemicals is one of several medical discoveries scientists at cancer diagnostics leader Quest Diagnostics will present during the 51st American Society of Hematology (ASH) Annual Meeting and Exposition, December 5-8, 2009, in New Orleans, LA.
http://www.medicalnewstoday.com/articles/172970.php
Did either of them work with benzene or formaldehyde?
She was a guinea-pig, I think for a then-new drug called interferon. She had to inject it into her stomach at night. I couldn't watch.
Biological therapy is a form of leukemia treatment that involves treatment with substances that affect the immune system's response to cancer. Interferon is a form of biological therapy that is used against some types of leukemia.
What does it mean biological? as opposed to chemical? What's interferon anyway?
Biological therapy is treatment with substances that are made naturally in the body or block chemical processes in the body. The most commonly used biological therapy for CML is imatinib (Glivec). This has largely replaced interferon combined with chemotherapy. Imatinib blocks a protein made by CML and stops the overproduction of white blood cells. Doctors are also developing new biological therapies, such as dasatinib and nilotinib.
Interferon alpha is a man-made copy of a substance that some types of white blood cell make naturally in the body. The blood cells make interferon as part of the immune response, when the body reacts to infection or to cancer.
Interferon works in several ways. It interferes with cancer cells and stops them growing and multiplying. And it stimulates the immune system by encouraging killer T cells and other cells to attack cancer cells. It also encourages cancer cells to send out chemicals that attract the immune system cells to them.
So the way they treated my mother - interferon combined with chemotherapy - is no longer used... Well -I would hope in 21 years that things have moved on I suppose.

