About
A little background on why I am writing this blog and what I hope to accomplish. On June 11, 2009 I was diagnosed with PH+ Adult Lymphoblastic Leukemia (ALL). The onset of symptoms in hindsight only began around early June. My first symptom was extreme back and hip pain, that I originally thought was related to a left knee injury in April. I believed the back pain was caused due to walking and gait changes associated with the leg immobilizer and the need for physical therapy.
Over the next week, I began to notice substantial and numerous unexplained bruises and petechial rashes on my skin. This prompted me to go to my doctor on June 10th with the belief that maybe I was anemic. The following morning my doctor contacted me and indicated that I should go to the hospital for follow-up tests as the blood test results were alarming. A few hours later, I was diagnosed with Leukemia.
And so begins my journey as a cancer survivor.
I was encouraged by friends to start keeping a diary of sorts as a form of therapy, but I was a very private person and initially resisted. In time, I have come to believe, that instead of keeping a blog as means of expressing my emotions or thoughts, that I would instead use it to share what I have learned about my disease and to provide updates with my friends and family.
First a few statistics to show how many people are affected by ALL
It is estimated that 5,760 men and women (3,350 men and 2,410 women) will be diagnosed with and 1,400 men and women will die of acute lymphocytic leukemia in 2009
From 2002-2006, the median age at diagnosis for acute lymphocytic leukemia was 13 years of age. Approximately 60.8% were diagnosed under age 20; 10.1% between 20 and 34; 6.5% between 35 and 44; 6.4% between 45 and 54; 5.8% between 55 and 64; 5.1% between 65 and 74; 3.8% between 75 and 84; and 1.5% 85+ years of age.
From 2002-2006, the median age at death for acute lymphocytic leukemia was 48 years of age. Approximately 20.9% died under age 20; 16.0% between 20 and 34; 9.6% between 35 and 44; 11.3% between 45 and 54; 12.2% between 55 and 64; 12.7% between 65 and 74; 11.6% between 75 and 84; and 5.8% 85+ years of age.
ALL has also impacted my chromosomes in what is called the “Philidelphia Chromosome (PH+)”.
The Philadelphia chromosome (named because it was discovered at hospital in
Philadelphia), is actually what is known as a balanced, or reciprocal,
translocation. What this means is that early in cell division a process
known as crossing over occurs. This is when the tip of each of a a pair
of chromosomes breaks off and switches places. This increases genetic
variety in a species and is one of the reasons that no two organisms are
exactly alike (unless they are clones). Sometimes the pieces don’t
switch places correctly. One of the errors that can happen is called a
translocation. A piece of one of the chromosome pairs doesn’t make it
to the other to trade and actually attaches to another chromosome that
isn’t its pair. In the “Philadelphia chromosome” a piece of chromosome
9 attaches to chromosome 22. It is a reciprocal translocation because
part of 22 also attaches to 9. Other types of translocations occur when
the piece attaches to the other chromosome but they don’t trade info.
The information that piece carries is inserted next to another gene and
causes what is known as a “fusion protein.”Reference: http://www.newton.dep.anl.gov/askasci/mole00/mole00336.htm
Although more than 60% of patients with PH+ ALL succeed in achieving complete remission using chemotherapy, most of them will relapse and fewer than 10-20% will remain alive 5 years after diagnosis. This has prompted doctors to forgo prolonged rounds of chemotherapy and instead pursue a bone marrow transplant as the preferred method of treatment. The optimal time for the transplant has been shown to be when the patient is in what is called CR1, which is the time immediately proceeding chemotherapy when the ALL is in remission for the first time. The graph below show the improved long-term survival rates of ALL treated by transplant from 1987-2006.
- Bone Marrow Tranplant Outcomes
