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Acute Lymphoblastic Leukemia - Research Paper Example

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Acute Lymphoblastic Leukemia

Acute Lymphoblastic Leukemia, or ALL, is the most common malignant carcinoma in pediatric patients (Cipoloti et al., 2003). It is characterized by abnormal proliferation of leukemic blasts that are poorly differentiated, leading to inadequate hematopoiesis (Siddique et al., 2011). Pathogenesis There are several studies that dissect the underlying cellular events responsible for acute lymphoblastic leukemia. The basic mechanism for abnormal proliferation of any cell remains the same. The cell cycle consists of different phases with various check points to control abnormal division. The most important are the transition from G1 to S phase and G2 to M phase. Division of cell only takes place after receiving instructions from some external stimulation (Cipoloti et al., 2003). There are various mechanisms by which cells are regulated for division. This includes stimulation from special molecules called mitogenic substances, inhibition by various anti-proliferative cytokines and regulation by adjacent cells. Most of the cancer cells including those involved in ALL, abandon these regulatory mechanisms. Various studies including one by Cipoloti et al. tried to isolate mutations in those tumor suppressor genes that are responsible for keeping a check during cellular division. An example is the inactivation of p15 gene in children with acute lymphoblastic leukemia....
According to the report, Notch 1 is a signaling pathway crucial for the development of T-cells and its mutation is found commonly in patients with ALL. To verify the extent of this abnormal expression, real time PCR was used to detect the gene and its mutation. It was evident in the results that most patients had overexpression of Notch 1 gene that contributed to overproliferation of T cells in ALL (Lin et al., 2012). Subtypes It is important to remember that there is no single cause of cancerous growth of cells in ALL, but various factors unite together and lead to this abnormal proliferation. Moreover, there are various subtypes within ALL, such as precursor B-Cell and T-Cell leukemia. All these subgroups show some variation in their pathogenesis. A study by Teuffel et al. in 2008 focused on anemia and survival in children suffering from various subtypes of acute lymphoblastic leukemia. In the above mentioned cohort study, 1162 patients were analyzed for the subtype of ALL and their associated Hb levels. It was evident that patients with the T cell subtype had a higher level of hemoglobin as compared to the B cell precursor type. Moreover, less severe anemia was associated with an increased survival rate in early childhood. This explains that various subtypes have different impacts on the hematopoietic system and, therefore, variable survival rate. Risk Factors Few risk factors have been isolated for acute lymphoblastic leukemia. Those which are assumed to be associated with ALL are poorly verified and contain diverse controversial evidence. A matched control case study found that increased maternal age is associated with increased incidence of ALL. Paternal age showed no association and only a weak link ...Show more

Summary

Leukemia is a malignant disease that affects the hematopoietic system. If the overproliferation of immature leukocyte is evident, it is called acute leukemia, whereas well differentiated leukocytes are found in chronic leukemia …
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