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Leukemia

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Millie Flamm snuggles with her stuffed elephant at Primary Children's Hospital.
Millie passed away from Leukemia in June 2013

Leukemia or leukaemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts".

Leukemia is a part of a group of diseases affecting the blood, bone marrow, and lymphoid system, which are all known as hematological neoplasms.

In 2000, approximately 256,000 children and adults around the world developed some form of leukemia, and 209,000 died from it. About 90% of all leukaemias are diagnosed in adults.

Types and treatment

Most forms of leukemia are treated with pharmaceutical medication, typically combined into a multi-drug chemotherapy regimen. Some are also treated with radiation therapy and a bone marrow transplant.  Clinically and pathologically, leukemia is subdivided into a variety of large groups. The first division is between its acute and chronic forms: 

  • Acute leukemia is characterized by a rapid increase in the number of immature blood cells. Crowding due to such cells makes the bone marrow unable to produce healthy blood cells. Immediate treatment is required in acute leukemia due to 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 build up of relatively mature, but still abnormal, white 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 theoretically occur in any age group.

The disease is further subdivided according to which kind of blood cell is affected.

B cell 

This is Denys - a victim of Chernobyl and
waiting for treatment - see LINK for his
story and a chance to help him
 

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. 

  • Acute lymphoblastic leukemia is the most common type of leukemia in young children, but also affects adults, especially those age 65 and older. Standard treatments involve chemotherapy and radiotherapy. The survival rates vary by age: 85% in children and 50% in adults 
  • Chronic lymphocytic leukemia 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 75%. It is incurable, but there are many effective treatments.
  • Hairy cell leukemia is sometimes considered a subset of chronic lymphocytic leukemia, but does not fit neatly into this pattern. About 80% of affected people are adult men. No cases in children have been reported. It is incurable, but treatable. Survival is 96% to 100% at ten years.

Red blood cells

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. 

  • Acute myelogenous leukemia occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%. 
  • Chronic myelogenous leukemia occurs mainly in adults, although a very small number of children may develop this disease. Treatment is with imatinib – a drug  or other drugs. The five-year survival rate is 90%
 

T cells

In some cases it is the T cell which is attacked.  A further classification is then used for some of these less common types of the disease 

  • T-cell prolymphocytic leukemia is a very rare and aggressive leukemia affecting adults; somewhat more men than women are diagnosed with this disease. Despite its overall rarity, it is the most common type of mature T cell leukemia; 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; it is a rare and indolent (not aggressive) leukemia. 
  • Adult T-cell leukemia is caused by human T-lymphotropic virus, 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, it "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.

Symptoms

The symptoms are shown below in a diagram provided by Wikipedia.  All symptoms associated with leukemia can be attributed to other diseases.  In effect, leukemia causes a whole host of other diseases and it is these diseases that can result in spiritual experiences.

Infection

White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient'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 patients experience frequent infection, ranging from infected tonsils, sores in the mouth, or diarrhea to life-threatening pneumonia.  

Nasser Mutashar and his son Muhammad - Iraq

Anaemia

The red blood cell deficiency leads to anaemia, which may cause dyspnea and pallor.  

Starvation

Some patients experience nausea or a feeling of fullness due to an enlarged liver and spleen; this can result in unintentional nutritional deprivation. 

Extreme pain

Blasts affected by the disease may come together and become swollen in the liver or in the lymph nodes causing pain.  

Brain damage

If the leukemic cells invade the central nervous system, then neurological symptoms can occur – see brain damage.

‘Thin blood’ and clotting disorders

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 or bleed excessively. 
Medically, this is termed ‘Coagulopathy’ (also called clotting disorder and bleeding disorder) - a condition in which the blood’s ability to clot is impaired. This condition can cause prolonged or excessive bleeding.

Causes

If you follow the chain back there are any number of possible mechanism here.

Where is leukaemia to be found and what marks out these countries from others?  In the chart above we can see the ‘Age-standardized death from leukemia per 100,000 inhabitants in 2004’.  We will find that there appears to be a correlation between causes and incidences in the chart.  Leukemia, like other cancers, results from mutations in the DNA.

So, what are the causes?

Exposure to radiation - domestic and industrial

This may be in the form of ultra low fequency electromagnetic radiation – see also Exposure to low frequency domestic magnetic fields, and Exposure to low frequency industrial magnetic fields  for more details on this source.  Industrialised countries such as the USA, Australia, and many countries of Europe might suffer here.

 

In this, we need to remember that there are quite a number of sources of radiation of which we may be only slightly aware.

Chromosomal abnormalities -   people with chromosomal abnormalities or certain other genetic conditions have a greater risk of leukemia. For example, people with Down syndrome have a significantly increased risk of developing forms of acute leukemia (especially acute myeloid leukemia),  but saying this is a little meaningless, because ultimately we need to know why those chromosomal abnormalities occurred.  Radiation is a known cause, viruses [of which more in a moment] are another, as are toxins, thus 'chromosomal abnormalities' is not a cause of leukemia, it is an effect of other more fundamental causes.  See Inherited diseases for a perspective on this aspect.

Exposure to radiation - War and nuclear accidents

 

Radiation can also come from nuclear accidents like Chernobyl or even possibly a high incidence of nuclear use.  France relies heavily on nuclear power. Furthermore it was very heavily involved in nuclear testing of weapons in, for example, the Pacific.

We have a tendency to think that nuclear bombs are the only sources of weapons that are 'radioactive', but as you will see from the following, the use of radiation containing weapons of war extends into far more areas:

There have been anecdotal reports of increases in birth defects and cancer in Fallujah, Iraq blamed on the use of ‘novel’ weapons (possibly including depleted uranium) in heavy fighting which occurred in that town between US led forces and local elements in 2004. In Jan/Feb 2010 the authors organised a team of researchers who visited 711 houses in Fallujah, Iraq and obtained responses to a questionnaire in Arabic on cancer, birth defects and infant mortality. The total population in the resulting sample was 4,843 persons with and overall response rate was better than 60%. Relative Risks for cancer were age-standardised and compared to rates in the Middle East Cancer Registry (MECC, Garbiah Egypt) for 1999 and rates in Jordan 1996-2001.
Between Jan 2005 and the survey end date there were 62 cases of cancer malignancy reported .. including 16 cases of childhood cancer 0-14 …. Highest risks were found in

  • all-leukaemia in the age groups 0-34  (20 cases),
  •  all lymphoma 0-34 (8 cases),
  • female breast cancer 0-44 (12 cases) and
  • brain tumours all ages (4 cases).

Infant mortality was based on the mean birth rate over the 4 year period 2006-2009 with 1/6th added for cases reported in January and February 2010. There were 34 deaths in the age group 0-1 in this period giving a rate of 80 deaths per 1,000 births. This may be compared with a rate of 19.8 in Egypt , 17 in Jordan in 2008 and 9.7 in Kuwait in 2008.
The mean birth sex-ratio in the recent 5-year cohort was anomalous. Normally the sex ratio in human populations is a constant with 1,050 boys born to 1,000 girls. This is disturbed if there is a genetic damage stress. The ratio of boys to 1,000 girls in the 0-4, 5-9, 10-14 and 15-19 age cohorts in the Fallujah sample were 860, 1,182, 1,108 and 1,010 respectively suggesting genetic damage to the 0-4 group.
Whilst the results seem to qualitatively support the existence of serious mutation-related health effects in Fallujah, owing to the structural problems associated with surveys of this kind, care should be exercised in interpreting the findings quantitatively.  PMID:  20717542

 Viruses

We have seen above that one type of leukemia is known to be caused by a virus.  Human T-lymphotropic virus, 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, it "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.

 Experiments on mice and other mammals have demonstrated the relevance of retroviruses as a whole in leukemia.   

Retroviridae is a family of enveloped viruses that replicate in a host cell through the process of reverse transcription. A retrovirus is a single-stranded RNA virus that stores its nucleic acid in the form of an mRNA genome and targets a host cell as an obligate parasite. Once inside the host cell the virus uses its own reverse transcriptase enzyme to produce DNA from its RNA genome, the reverse of the usual pattern, thus retro (backwards). This new DNA is then incorporated into the host cell genome by an integrase enzyme, at which point the retroviral DNA is referred to as a provirus. The host cell then treats the viral DNA as part of its own genome, translating and transcribing the viral genes along with the cell's own genes, producing the proteins required to assemble new copies of the virus. It is difficult to detect the virus until it has infected the host. At that point, the infection will persist indefinitely

This is a big classification and includes the hepatitis virus.  According to Wikipedia, the current classification also includes the following:

  • Genus Alpharetrovirus; type species: Avian leukosis virus; others include Rous sarcoma virus
  • Genus Betaretrovirus; type species: Mouse mammary tumour virus
  • Genus Gammaretrovirus; type species: Murine leukemia virus; others include Feline leukemia virus
  • Genus Deltaretrovirus; type species: Bovine leukemia virus; others include the cancer-causing Human T-lymphotropic virus
  • Genus Epsilonretrovirus; type species: Walleye dermal sarcoma virus
  • Genus Lentivirus; type species: Human immunodeficiency virus 1; others include Simian, Feline immunodeficiency viruses
  • Genus Spumavirus; type species: Simian foamy virus

Toxins

Chemicals are implicated, notably benzene.  Some case-control studies have linked exposure to some petrochemicals and hair dyes to the development of some forms of leukemia.  Where are petrochemicals to be found? – the middle east countries such as Saudi Arabia, Iraq and Iran and places like Venezuela.

Tobacco -  is also associated with a risk of developing acute myeloid leukemia in adults. But not the nicotine - the smoke particles.   Smoking is generally five times higher among men than women and men are more prone to getting leukemia in their adult years.  If you compare the chart below which shows smoking prevalence in the male population by country you should be able to find an extraordinary amount of correlation. 

Nanoparticles

Nanoparticles are starting to be used in all sorts of unforeseen and perhaps unwise ways.  They are even being considered as a means of treating leukemia.  But nanoparticles cause genetic mutations [see link].  They are being used in lipsticks, sun tan lotion and cosmetics, and on fabrics..............

Anatase TiO₂ nanoparticles (TNPs) are synthesized using the sol-gel method and loaded onto the surface of polyester-cotton (65/35) fabrics. The nanofabrics degrade formaldehyde at an efficiency of 77% in eight hours with visible light irradiation or 97% with UV light. The loaded TNPs display very little release from nanofabrics (~0.0%) during a standard fastness to rubbing test. Assuming TNPs may fall off nanofabrics during their life cycles, we also examine the possible toxicity of TNPs to human cells. We found that up to a concentration of 220 μg/mL, they do not affect viability of human acute monocytic leukemia cell line THP-1 macrophages and human liver and kidney cells.

but over that amount they do.

 Pharmaceuticals

According to Wikipedia, a study conducted at the Center for Research in Epidemiology and Population Health in France, found that 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.  This may be simply a statistical anomaly, as fertility treatments in general have unwelcome side effects.  It may not be helpful to single out just this one.

If we now turn to the eHealthme website, which collects and classifies Adverse Drug Reports received from doctors and sent to the FDA and SEDA in the USA, they too found a small link with certain pharmaceuticals.  This LINK takes you to the page on eHealthme showing the actual pharmaceuticals implicated in causing certain forms of leukemia.

Please note that if this link is broken, use the symptom chart n the eHealthme page to find leukemia, and then scroll down the page to find the section 'drugs that may cause'.

How it works

As we have seen above any one of the above diseases resulting from leukaemia can themselves produce an experience. 

The surgical treatment can also produce effects.  Below we have an example which shows that bone marrow transplants can produce their own effects see Pathological nystagmus

Cortical blindness following ictal nystagmus - Ramani V.
Both ictal nystagmus and cortical blindness may occur transiently in acute cerebral disorders and therefore escape clinical detection, particularly in confused, agitated patients.  The following case report describes a young woman with chronic myelogenous leukemia who became progressively ill following bone marrow transplantation. During the course of her illness, acute ictal nystagmus developed from focal right occipital ischemia; postictally she remained cortically blind with possible visual hallucinations for 48 hours.

Medication - What is apparent from the description is that one of the causes of spiritual experience can be the medication given to people.  The opium based drugs, for example, given to the poor people to ease the pain were a high contributory factor:

Altered mental status in patients with cancer
- Tuma R,   DeAngelis LM; Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, USA.

OBJECTIVE  To identify the causes of an altered mental status in a cancer population.

METHODS We studied 140 confused patients with cancer (100 prospectively and 40 retrospectively) between January 1, 1991, and June 30, 1992, to determine clinical findings, causes, and outcome.

RESULTS  All patients had non-central nervous system cancers. The most common primary cancer types were 

  • lung (20%),
  • gastrointestinal tract (18%),
  • leukemia and lymphoma (17%),
  • and breast (11%).

Median patient age was 73 years, and 49% were men. Disseminated systemic metastases were present in 50% of patients; 34% were confused at hospital admission and 66% developed confusion during hospitalization. Symptoms included 

  • lethargy or coma in 61% of patients,
  • agitation in 44%,
  • disorientation in 83%,
  • lateralizing signs in 41%,
  • delusions or hallucinations in 28%,
  • and seizures in 9%.

 A single cause of the altered mental status was found in 33% of patients, whereas 67% had multiple causes.

  • Drugs, especially opioids, were associated with altered mental status in 64% of patients,
  • metabolic abnormalities in 53%,
  • infection in 46%,
  • and recent surgery in 32%.
  • A structural brain lesion was the sole cause of encephalopathy in 15% of patients.

Although delirium improved in 67% of patients, it was a poor prognostic factor for overall outcome. Thirty-day mortality was 25%, and 44% of patients died within 6 months, usually from progression of the underlying cancer.
Prolonged delirium suggested infection or coagulopathy.

was the pathogen already there?  That is the question we should be asking and if it was, was it the cause of the cancer.

References and further reading

  • Int J Environ Res Public Health. 2010 Jul;7(7):2828-37. doi: 10.3390/ijerph7072828. Epub 2010 Jul 6. Cancer, infant mortality and birth sex-ratio in Fallujah, Iraq 2005-2009.  Busby C1, Hamdan M, Ariabi E.

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