Inheritance

     Leukemia is not hereditary; it happens mainly randomly. However, hereditary influence and environmental exposures can influence a person's risk for leukemia. In a few rare cases, parents seem to pass on the susceptibility to the disease, and the gene that causes this seems to be designated as CBFA2. For more information on this gene and how it affects a person's susceptibility to leukemia, see Research Outlook.

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Research Outlook

     Although leukemia is not typically inherited through heredity, there are rare cases where a gene is inherited that makes a person more susceptible to the disease. In 1990, a woman went to Gary Gilliland for a second opinion after her diagnosis of acute leukemia. The woman seemed to be from a family that had an unusually high risk for developing acute leukemia, and after taking blood samples from five generations of her family, Gilliland identified a genetic mutation that causes a familial platelet disorder. This disorder increases a person's risk for developing acute leukemia, and it first is visible at birth. "A mother can tell instantly if the child has the trait because they're badly bruised from the trauma of childbirth" (Gilliland). Later on their lifetimes, these people have a high risk of developing AML. Using blood and bone marrow samples from the woman's family, Gilliland narrowed done the region for this gene to chromosome 21. The researchers found a mutation in a gene designated CBFA2, which produces a protein that activates blood cell development. The mutation caused the function of the gene to be void, but if the mutation occurs in even one copy of the gene, it can increase a person's risk for AML. It is unusual to see a gene problem arising from only one copy of the gene being mutated, researchers don't normally see this happening in autosomal dominant diseases. 

For more information of Glliland's research and results, Click Here.

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Chromosome Specific Causes for Leukemia

     Leukemia is caused when chromosomes go through translocation, or the transfer of one piece of a chromosome to a non homologous chromosome, and often the two non homologous chromosomes will swap segments. In leukemia, CML is caused by the translocation between one chromosome 9 and one chromosome 22; the translocation designated t(9;22). This results in a chromosome 9 that is longer than normal and a chromosome 22 that is shorter than normal (the Philadelphia chromosome or PH1). The gene that is removed from chromosome 9 is designated c-ABL, and it contains most of the proto-oncogene. A proto-oncogene is gene with one normal cell and one mutated cell; the mutated cell is called an oncogene, and it is dominant. The break in the chromosome 22 occurs in the middle of a gene called BCR. The resulting chromosome, the Philadelphia chromosome, contains a section of the BCR fused with most of the proto-oncogene.

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Complications of Leukemia

     In patients with leukemia, complications such as repeated infections arise. They may also experience kidney failure or impaired function, or a decreased number of white blood cells. Also, the treatments for leukemia can have serious side effects such as weight loss, bleeding, infection, fatigue, hair loss, or nausea. 

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Stem Cell Transplant

     The stem cell transplant is a procedure to replace one's damaged bone marrow with healthy bone marrow. Before going through with this procedure, a person will receive high amounts of chemotherapy or radiation therapy to destroy the diseased bone marrow. Once through with this, the person will receive new blood-forming stem cells to help rebuild the bone marrow. Stem cells for the procedure may be donated or used from another part of the person's body.

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Radiation Therapy

     Radiation therapy consists of using X-rays or other high energy beams to damage leukemic cells and stop their growth. During this therapy, a machine will direct the radiation to precise points on a person's body. Radiation may be received in a single area with a large number of leukemic cells or over a person's whole body.

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Biological Therapy and Targeted Therapy

Biological Therapy:

     This type of therapy works by helping a person's immune system recognize and attack leukemic cells.

Targeted Therapy:

     Just as in Chemotherapy, targeted therapy uses drugs. These drugs attack specific vulnerabilities within leukemic cells. This type of therapy can help control the disease.

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