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School of Medicine
Johns Hopkins is home to one of the largest leukemia programs worldwide. Groundbreaking treatments in all types of leukemias and blood disorders are just the beginning of unparalleled care and commitment to our patients and families in the Johns Hopkins Leukemia Program.
Leukemia experts at Johns Hopkins are world-renowned for their experience in the treatment and management of leukemia and blood disorders.
Leukemia is a cancer of the blood cells, which are produced in the bone marrow -- the spongy interior of the bones. Normally, blood cells are made in an orderly, controlled way. When leukemia develops, the bone marrow produces abnormal cells; therefore, the cells that are responsible for fighting infections and preventing bleeding are not made correctly.
Leukemias are classified as acute or chronic; acute leukemias progress more rapidly, while chronic leukemias gradually worsen. They are also classified by the type of white blood cells in which they arise -- lymphoid cells (cells produced by the bone marrow that function as immune cells) or myeloid cells (stem cells produced by the bone marrow that mature into diverse cell types including oxygen-carrying red cells, infection-fighting white cells, and blood clot-forming platelets). An estimated 44,000 new cases of leukemia develop in the United States each year, according to the Leukemia & Lymphoma Society.
Even if you’re in remission, the effects of your leukemia and your leukemia treatment can last for many years. For instance, a growing number of studies show that the treatments you received as part of your leukemia therapy can lead to health problems later in life. These “late effects,” which can occur in pediatric and adult leukemia survivors, include learning disabilities, poor work performance, psychological distress and health insurance discrimination. A patient’s age at the time of treatment, and his/her overall level of health, and type and duration of therapy, may affect the risk of developing a long-term effect. Always discuss any health concerns and symptoms with your doctor.
Other long-term effects include:
- Development of a secondary cancer – Exposure to chemotherapy agents such as VePesid, Adriamycin, Blenoxane, Oncovin, Velban, Cytoxan, and corticosteroids has been associated with developing a secondary cancer, especially if the patient also had radiation therapy. The most frequent secondary cancer is skin cancer, so leukemia survivors should be checked annually by a dermatologist. High doses of Cytoxan and VePesid have been linked to the development of AML or MDS. Young women who had radiation to the chest area may be at higher risk of breast cancer later in life. Report any new or unusual symptoms to your doctor, and schedule routine screenings like mammograms and colonoscopies.
- Peripheral neuropathy – Peripheral neuropathy, or numbness, tingling or pain in the hands and feet, can last months after therapy with agents such as Oncovin.
- Heart problems – Heart failure and heart muscle injury can result soon or years after therapy with drugs such as Adriamycin, high doses of Cytoxan, or from radiation to the chest.
- Lung problems – Alkylating agents, Blenoxane and radiation can lead to lung tissue injury.
- Bone damage – Chemotherapy or corticosteroid treatment can lead to osteopenia and osteoporosis – signs of decreased bone density, increasing the risk of fractures.
- Premature ovarian failure/early menopause/male sterility – High-dose chemotherapy for leukemia associated with a bone marrow/stem cell transplant can cause premature menopause and create fertility problems in women. Men may experience temporary or lasting sterility.
- Thyroid damage – Radiation therapy can render the thyroid gland underactive.
- Cognitive effects/fatigue
As you recover, take charge of your health by eating healthy, exercising and reducing stress. Avoid tobacco and limit alcohol intake. Keep up with screenings for other cancers, like mammographies and colonoscopies.
Read more about the Michael J. Garil Leukemia Survivors Program at Johns Hopkins Kimmel Cancer Center. Read a booklet by the National Cancer Institute, “What You Need to Know About Leukemia” . The Leukemia and Lymphoma Society provides information and resources for patients and survivors.
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