Blood Disorders : Aplastic Anemia

Aplastic anemia is a condition where the bone marrow does not produce sufficient enough of new cells to replenish the blood cells in the body.








There are many circumstances why the bone marrow can shut down production of new cells.

• Radiation and chemotherapy treatments. While these cancer-fighting therapies kill cancer cells, they can also damage healthy cells, including stem cells in bone marrow. Aplastic anemia can be a temporary side effect of these treatments.
• Exposure to toxic chemicals. Exposure to toxic chemicals, such as some used in pesticides and insecticides, may cause aplastic anemia. Exposure to benzene — an ingredient in gasoline — also has been linked to aplastic anemia. This type of anemia sometimes gets better on its own if you avoid repeated exposure to the chemicals that caused your initial illness.
• Use of certain drugs. Some medications, such as those used to treat rheumatoid arthritis and some antibiotics, can cause aplastic anemia.
• Autoimmune disorders. An autoimmune disorder, in which your immune system begins attacking healthy cells, may involve stem cells in your bone marrow.
• A viral infection. Viral infections that affect bone marrow may play a role in the development of aplastic anemia in some people. Viruses that have been linked to the development of aplastic anemia include hepatitis, Epstein-Barr, cytomegalovirus, parvovirus B19 and HIV.
• Pregnancy. Aplastic anemia that occurs in pregnancy may be related to an autoimmune problem — your immune system may attack your bone marrow during pregnancy.
• Unknown factors. In many cases, doctors aren't able to identify the cause of aplastic anemia. This is called idiopathic aplastic anemia.

Above is an image of Aplastic anemia bone marrow biopsy under a microscope.

How is Aplastic Anemia Diagnosed?
A complete blood count is performed and the cell counts, hemoglobin will be low.  Also a bone marrow biopsy will be performed and sent to pathology for the cytology technologists to stain and prepare to be read by the pathologist.  The report is then sent to your family doctor , specialist or oncologist.  Hematology oncologist is the doctor who should treat aplastic anemia. If you like to view a bone marrow biopsy then go tot the following website.http://youtube.com/watch?v=dTKAU34
Reticulocyte count is another test that is ordered in the diagnosis of Aplastic anemia. It is a test that measures how fast the bone marrow is producing new red cells. The reticulocyte test will be higher in if the hemoglobin is low and the bone marrow is trying to produce more cells due to blood loss.
Erythropoietin is a blood test that measures the amount of erythropoietin, a hormone which tells the bone marrow to produce more red cells.  This hormone is made by the cells in the kidney. The kidney produces more of the EPO hormone when oxygen levels are lower.  When someone is anemic they have trouble breathing because they do not have enough red cells to carry the oxygen.

Treatment for Aplastic anemia includes blood transfusions, platelet transfusions, a stem cell transplant, immunosuppressants, bone marrow stimulants and antiviral medications.

Anytime you may feel abnormally fatigued and have shortness of breath you need to see care from a medical professional.  You need to make sure that a complete blood count is performed .

http://www.mayoclinic.com/health/aplastic-anemia/; http://www.medline.com ; http://labsonline.com

	Featured on MedicineNet Type 1 Diabetes Slideshow Myths About Depression See How to Relieve OA Pain Healthy Back Tips Definition of Erythropoietin (EPO) Related Articles Anemia Cancer Dehydration Heart Attack Kidney Failure Stroke MedicineNet Authored Webster's New World Medical Dictionary Learn more » MedTerms Medical Word of the Day <script language="JavaScript1.2" type="text/javascript" src="http://as.webmd.com/js.ng/Params.richmedia=yes&transactionID=466909359615&tile=466909359615&xpg=0&artid=7032&site=2&affiliate=22&uri=articlekey%3D7032&pos=113"></script>
		Featured on MedicineNet Type 1 Diabetes Slideshow Myths About Depression See How to Relieve OA Pain Healthy Back Tips Definition of Erythropoietin (EPO) Related Articles Anemia Cancer Dehydration Heart Attack Kidney Failure Stroke MedicineNet Authored Webster's New World Medical Dictionary Learn more » MedTerms Medical Word of the Day <script language="JavaScript1.2" type="text/javascript" src="http://as.webmd.com/js.ng/Params.richmedia=yes&transactionID=466909359615&tile=466909359615&xpg=0&artid=7032&site=2&affiliate=22&uri=articlekey%3D7032&pos=113"></script>

Blood From Mollusk Could Cure Cancer

There is great research being done on a giant keyhole limpets hemolymph.that carries a protein that is essential component of the new cancer vaccine. What it the function of the keyhole limpets hemocyanin? It is to carry oxygen in their blood.  The protein is unusually large in size, nearly the size of a virus. Keyhole limpet hemolymph contains epititopes. An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells. The part of an antibody that recognizes the epitope is called a paratope. Although epitopes are usually thought to be derived from non-self proteins, sequences derived from the host that can be recognized are also classified as epitopes.
The epitopes of protein antigens are divided into two categories, conformational epitopes and linear epitopes, based on their structure and interaction with the paratope.^[1] A conformational epitope is composed of discontinuous sections of the antigen's amino acid sequence. These epitopes interact with the paratope based on the 3-D surface features and shape or tertiary structure of the antigen. Most epitopes are conformational.
By contrast, linear epitopes interact with the paratope based on their primary structure. A linear epitope is formed by a continuous sequence of amino acids from the antigen.

The result of doctors injecting  keyhole limpet hemolymph (KLH) is a poweful immune response. The immune system can be stimulated to attack a certain cancer by attaching markers to KLH. A real plus by using KLH is that it is nontoxic.

As you know before using a vaccine for cancer treatment clinical trials have to performed.  A treatment for bladder cancer is now approved in Europe and Asia.
You can read more in Popular Science article written by Sam Roudman on the December 2011 issue.

Blood Disorders: Polycythemia Vera

Polycythemia vera is not a cancer,but is a disease of the bone marrow.  Hematology oncologists handle the diagnosis and treatment of this disease. The bone marrow makes too many red cells.  Polycythemia is rare and develops slowly.  The problem of elevated red blood cells is usually found in a routine complete blood count which is ordered by doctor.   The image below shows what polycythemia vera looks like under the microscope.

If  polycythemia vera is not treated then it could become life threatening. The symptoms are the following:
In its early stages, polycythemia vera usually doesn't cause any signs or symptoms. However, as the disease progresses, you may experience:

• Headache
• Dizziness
• Itchiness, especially following a warm bath or shower
• Redness of your skin
• Shortness of breath
• Breathing difficulty when you lie down
• Numbness, tingling, burning or weakness in your hands, feet, arms or legs
• A feeling of fullness or bloating in your left upper abdomen due to an enlarged spleen
• Fatigue  

Blood tests
Doctors most frequently use blood tests to diagnose polycythemia vera. If you have polycythemia vera, blood tests may reveal:

• An increase in the number of red blood cells and, in some cases, an increase in platelets or white blood cells.
• Elevated hematocrit measurement, the percentage of red blood cells that make up total blood volume.
• Elevated levels of hemoglobin, the iron-rich protein in red blood cells that carries oxygen.
• Very low levels of erythropoietin (EPO), a hormone that stimulates bone marrow to produce new red blood cells.

Bone marrow aspiration or biopsy
If your doctor suspects you have polycythemia vera, he or she may recommend a bone marrow aspiration or biopsy to collect a sample of your bone marrow. A bone marrow biopsy involves taking a sample of solid bone marrow material. A bone marrow aspiration is usually done at the same time as a biopsy. During an aspiration, your doctor withdraws a sample of the liquid portion of your marrow.
If an examination of your bone marrow shows that it's producing higher than normal numbers of blood cells, it may be a sign of polycythemia vera.
Tests for the gene mutation that causes polycythemia vera
If you have polycythemia vera, analysis of your bone marrow or blood also may show the mutation in the cells (JAK2 V617F mutation) that's associated with the disease.

n a bone marrow aspiration and biopsy, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone called the posterior iliac crest. A bone marrow biopsy is often taken at the same time. This second procedure removes a small piece of bone tissue and the enclosed marrow.

Treatment of polycythemia include doing a phlebotomy to remove blood that is putting your circulatory system in overload.  It is similar to giving blood to the Red Cross.  Drugs are given if the phlebotomy is not enough to relieve the increased red cell production.  
 Hydroxyurea (Droxia, Hydrea) or anagrelide (Agrylin), to suppress your bone marrow's ability to produce blood cells may be used. Interferon-alpha may be used to stimulate your immune system to fight the overproduction of red blood cells.
Any abnormal symptoms should always be addressed by a doctor.  Be in tune with your body and document changes to help the doctor to have a clearer picture of your health problems.

You can get more information be searching https:www.mayoclinic.com

Cancer Testing update

September 1, 2011

A breakthrough in medical science is on the door steps as scientists try to develop an anti-cancer virus. It is likely to change the approach to cancer treatment in the coming days. Modifying vaccinia virus which is being used to develop a smallpox vaccine were first time have been used on cancer patients with positive results.
The virus has initially been injected for testing its safety in 23 patients. The virus named JX-594, is dependent upon a chemical pathway, common in some cancers, in order to replicate. Its replication stops the growth of cancerous cells though does not kill them. In the eight patients receiving the highest dose, seven had the virus replicating in their tumors, but not in healthy tissue.
The approach is new and advances are encouraging. The currently recommended method is intravenous injection so that it can reach to all affected organs but higher concentrations directly at the affected points is also being considered to enable killing of diseased cells.
Cancer Research UK’s Prof Nick Lemoine, also director of Barts Cancer Institute, said: “Viruses that multiply in just tumor cells – avoiding healthy cells – are showing real promise as a new biological approach to target hard-to-treat cancers.

http://www.mediconews.com

Multiple Myeloma

Multiple Myeloma is a cancer that begins in a person's bone marrow.  Bone marrow is the soft tissue inside the bone.  The bone produces many cells in the blood of circulating in out body.  Multiple myeloma is the cancer of the plasma cells.  Below is an image of plasma cells be viewed through a microscope.









       

Plasma cells are a type of white cell that produces antibodies.  Cancer causes cells to multiply at an abnormal rate.  This what happens in Multiple Myeloma.

Collections of abnormal cells accumulate in bones, where they cause bone lesions (abnormal areas of tissue), and in the bone marrow where they interfere with the production of normal blood cells. Most cases of myeloma also feature the production of a paraprotein, an abnormal antibody that can cause kidney problems and interferes with the production of normal antibodies leading to immunodeficiency. Hypercalcemia (high calcium levels) is often encountered.^[1] Myeloma is diagnosed with blood tests (protein electrophoresis, peripheral blood smear), microscopic examination of the bone marrow (bone marrow biopsy), and radiographs of commonly involved bones. Myeloma is generally thought to be incurable, but remissions may be induced with steroids, chemotherapy, thalidomide and stem cell transplants. Newer drugs, such as lenalidomide and bortezomib, are often used in more advanced disease. Radiation therapy is sometimes used to treat bone lesions that are causing symptoms.^[1]
The disease develops in 1–4 per 100,000 people per year. It is more common in men, and for yet unknown reasons is twice as common in African Americans as it is in white Americans. With conventional treatment, the prognosis is 3–4 years, which may be extended to 5–7 years or longer with advanced treatments. Multiple myeloma is the second most common hematological malignancy (13%) and constitutes 1% of all cancers.^[1]


What are the common lab tests performed in diagnosing and managing multiple myeloma?

A blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of monoclonal proteins (M proteins) — referred to as an "M spike" — in your blood. Parts of M proteins may also be detected in a test of your urine. When M proteins are found in urine, they're referred to as Bence Jones proteins. Monoclonal proteins may indicate multiple myeloma, but also can indicate other conditions.

Monoclonal refers to a set of antibodies. These antibodies are the similar or identical antibodies. The reason behind these being similar antibodies is that they are produced by a single type of immune cell and all of them are clones of a single parent cell. If you give any substance, it is probable to generate monoclonal antibodies that specially bind to that matter. These antibodies can then serve up to sense or purify that matter. These antibodies have become a very important tool in the fields such as medicine, molecular biology and biochemistry.

As a tumor marker: a blood B2Microglobulin test may be ordered to help determine the severity and spread (stage) of multiple myeloma and may sometimes be ordered to evaluate the effectiveness of treatment. B2M has been associated with tumor burden, the amount of cancer present, and may be ordered to help evaluate the prognosis of cancers such as leukemia and lymphoma.

Sometimes people with multiple myeloma don't have signs or symptoms. Other times, they may have fever, bruising, bleeding and tiredness. People with multiple myeloma may also have painful bone fractures and damage to organs, especially the kidneys.
Although there is no cure at this time, the latest treatments can help control the disease, relieve pain, limit complications and slow the progress of multiple myeloma in most people. This tremendous progress in treatment means that most people with multiple myeloma live longer than ever before.

Repeated lab tests help the oncologist to know the progression of the Multiple Myeloma and if the treatment is working to control the cancer.

To learn more go to www.mayoclinic.com , www.labtestsonline.org, www.wikipedia.org

Hairy Cell Leukemia

Hairy Cell leukemia is a rare blood cancer.  This cancer is seen more in men that women and most often middle age to senior age adults. HCL is a slow growing leukemia and it affects the B-cells,lymphocytes, in the bone marrow.
Below is image of what HCL looks like under the microscope.

What are the symptoms of HCL?
You will notice that the white cells, lymphocytes, are larger than normal lymphocytes.  Also, notice the hair-like projections on the edge of the cytoplasm.

In hairy cell leukemia, the "hairy cells" (malignant B lymphocytes) accumulate in the bone marrow, interfering with the production of normal white blood cells, red blood cells, and platelets. Consequently, patients may develop infections related to low white blood cell count, anemia and fatigue due to a lack of red blood cells, or easy bleeding due to a low platelet count.^[12] Leukemic cells may gather in the spleen and cause it to swell; this can have the side effect of making the person feel full even when he or she has not eaten much.
Hairy cell leukemia is commonly diagnosed after a routine blood count shows unexpectedly low numbers of one or more kinds of normal blood cells, or after unexplained bruises or recurrent infections in an otherwise apparently healthy patient.
Platelet function may be somewhat impaired in HCL patients, although this does not appear to have any significant practical effect.^[13] It may result in somewhat more mild bruises than would otherwise be expected for a given platelet count or a mildly increased bleeding time for a minor cut. It is likely the result of producing slightly abnormal platelets in the overstressed bone marrow tissue.
Patients with a high tumor burden may also have somewhat reduced levels of cholesterol,^[14] especially in patients with an enlarged spleen.^[15] Cholesterol levels return to more normal values with successful treatment of HCL.

The causes of HCL has determined that persons who farm and garden may have increases risk in getting this cancers. 
The U.S. Institute of Medicine (IOM) announced "sufficient evidence" of an association between exposure to herbicides and later development of chronic B-cell leukemias and lymphomas in general.


Diagnosis for HCL involves the following lab tests.
  Acomplete blood count (CBC), but additional testing is necessary to confirm the diagnosis. A CBC normally shows low counts for white blood cells, red blood cells, and platelets in HCL patients. However, if large numbers of hairy cells in the blood streams ,then normal or high lymphocytes can be found.  Another test is viewing a slide in which a drop of blood has been smeared across the glass and then stained with a Wrights which differentiates the different types of white cells.  HCL appear as the image above.  A bone marrow aspirate is a great tool in the final diagnosis.  The bone marrow is where blood cells are made.  The bone marrow will be stained and viewed under a microscope. The diagnosis can be confirmed by using the stain known as TRAP(tartrate resistant acid phospatase).


Hairy cell leukemia is not curable, but can be easily put into remission for several years.

For more info:  mayoclinic.com/hairycellleukemia, wilkipedia.com/hairycellleukemia

Tumor Markers

When cancer is present certain tumor markers are present.  Tumor markers are proteins that can be found in blood  and  can be increased with certain cancers.  Tumor markers can also be in other body fluids such as urine and in tumors.  Most tumor markers are proteins but some  of newer ones are genes and other substances.
The procedure for testing for tumor markers is first a blood draw or urine specimen is sent to the lab for testing.  The specimen is then combined with man-made antibodies that react with the tumor marker protein.
Rarely is a tumor marker is used to diagnose if a cancer is present.  The oncologist uses a battery of testing in the diagnosis of cancer such as pet scan, MRI, biopsies,etc.  Tumor markers are helpful in knowing the progression of the cancer during treatment.

Oncologist usually order the following tumor markers.

CEA Carcinoembryonic antigen is a protein associated with certain tumors and fetus.  It is a glycoprotein and associated with the plasma membrane of a tumor membrane.  It is from the plasma membrane that the carcinoembryonic antigen is released.  At first it was used to identify colon caner but was later found in other cancers such as pancreatic,lung,gastric and breast.  CEA was also found in non-cancer illnesses such as cirrhosis,

bowel inflammatory disease, chronic lung disease and pancreatitis.  In advanced stage of cancer the CEA is elevated which means that the cancer survival of the patient is shortened.

AFP-  Alpha- fetoprotein  SELL has determined that this is the most single discriminating laboratory test indicative of a malignant disease.  It is used in screening hepatatocellular disease.  

AFP is elevated in testicular germ cell tumors containing embryonal or endodermal sinus elements. A defenitive positive marker value is highly sensitive in indicating relapse or response to treatment.

HCG - In pregnancy the HCG is produced by the syncytiotrophoblastic cells of the placenta and of course is elevated in pregnancy. It is a highly sensitive test in the detecting the smallest of trophoblastic neoplasms in women.  The larger the tumor then the higher the HCG result. The HCG is essential for the oncologist measuring the effectiveness of the treatment.

Neuron Specific Enolase - Neuron indicates that this is part of the brain.  When "ase" is seen at the end of the scientific word it is an enzyme.  NSE is an isozyme of the glycolytic pathway that is strictly seen in the brain and the neuroendocrine tissue.  This tumor marker is valuable in diagnosing and evaluating the treatment of tumors of the central nervous system, neuroblastomas, and APUD tumors.  NSE is a immunohistochemical marker for tumors. 

CA125  is a helpful tool in ovarian cancer because it is found in about 80% of non mucinous ovarian carcinomas.  It is elevated on ovarian cancer.  CA125 is used to let the oncologist know if the treatment for the cancer is working. CA125 is elevated in other cancers such as pancreas, endometrial,lung, breast and colon.

CA19-9 is an monoclonal antibody generated against colon carcinoma cell line to detect monosialoganglioside found in tissues of persons with gastrointestinal adenocarcinoma.  It is also elevated in gastric, pancreatic, and colon cancer.


CA 15.3  helps to monitor certain cancers but most prominently breast cancer.  This antigen sheds sheds into the blood because it is found on the surface of many types of cancer. It has been found that CA 15.3 in conjunction with Alkaline Phosphatase  is elevated is found to be associated with increase chance of early recurrence of breast cancer.  This marker is used to monitor treatment of breast cancer.


PSA  means prostrate specific antigen.  Another name is gamma-seminoprotein or Kallikrein.  It is a glycoprotein and in humans it is encoded with KLK3 gene. It is secreted by the epithelial cells for the prostrate gland. Normal levels of PSA is produced in all men, but is elevated in prostrate cancer and other prostrate problems.  PSA  serum levels are drawn regularly from patients who are being treated to help the oncolgist know the progression of the cancer.

For more information go to tc-cancer.com  , wilkipedia, National Cancer Institute