MICROBIO 160 1st Edition Lecture 19Outline of Last Lecture I. Brain Tumor FactsII. DistributionIII. Risk in Males and FemalesIV. SymptomsV. Areas of the BrainVI. DiagnosisVII. TreatmentVIII. PrognosisIX. 5-Year Survival Rate Based on AgeOutline of Current Lecture I. Childhood CancerII. Common Types of Childhood CancerIII. Adult Cancers vs. Childhood CancerIV. Possible Causes of Childhood CancerV. Incidence vs. Mortality of Childhood CancersVI. Treatment of Childhood cancers and Long Term Problems VII. LeukemiaVIII. Leukemia TreatmentThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.IX. LymphomaX. Ann Arbor Staging for Hodgkin’s disease:XI. RetinoblastomaCurrent LectureChildhood Cancer: a Brief Anecdote - Saint Jude: patron saint of hope and impossible causes- Survival rate of acute lymphoblastic leukemia (ALL) today >90%- Survival rate of all in 1950’s <5%- 1960’s Experimental drug: “Total Therapy III” o Chemo and radiation- 26 children in this studyo 5 reached adulthoodo 3 alive today Cancer is the #1 cause of disease-related death for children Common Types of Childhood Cancer:- Leukemia: acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL)- Brain and other nervous system tumors- Neuroblastoma: most common extracranial solid cancer in childhood, cancer of nerve tissue- Wilms tumor (nephroblastoma): kidney cancer- Lymphoma: cancer that originates in lymphatic tissue- Rhabdomyosarcoma: cancer of soft connective tissue- Retinoblastoma: almost half of diagnosed children have a hereditary defect component- Bone cancer: develops from osteoblastsAdult cancers vs. Childhood Cancers: Adult:- Incidence/prevalence:o Cancer in adults is fairly common (1 in 3)- Causation:o Approximately 90% of adult cancers can be attributed to environmental factors- Survivabilityo Adult survivability for cancer overall is less than 50%Childhood:- Incidence/prevalence:o It is extremely rare for children to have cancer (1 in 600)- Causation:o Most childhood cancers have no clear causation- Survivability:o The most striking difference between childhood cancer and adult cancer is childhood cancer is much more curable (2/3 children survive and live healthy lives)Cancer at an increasing age: the older you are, the more likely you are to develop cancer—as you get older the cancer incidences sky rocketPossible causes of Childhood Cancer:- The best established environmental cause of childhood cancer is ionizing radiation- High dose radiation exposure is linked to ALL, AML, osteosarcoma, thyroid cancer, and soft-tissue sarcoma- Viral infections might be involved in certain non-Hodgkin's lymphomas and leukemia- Maternal use of alcohol during pregnancy is associated with a 2.6 fold increased risk of ALLSigns of cancer: the child might not exhibit different symptoms Incidence vs. Mortality of Childhood Cancers: - Study by SEER (Surveilance, Epidemiology, and End Results)- Incidence and Mortality of all childhood cancers under 20 years of age- Why an increase in incidence? We get better diagnostic tools (test more accurate), environmental factors)Treatment of Childhood cancers and Long Term Problems - Treatment efficiency has improved, but survivors pay a high price in side effects (you are giving them toxic drugs)- 1997: 50% 5-year survival rates- 2007: 80% 5-year survival rates- Side effects:o Secondary cancerso Heart damageo Lung damageo Infertilityo Chronic hepatitiso Alterations in growth and developmento Impaired cognitive abilities and psycho-social impact 2/3 of survivors experience at least one of these side effectsTypes of Childhood Cancer: Leukemia: Leukemia: affects the organs that manufacture blood cells—it begins in the bone marrow or lymph system where blood cells originate and mature before being released into the blood stream - Normal Blood: contains mostly red cells and a small percentage of white blood cells- Abnormal: a person with chronic lymphocytic leukemia—the white cell count is abnormally high- Distribution of Leukemia Types among Children in the USo Acute Mylogenous leukemia 20% AML is cancer of the myeloid blood cells that form white blood cells (other than lymphocytes), red blood cells, or plateletso Chronic Mylogenous Leukemia 5%o Acute Lymphocytic Leukemia 75% The most common childhood cancer Accounts for about ¾ cases of childhood leukemia Starts from early forms of lymphocytes in the bone marrow Leukemia Treatment: you take bone marrow out of the patient, destroy all of the bone marrow cells, repopulate with the cells you extracted (bone marrow transplant)- The most common treatment includes chemotherapy followed by a bone marrow transplantBone marrow/Stem Cell Transplant:- Stem cells or bone marrow can be harvested from the patient or from compatible donor (sibling or other good match)- High doses of radiation and/or chemotherapy kill ALL blood cells in bone marrow o Sample of bone marrow or stem cells harvestedo Treated with agents that destroy leukemia cells without harming bone marrow orstem cellso Patient’s remaining bone marrow and leukemia cells destroyed o Bone marrow or stem cells injected Lymphomas: - Hodgkin's disease or Hodgkin's lymphomas: affect lymph nodes nearer to the body’s surface, such as in the neck, armpit, or groin area- Non-Hodgkin Lymphomas: affect lymph nodes found deep within the body—this includeBurkitt's, non-Burkitt's, and lymphoblastic lymphomaLymphoma: The maturation stage of the cell of origin determines the type of lymphoma - The Maturation Stage of the cell of Origin determines the Type of Lymphoma- Plasma cell—Waldenstrom’s Macroglobulinemia- Activated B-cell—Diffuse large B-cell Lymphoma- B Cell after antigen exposure— Follicular Lymphoma, Mantle Cell- B Cell before antigen exposure—CLL/SLL- Immature B-cell—Small Non-cleaved Lymphoma (Burkitt’s)- Pre-B Cell- Lymphoid Stem Cell—Precursor B-Cell Acute Lymphblastic Lymphoma/Leukemias- Pluripotent Stern Cell – Chronic Myeloid Leukemia (MCL)Ann Arbor Staging for Hodgkin’s disease:- Stage I: only one spot on the diaphragm- Stage II: several spots in the same location - Stage III: several spots in different locations- Stage IV: many spots all over Treatment for Lymphoma: - Selected surface antigens and receptors that are currently being targeted by monoclonalantibodies in patients with Hodgkin’s and Non-Hodgkin’s Lymphoma-
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