MICROBIO 160 1st Edition Lecture 19 Outline of Last Lecture I Brain Tumor Facts II Distribution III Risk in Males and Females IV Symptoms V Areas of the Brain VI Diagnosis VII Treatment VIII Prognosis IX 5 Year Survival Rate Based on Age Outline of Current Lecture I Childhood Cancer II Common Types of Childhood Cancer III Adult Cancers vs Childhood Cancer IV Possible Causes of Childhood Cancer V VI Incidence vs Mortality of Childhood Cancers Treatment of Childhood cancers and Long Term Problems VII Leukemia VIII Leukemia Treatment These 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 X Lymphoma Ann Arbor Staging for Hodgkin s disease XI Retinoblastoma Current Lecture Childhood 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 study o 5 reached adulthood o 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 osteoblasts Adult 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 Survivability o 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 rocket Possible 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 ALL Signs 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 cancers o Heart damage o Lung damage o Infertility o Chronic hepatitis o Alterations in growth and development o Impaired cognitive abilities and psycho social impact 2 3 of survivors experience at least one of these side effects Types 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 US o Acute Mylogenous leukemia 20 AML is cancer of the myeloid blood cells that form white blood cells other than lymphocytes red blood cells or platelets o Chronic Mylogenous Leukemia 5 o Acute Lymphocytic Leukemia 75 The most common childhood cancer Accounts for about 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 transplant Bone 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 harvested o Treated with agents that destroy leukemia cells without harming bone marrow or stem cells o 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 include Burkitt s non Burkitt s and lymphoblastic lymphoma Lymphoma 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 monoclonal antibodies in patients with Hodgkin s and Non Hodgkin s Lymphoma Treatment planning to target the lymphoma and make sure the side effects are minimal plays an important part in radiotherapy Retinoblastoma Symptoms a white glow or glint in the pupil The presence of a white pupil in
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