Hematology

What Has The Graphic Design to Do with The Acute Lymphatic Leukemia ?

At the first four years at the university, I've been lucky enough to try several things so I can have an idea about what I truly want from life, the graphic design was one of the skills that I have tried to master at that time.

When I started feeling curious about this skill i start using simple tools and free design websites ( Canva in making designs, Pixabay in finding professional pictures without facing a problem with the credit matters and Flaticon in finding icons) giving the fact I had no access to pay on the internet and I worked more on this skill by using it in the mediatic side of scientific clubs and volunteering teams that I've made apart of.


One of the most inspiring people in this field, Basma Hosam, an Egyptian illustrator who uses graphic design to illustrate stories made for children that even attract adults! A kind of creative illustrations revealing Basma's personality: feminine, imaginative and above all childlike ( The ones in the main picture.)

The thing that reminds me of the character played by Renée Zellweger in "Miss Potter"; a biographical movie that had been directed by Chris Noonan and released in 2006, telling the story of the illustrator, botanist and the writer of "The Tale of Peter Rabbit" one of the greatest bestsellers of all time; Beatrix Potter.

The movie is mainly based on the private life of Beatrix and her love story with her fiance; the editor Norman Warne (played by Ewan McGregor) the man who supported her at the beginning of her career and who believed in the magic she will bring to the world.


Their story didn't last due to the death of Norman by acute lymphatic leukemia during the annual vacation of Beatrix and her family to their hometown.

Feeling a bit strange while trying to write about a specific person's disease, but that's the easiest way to memorize pieces of information! So what's the Acute lymphoblastic leukemia, its symptoms, diagnosis, and its treatment?


Acute lymphoblastic leukemia is a type of cancer caused by the multiplication of defective lymphocytes in the bone marrow called blasts. The term "Acute" indicates rapid progression, with only a few days or weeks between the first symptoms and making the diagnosis.
They are leukocytes (white blood cells) whose development has been blocked at an immature stage; these blasts are therefore unable to protect us against foreign bodies, which all normal cells of our immune system do. Without treatment, the blasts will proliferate, invading the bone marrow, and all other organs.

It is a disease whose causes are still unknown. It is not contagious, neither transmissible nor hereditary. It can occur at any age.

Physiopathology:

In ALL, very immature leukemia cells accumulate in the bone marrow, then destroy and replace the cells that make blood. Leukemia cells reach the liver, spleen, lymph nodes, brain and testes through the bloodstream where they can continue to grow and multiply. However, ALL cells can accumulate anywhere in the body. They can spread into the layers of tissue that cover the brain and spinal cord (leukemic meningitis) and cause anemia, liver and kidney failure, and damage to other organs.

Symptoms:

The first symptoms of ALL are caused by the inability of the bone marrow to make enough normal blood cells.
The presence of fever and excessive sweating may indicate an infection. Deficiency in white blood cells can increase the risk of infection.
Weakness, fatigue and pallor, which are signs of anemia, are a result of the decrease in the number of red blood cells. Some people may have difficulty breathing, have tachycardia (rapid heartbeat), or chest pain.
The tendency to bruises and hemorrhages, sometimes seen in the form of nosebleeds or gum bleeding, results from platelet deficiency. In some cases, bleeding can occur in the brain or abdomen.
Other symptoms occur when the leukemia cells invade other organs.
Leukemia cells in the brain can cause headaches, vomiting, stroke, and impaired vision, balance, hearing and facial muscles.
The leukemia cells found in the bone marrow can cause bone and joint pain.
A bloated feeling and sometimes abdominal pain can be seen when the leukemia cells cause enlarged liver and spleen.

Diagnosis:

Blood tests; blood count can reveal the first sign of ALL; The total number of white blood cells can be decreased, normal or increased, but the number of red blood cells and platelets is almost always decreased. Besides, very immature white blood cells (blasts) are present in the blood.
A bone marrow exam is almost always done to confirm the diagnosis and differentiate ALL from other types of leukemia. Blasts are tested for abnormalities in the chromosomes, which help doctors determine the exact type of leukemia and the drugs to use to treat it.
Blood and urine tests are done to detect other abnormalities, including electrolyte abnormalities.
Imaging tests may also be required; A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan is done if the person has symptoms that may indicate the presence of leukemia cells in the brain. A chest CT scan checks for leukemia cells in the area around the lungs. CT, MRI or ultrasound of the abdomen can also be done when certain internal organs are enlarged. Echocardiography (ultrasound of the heart) can be done before starting chemotherapy, as chemotherapy sometimes has effects on the heart.

The treatment :

Chemotherapy is the most effective and it's administered in the form of treatment cycles.
Other drugs, such as immunotherapy and/or targeted therapy
More rarely, a stem cell transplant or radiotherapy
During the previous treatments, transfusions of blood and platelets may be needed to treat anemia and prevent bleeding, as may the administration of antibiotics to treat possible infections. Intravenous administration of rehydration fluids.

Leukemia cells can reappear (this is called a relapse) in the blood, bone marrow, brain or testes. An early relapse that affects the bone marrow (spinal relapse) is particularly serious. Another chemotherapy is given and although many people respond to this repeated treatment, the disease tends to recur, especially in infants and adults.

In the event of a relapse, high-dose chemotherapy drugs, as well as an allogeneic stem cell transplant ("allogeneic" means that the stem cells come from another person), offer the best chance of success. The donor is usually a brother or sister, but cells from someone unrelated whose spinal cord is compatible with the recipient is sometimes used. Stem cell allograft is rarely used in people over the age of 65 because it offers less guarantee of success and side effects are more often fatal.

New therapies using monoclonal antibodies (proteins that specifically bind to leukemia cells and mark them for destruction) are also used in some people with relapsed ALL. An even more recent treatment that can be used in some people with relapsed ALL is called chimeric antigen receptor T-cell therapy (CAR-T) or chimeric antigen receptor T-cell therapy. This treatment involves modifying a type of lymphocyte (T lymphocyte) from the person with leukemia so that the new T lymphocytes recognize and attack the leukemia cells.


And since it's about the Graphic design I should recommand the work of the talented Farouk Hafsaoui the owner of OPIXIUM Animation who made the logo of Inside My bubble !

References:

  1. Kaushansky K, et al., eds. Acute lymphoblastic leukemia. In: Williams Hematology. 9th ed. New York, N.Y.: McGraw-Hill Education; 2016. http://accessmedicine.mhmedical.com. Accessed March 31, 2017.
  2. AskMayoExpert. Acute lymphoblastic leukemia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  3. Childhood acute lymphoblastic leukemia treatment (PDQ). National Cancer Institute. https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq#section/all. Accessed June 26, 2017.
  4. Adult acute lymphoblastic leukemia treatment (PDQ) — Health professional version. National Cancer Institute. https://www.cancer.gov/types/leukemia/hp/adult-all-treatment-pdq#section/all. Accessed June 26, 2017
  5. https://www.webmd.com/cancer/lymphoma/acute-lymphoblastic-leukemia#1

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