The celebrity hairdresser Sebastian Böhm passed away at the age of only 36. He lost the fight against blood cancer. What makes the disease so dangerous – and why it often goes undetected for so long.
Leukemia, commonly known as blood cancer, is one of the most dangerous forms of cancer. Compared to other types of cancer, such as breast cancer or colon cancer, leukemia is relatively rare with around 12,000 new cases per year, including around 600 children.
But because the blood cancer is usually discovered late, the prognosis is not good. Only half of the sick people are still alive five years after being diagnosed with leukemia. Permanent healing is rare. Incidentally, unlike with cancer, younger age in leukemia is associated with a better prognosis. The chances of recovery for children with leukemia are good, but rather poor for seniors.
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But why is leukemia often recognized so late? The signs of these diseases of the hematopoietic system are very unspecific. Anyone who has frequent nosebleeds or quickly develops hematomas does not immediately think of cancer. Other symptoms that can indicate leukemia:
One or more of these signs does not mean that leukemia is present. But the symptoms should definitely be clarified by a doctor.
Various methods are available to doctors to diagnose leukemia:
Leukemia is the generic term for malignant diseases that are associated with a blood formation disorder. Therefore also called blood cancer. Most forms of leukemia are caused by a mutation in the immature precursors of the blood cells in the bone marrow.
To better understand the mechanism: All blood cells arise from a common, hematopoietic type of stem cell in the bone marrow. Then they split into two groups
The young blood cells then go through further stages of development, leaving the bone marrow and maturing in the lymph nodes and spleen. You will
They can degenerate at any stage of their maturation.
Mutated blood cells no longer mature normally. They can no longer fulfill their differentiated functions, such as killing germs, but divide uncontrollably and bear the same characteristics as the degenerated parent cell. These clones are called leukemic blasts.
They build up in the bone marrow. This in turn hinders the formation of healthy blood cells.
This imbalance is expressed throughout the body and can lead to the symptoms mentioned. Anemia, immunodeficiency, a tendency to bleed and organ damage are the consequences of leukemia.
Depending on the cell type that has degenerated and the course of the disease, leukemias can be divided into different forms. A sudden, strong feeling of illness is typical for the acute forms, such as with the flu. Chronic leukemia, on the other hand, develops gradually and unobtrusively. The complaints are non-specific. The different forms of leukemia:
In this form of leukemia, the myeloid cells have changed and multiplied uncontrollably. This affects part of the white blood cells, the red blood cells and the platelets. The causes are exposure to chemical substances such as benzene and ionizing radiation, such as radioactive substances.
Too many granulocytes are formed in the bone marrow. Most patients with CML have a specific genetic abnormality called the Philadelphia chromosome. This mutation occurs throughout life and is not hereditary.
The cause here are degenerated precursors of the lymphocytes. ALL primarily affects children and young adults. It is even the most common type of cancer in children. Acute lymphoblastic leukemia usually occurs between the ages of three and seven years.
In CLL, too, dysfunctional lymphocytes multiply uncontrollably. Depending on which subgroup of lymphocytes this affects, it is divided into
The cancer affects the lymphatic system, meaning the lymph nodes, spleen, and/or liver. It is mostly B-CLL, a non-Hodgkin lymphoma, the most common form of leukemia. Men are mostly affected. The main symptom is swollen lymph nodes.
Depending on the form of leukemia, a special treatment plan is drawn up. This is usually done by experts in one of the many haematological-oncological centers in hospitals.
Above all, the treatment of acute leukemia must start as quickly as possible. This is because the number of properly functioning immune cells decreases rapidly, and the number of red blood cells and platelets also decreases rapidly.
The basis of therapy for acute leukemia is:
Chemotherapy is performed on an inpatient basis and sometimes on an outpatient basis. Especially at the beginning of treatment, cytostatics are given in high doses as injections or tablets (induction therapy). In order to enable an optimal relationship between the effect and side effects, treatment is given at intervals, and later at longer intervals (consolidation therapy and maintenance therapy).
With radiation therapy, leukemia cells can be destroyed in a targeted manner, for example in lymph nodes that have undergone malignant changes.
Bone marrow or blood stem cell transplantation is only considered if these treatments do not work. Treatment is complex but often successful. It is particularly effective for AML and non-Hodgkin’s lymphoma.
The prerequisite is the right donor. Siblings are suitable for only one third of leukemia patients. For this reason, and also because many people are only children, it is difficult to find suitable donors. Here, for example, the German Bone Marrow Donor Center (DKMS) is involved.
Before the blood cells are transplanted, the patient’s entire bone marrow should usually be destroyed if possible so that no diseased cells survive. This is done with high-dose chemotherapy or radiation. The patient then receives the healthy blood stem cells via a blood transfusion. It usually only takes three weeks for the blood levels to return to normal afterwards.
Cytostatics are also used against CML and CLL, but in lower doses than against acute leukemia. The active ingredients are also less aggressive. The treatments are repeated regularly.
CML therapy includes tyrosine kinase inhibitors. The drugs specifically block an enzyme that is only produced by leukemia cells. As a result, the degenerated cell can no longer divide uncontrollably. Tyrosine kinase inhibitors are about
Tyrosine kinase inhibitors belong to a new class of cancer therapies known as targeted therapies.
Patients often have to take these drugs for life. So healing is almost impossible. In the case of chronic myeloid leukemia, this chance often only exists with a stem cell transplant.
It is different with chronic lymphocytic leukemia. Patients often feel well and have no complaints. Then it is only necessary to check the blood values regularly so that if they deteriorate, therapy is started. The options are then:
A new group of active ingredients, BCL-2 inhibitors, is particularly promising for chronic myeloid leukemia such as non-Hodgkin’s lymphoma. These substances specifically stimulate the apoptosis of cancer cells in CLL. The first active substance from this group, venetoclax, is now approved in the USA; approval has only just been applied for in Germany.
In studies, the drug proved that it can massively reduce the number of diseased blood cells. Venetoclax is simply taken orally and works quickly. Another new approach is immunotherapy, in which genetically engineered T cells specifically attack and destroy leukemia cells.
Blood cancer can be prevented to a certain extent. You can avoid the following risk factors:
