Abstract

Identifying Factors that Cause Acute Leukemias Laurel EdingtonManchester-Essex High School, Manchester-by-the-Sea, MATeacher, Dr. Maria Burgess, Manchester-Essex High SchoolMentor, Dr. Karen Balen, Mass General Hosp, Boston, MA

Acute leukemia is a cancer of the blood and bone marrow that acts quickly. There are two types of acute leukemia—acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL.) AML is a cancer that affects myeloid cells while ALL is a cancer that affects the lymphoid cells. In this study, blood, bone marrow, and buccal cell samples were collected from adult acute leukemia patients and were stored for future study. Patient histories were read and pertinent information was entered into a database for future research. The purpose of this study is to research the factors that cause acute leukemia in adults.

IntroductionLeukemia is a cancer of the blood and bone marrow. It’s diagnosed when the body contains more than 5% of unformed blood cells called blasts.

Leukemia can be either acute or chronic.•Acute—progresses quickly•Chronic—progresses slowly with more mature cells

It is classified by the type of affected cells.•Acute Lymphoblastic Leukemia (ALL)—lymphoid blasts•Acute Myeloid Leukemia (AML)—myeloid blasts

There are few known causes.•Obesity•Smoking•Genetic translocations•Benzene, radiation exposure

AcknowledgmentsI thank Karen Ballen for mentoring me; Shannon Hubbs for teaching me how to use the database and CAS; Amir Fathi, Yi Bin Chen, and Eyal Attar for teaching me so much in the hospital; and a special thank you to Maria Burgess for helping me find my internship.

Supported by a grant from the Spaulding Education Fund.

Methods and MaterialsPatients signed consent forms.

Doctors collected•Blood•Bone marrow•Buccal cell samples

Researchers used databases and computer applications to enter data in the following order:

•Open CAS and CRIS•Choose patient, enter medical record number into CAS, CRIS•Find admit date in CAS, CRIS•Create Comorbidity, New Patient Workup, Chart review forms, enter data

SHORTE

Researchers read patient files and test results found in CAS to enter information about patient histories in CRIS. The admittance notes in CAS from when the patients were diagnosed with leukemia contain the most information about the patients and they are the major note used to fill out the forms in the database.

Works CitedBowen DT. Etiology of acute myeloid leukemia in the elderly. Semin Hematol. 2006 Apr;43(2):82-8. Deschler B, Lübbert M. Acute myeloid leukemia: epidemiology and etiology. Cancer. 2006 Nov 1;107(9):2099-107. Kasim K et al. Lifestyle factors and the risk of adult leukemia in Canada. Kaufman DW et al. Risk factors for leukemia in Thiland. Ann Hematol. 2009 Nov;88(11):1079-88. Meloni G et al. Obesity and autologous stem cell transplantation in acute myeloid leukemia. Bone Marrow Transplant. 2010 Aug;28(4):365-8. Nikolousis E et al. Allogenic transplant outcomes are not affected by body mass index (BMI) in patients with haematological malignancies. Ann Hematol. 2010 Nov;89(11):1141-5 Personal communication. Ross JA et al. Hormone replacement therapy is not associated with an increased risk of leukemia. Cancer Causes Control. 2005 Jun;16(5):483-8. Verdeguer A. Genetic alterations in children and adolescents with a cute myeloid leukaemia. Clin Transl Oncol. 2010 Sep;12(9):590-6. Vogel VG, Fisher RE. Epidemiology and etiology of leukemia. Curr Opin Oncol. 1993 Jan;5(1):26-34. Yun JP et al. Diet-Induced Obesity Accelerates Acute Lymphoblastic Leukemia Progression in Two Murine Models. Cancer Prev Res (Phila Pa). 2010 Sep 7.

Laurel EdingtonAuthentic Science Research Program

Manchester-Essex Regional High School, Manchester-by-the-Sea, MA 01944

Figure 1. This is an image of leukemic cells. The dark purple cells are the abnormal blast cells.

Figure 2. This is a diagram of the differentiation of blood cells. Blood stem cells differentiate into either myeloid stem cells or lymphoid stem cells. If there are abnormal myeloid blasts, the patient has AML. If there are abnormal lymphoid blasts, the patient has ALL.

Figure 4. Researchers can find doctors notes, test results, and patient information in the CAS program at Massachusetts General Hospital.

For further informationPlease contact laurel.edington@yahoo.com. More information on this and related projects can be obtained at www.merhs.mersd.org.

Figure 5. The comorbidity form has the researcher enter information about previous disorders, including other cancers and heart diseases.

Three main forms were completed for the database and they were found in the CRIS Leukemia Database:

•Comorbidity form•Chart Review form•New Patient Workup form

These forms contained information about•Each patient’s medical history. •Current disease•Treatments•Procedures related to the leukemia•Tests and test results•Protocol information•Demographics and background•Relapse, remission

After the comorbidity form is completed, researchers enter data into either the Chart Review form (below) or the New Patient Workup form. If the patient is deceased, the Chart Review form is used. The other two forms are almost identical except for a few questions about patient status.

Identifying Factors that Cause Acute Leukemias

Figure 3. Researchers open the CRIS Leukemia Database to enter data about the patients. This is the main screen for the database where the researchers create forms for the data entry.

Figure 6. The Chart Review form contains more information about patient histories and current disease status. There are also sections about tests, such as bone marrow biopsies, and the results.