Causes and future perspectives
In spite of all the progress that has been made, and the tireless research that has been done, we still do not know what causes leukaemia. We know that it affects males more than females and white people more than black people, but we still can't explain satisfactorily why some people get the disease, and others don't.
After studying a large number of cases it has been possible to establish certain risk factors that might lead to the development of the disease. For example, exposure to high levels of radiation, such as that produced by the atom bombs dropped in Japan during the Second World War, or by accidents at nuclear power stations, which can increase the risk of developing leukaemia. That is why nuclear power stations have strict safety regulations to protect the workers and the general public from exposure to harmful radiation. On the other hand, the relationship between electromagnetic radiation (mobile phones, telephone and radio masts, etc.) and the development of leukaemia, has never been proven.
Some genetic characteristics might increase the risk of developing leukaemia.. One of these is Down Syndrome. Children born with this syndrome are more susceptible to developing the disease.
Similarly, exposure, over long periods of time, to certain chemical agents such as benzene, could also be a risk factor. Additionally, treatments used to combat other types of cancer might increase the patient's risk of developing leukaemia. However, the risks presented by chemotherapy are minimal in comparison to its benefits.
Scientists have identified a virus that seems to increase the risk of developing a very rare kind of leukaemia, although it would not seem to be associated with the development of more common forms of leukaemia. All over the world, researchers are studying viruses and other possible risk factors. It is hoped that the results of these studies will help us to clarify, and understand more about, the causes of leukaemia, so that we will then be in a better position to decide on the best forms of prevention and treatment.
The never-ending scientific research into leukaemia has lead to the discovery of new and better forms of treatment and the possibility of finding a cure increases all the time. Despite this, it is normal that many patients and their families show concern about the future.
With of the aim of making leukaemia a disease that, one day, will be 100% curable, and with the aim also of improving patients' quality of life, the Josep Carreras Foundation has launched the Josep Carreras Institute for Research against Leukaemia, the first such centre in Spain for research exclusively into malignant blood diseases.
Sometimes, survival rates and other statistics are used to try and determine whether a certain patient might overcome the disease. Nevertheless, it is important to remember that statistics and averages are calculated on the basis of a large number of cases and can not be used to predict the evolution of the disease for a particular patient because no two patients are the same, and responses to treatment can vary enormously from one patient to the next. Percentages can therefore vary from a 90% rate of cure for certain kinds of acute myeloblastic leukaemia (promyelocytic leukaemia) and childhood acute lymphoblastic leukaemia, to less than 20% for leukaemias that appear after a myelodysplastic syndrome or the accelerated phases of chronic myeloid leukaemia. It is the patient's doctor who is in the best position to form an opinion about the prognosis, but it must always be borne in mind that doctors themselves may not know the final outcome.
Doctors often speak of survival and remission rather than of a cure because, although many leukaemia patients are cured, the disorder may reappear up to 4 or 5 years after remission has been achieved.