LEUKEMIA

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia; it may account for approximately 10% of all leukemias. The problems associated with leukemia depend on the stage of the disease present at the time of diagnosis, often made by chance on a routine blood count.
Complications include anemia, low platelets and low white blood cell count.

A favorable response can be expected in most individuals treated with chemotherapy, radiation or both.

Acute leukemia accounts for 10% of all human cancers, and it is the leading cause of cancer deaths in adults younger than 35 years old. There are two main types: acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL). The cause of acute leukemia remains unknown. Treatment is usually by cytotoxic agents and/or by bone marrow transplantation.

Individuals with leukemia are very sensitive to infections because of their low white blood cell count. Unfortunately, for adults, the response to treatment is not good as with children with the same disease. Several adjunctive measures are useful to treat the diseases associated with leukemia: antibiotics and antifungal agents; blood cell growth factors; and blood transfusions, which may raise red cell and platelet counts.

Fitness and Diving:
The leukemias, whether acute or chronic, are serious diseases that result in a limited lifespan. CLL patients may require no treatment and can do relatively well so they should be assessed on a case-by-case basis. Treatments have improved dramatically in recent years. However, unless acute leukemia is in full remission and exercise tolerance is acceptable, scuba diving is not recommended. The side effects of cytotoxic drugs and radiation treatments and other problems associated with the leukemia make continuation of diving - or its commencement - unwise.

Other factors to be considered include: (1) complications of the original disease; (2) the effects and complications of secondary diseases such as pneumonia; and (3) the effects of treatment.

Medication used in treatment:
Cytotoxic drugs, blood transfusions, radiation therapy.

Additional Information:
Leukemia Society of America-www.leukemia.org/
International Bone Marrow Transplant Information-www.bmtinfo.org

(Guy De Lisle Dear MD, Alert Diver, Sept-Oct 1999.)