Question

3. Read the paragraph below (Adapted from the Emperor of all Maladies by Sidddhartha Mukherjee)

Childhood Acute Lymphoblastic Leukemia (ALL) is a type of cancer where the bone marrow makes too many immature white blood cells (lymphocytes). This type of leukemia can effect red blood cells, white blood cells and platelets. It was one of the earliest non-solid (non-tumorous) cancers targeted for a cancer cure. Chemotherapy was the choice of treatment. After several tries, physicians discovered that certain synthetic organic chemicals could in fact send a patient into remission (no cancer detected in the blood). However, these remissions were short lived, as the young patients would relapse and return to their doctors with an even more aggressive form of ALL. Scientists discovered that the new aggressive cancer originated from the brain or nervous system. They discovered that the chemotherapeutic drugs did not reach the brain and accessory nervous system.

• Explain why you think the chemotherapeutic drugs could not enter the brain. (Hint think about cell to cell associations).
• If you were an oncologist at that time, how would you recommend treatment for a patient with childhood ALL? How would you make sure that chemotherapeutic drugs reached the entire body of the patient?

Answer 1

• Chemotherapeutic drugs can not reach brain because of presence of blood brain barrier (BBB) Which is not allowing chemo drugs to enter in brain.

Blood brain barrier is a natural filter between blood and brain which prevents Brain from harmful drugs.

• Treatment of childhood ALL is-

Intrathecal or systemic chemotherapy is used in treatment

Radiation therapy is should be used for brain and in some cases stem cell therapy can be done.