Bio Factsheet

www.curriculum-press.co.uk Number 293

Synoptic Biology: Causes & treatment of leukaemia

Leukaemia is a common synoptic exam question because it allows the Treatment
examiners to test your understanding of several areas of Biology: Cancer may be treated by chemotherapy – drugs that kill cancer cells but
• Stem cells that are not meant to have any affect on normal healthy cells. The problem
is that cancer cells develop from healthy cells and, consequently, they are
• Cell cycle similar in many ways.
• Inheritance Fig.2 shows the expected effects of a cycle of chemotherapy.
• Enzyme function
• Transplants Fig.2: Effects of chemotherapy
• Chemotherapy and radiotherapy
• Epidemiology Chemotherapy drug given

This Factsheet will focus on myeloid leukaemia but the general principles
apply to all cancers.
Cause
Leukaemia is cancer of the white blood cells and bone marrow but
because white blood cells are found in the lymph nodes and spleen it can No. of
affect them as well. cells Healthy
Blood cells are made in the bone marrow and begin as stem cells that then cells
develop into the various types of blood cell (Fig.1).
Cancer
cells
Fig.1: How blood cells are created

Time

Repeated doses of the drug are necessary to stop the cancer cells
redeveloping and this usually results in a net loss of healthy cells too.
Fig.3 shows the results of giving patients different doses of a
chemotherapy drug.

Fig.3: Effect of chemotherapy dose on cancerous and

healthy cells

The unspecialised stem cells are pluripotent, meaning that they are able
to divide repeatedly by mitosis and then differentiate into all the cells of % of
the blood and immune system. cells Tumour Healthy
killed cells cells
However, in acute myeloid leukaemia (AML), the most common type of
leukaemia in adults, the affected bone marrow begins to release a large
number of immature granulocytes or monocytes. These immature blood
cells cannot function properly. As a result, the body is unable to effectively
combat bacteria and viruses and the body does not have sufficient red
blood cells (rbc) or platelets.
0 10 20 30 40 50 60 70 80 90 100
Q. Symptoms of AML include tiredness and excessive Dose of drug/mg
bleeding. Explain why.
platelets  
 

   

clotting
Q. Suggest the dose of this drug that should be used to
rbc   oxygen to tissues   rate of respiration   ATP production
 

treat a patient with a tumour.

  = leads to = decreased KEY:
 

of cancer cells but had less/little effect on healthy cells.

A. A. Hopefully you chose a value e.g. 50 that killed a high proportion

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293 Synoptic Biology: Causes & treatment of leukaemia Bio Factsheet
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Developing drugs against leukaemia Monoclonal antibodies

Scientists use their knowledge of how molecules interact to develop anti- Monoclonal antibodies have been developed that bind only to an antigen
cancer drugs. on myeloid leukaemia cells. They have a complementary shape to this
Normally, the protein BH3 combines with bcl-2 protein to prevent un- antigen and cannot attach to any other. Thus, by attaching drugs that are
controlled cell production. Cancer patients have very low levels of BH3 toxic to cells to these monoclonal antibodies the cancerous cells can be
protein in their cells. Fig.4 shows the structure of bcl-2 and the structure destroyed without harming healthy cells.
of four new drugs designed to mimic the action of BH3. Stem cells
Patients with diseased bone marrow can be treated with transplanted
Fig. 4: bcl-2 and BH3 mimics healthy bone marrow, obtained either from the individual themselves or
from other people. Before a patient receives chemotherapy, healthy stem
cells are removed and stored. Such stem cells could be removed from the
umbilical cord of every baby at birth and stored as insurance just in case
the individual suffers damage to their bone marrow in later life. This
bcl-2 approach has advantages and disadvantages:
Advantages:
Stem cells are unspecialized / are able to differentiate into any other cells
Stem cells present no immune response problems
May be possible to develop organs for transplants from them
Disadvantages:
There is limited storage capacity
The viability of the cells may decrease the longer they are stored
drug 1 drug 2
The cells may mutate
Studying the incidence of leukaemia
Scientists in Switzerland investigated claims that children living close to
nuclear facilities were more at risk of developing leukaemia. They
compared the rate of leukaemia in children living close to nuclear power
plants, research reactors and nuclear waste storage sites with the rate in
drug 3 drug 4 children living further away from such sites. They compared the rates by
calculating a ratio. Fig.6 shows the results. A ratio greater than 1 indicates
a higher chance of being diagnosed with leukaemia compared with
children living far away.

Q. Suggest which chemical is likely to be the most Fig. 6: Ratio of rates of leukaemia at different distances
successful in combining with bcl-2. from nuclear facilities
Nuclear power
precisely with bcl-2. Nuclear Other nuclear plant planned
power plant facilities but not built
Hopefully, you identified drug 3 – its shape enables it to combine Leukaemia
in 0-4 year
A. olds
0-5km
5-10km
10-15km
Recently, scientists have developed a fifth mimic of BH3 which has been Leukaemia
in 0-15 year
more effective than any previous drug. This is shown in Fig.5. olds
0-5km
5-10km
Fig. 5: Fifth mimic of BH3 10-15km

0.3 0.5 0.7 1 1.5 2 3 0.3 0.5 0.7 1 1.5 2 3 0.3 0.5 0.7 1 1.5 2 3
incidence rate ratio incidence rate ratio incidence rate ratio

drug 5 Q. Do the data in Fig.5 provide evidence of a link

between the rate of leukaemia and the distance of
a child’s home from a nuclear facility?
Q. Why might this drug be more successful than the been built.
Leukaemia rates can be higher even when no nuclear facility has •
earlier versions?
distance
• It may have fewer side effects Rate does not increase with proximity/decrease with increasing •
• It may enter cancerous cells more easily The error bars overlap in each case •
• It may provide binding sites for other drugs or enzymes nuclear facility and the rate of leukaemia
There are several possible reasons: The data provide no evidence of a link between proximity to a •
A. A.

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