Benzene

Since the 1920s, medical experts have been publicizing the relationship between benzene and leukemia. By the 1930s, workers exposed to benzene in the printing industry were known to be at risk for blood disease. In the 1940s, an American Petroleum Institute study cautioned that no “safe” level of benzene exposure exists. Yet still, in the decades since then, untold numbers of workers have been exposed in the workplace to dangerous levels of benzene.

Those at the greatest risk for benzene-related illnesses are workers exposed every day to the benzene contained in fuels, solvents and other products. Workers likely to have experienced prolonged exposure include chemical and petroleum industry workers, printers, painters, mechanics, railroad workers, rubber workers, seamen and many others.

Most workers exposed to benzene inhale the dangerous toxin. But workers can also suffer significant exposure when they get solvents or fuels on their hands. Benzene is particularly dangerous because it can take years from the time workers are exposed before they develop any symptoms of benzene-related blood cancers.

Benzene exposure causes a great number of health problems. When exposure is sudden and acute, it can cause anything from drowsiness to death. But when benzene exposure is chronic at lower levels, it more often leads over time to the development of blood-related illnesses. Two conditions that have been most closely linked to the toxic substance are acute myeloid leukemia (AML) and myelodysplastic syndrome.

Benzene-Related Acute Myeloid (or Myelogenous) Leukemia (AML)

Acute myeloid leukemia attacks bone tissue involved in the formation of blood cells.

AML Symptoms

In the early stages, AML’s symptoms are similar to flu symptoms:

• Aching bones
• Bleeding from the gums or nosebleeds
• Bruising easily
• Fatigue
• Fever
• Repeated infections
• Pale skin and
• Shortness of breath.

AML progresses quickly if not treated, so if you are experiencing these symptoms and you’ve had benzene exposure, get in touch with your doctor as soon as possible.

AML Diagnosis
Your doctor will conduct several tests to learn the cause of your symptoms:

• Blood tests, which if positive for AML will show the presence of more white blood cells than normal along with fewer red blood cells and platelets;
• Bone marrow biopsy, in which the doctor extracts a bone marrow sample from the hipbone for testing; and
• Lumbar puncture (spinal tap), which removes fluid through a needle in the lower back to look for leukemia cells.

If the doctor diagnoses AML, you will likely see a specialist — an oncologist, who treats cancer patients, or a hematologist, who treats blood-related diseases — who will decide upon treatment options.

AML Treatment
AML treatment depends on the type of disease and the extent to which it has progressed as well as your age and overall health. For most people, treatment involves two phases:

• Remission Induction Therapy. Traditional AML treatment’s first phase aims to destroy as many cancer cells as possible. The treatment usually involves chemotherapy, though some forms of AML also respond well to a combination of chemotherapy and other anti-cancer drugs.
• Maintenance Therapy. Because remission induction therapy usually does not kill off all the cancer cells, AML treatment also includes maintenance therapy (also called consolidation or post-remission therapy or intensification). Maintenance therapy often relies on further chemotherapy. Recently diagnosed AML patients may also receive a stem cell, or bone marrow, transplant either from a compatible donor (allogeneic transplant) or from the patient’s own healthy stem cells harvested during remission (autologous transplant).

For some patients, doctors recommend participation in an AML clinical trial studying an alternative, experimental therapy instead of the traditional AML treatment.

Myelodysplastic Syndrome (MDS)
Myelodysplastic syndromes are a group of blood conditions involving a problem in the bone marrow, causing it to make dysfunctional or immature blood cells that either die before they ever leave the bone marrow or soon after they enter the bloodstream.

MDS Symptoms
MDS symptoms, which usually appear only at the later stages of the disease, include:

• Excessive bleeding and/or bruising;
• Fatigue;
• Infections;
• Pale skin;
• Red pindots just beneath the skin (petechiae); and
• Shortness of breath.

MDS Diagnosis
Tests that confirm the presence of MDS commonly include some or all of the following:

• Complete blood count, which tallies the number of blood cells contained in a blood sample;
• Peripheral blood smear, which is examined for abnormalities in blood cells’ appearance, shape or size; and
• Bone marrow biopsy, which withdraws bone marrow and a sliver of bone through a thin needle inserted into the hipbone to examine the material for abnormalities.

MDS Treatments
Doctors are still working on a cure for myelodysplastic syndromes. Treatments to manage MDS symptoms and complications include:

• Growth factor medications. These may increase the number of the body’s red blood cells, which could reduce the need for blood transfusions. Other growth factors boost white blood cell production which helps prevent infection.
• Medications to stimulate cell maturity. These may help blood cells grow to maturity, which improves quality of life and may help to delay development of acute myelogenous leukemia (AML).
• Medications to suppress the immune system.
• Medications to prevent the need for blood transfusions.
• Bone marrow/stem cell transplant. This procedure is risk-prone for the older patients who usually develop MDS. It replaces dysfunctional bone marrow cells with healthy cells from a compatible donor (allogeneic transplant) or from the patient’s own healthy stem cells harvested during remission (autologous transplant).
• Healthy living. MDS patients benefit by developing habits to prevent infection, such as frequent hand-washing, thoroughly washing and cooking food and staying away from people who are sick.