Monday, March 31, 2008

My husband was diagnosed with CLL in 2000. Everything I've read says that leukemia isn't hereditary. However, he's had two family members die with leukemia, and one die with lymphoma. Wouldn't you say there's got to be a hereditary factor involved here? This makes me worry about my children. Is there any advice you would give me?

I too am strongly concerned about an inherited component to this disease. Unlike other cancers, such as breast or ovary, wherein well-defined inherited cancer syndromes are known, chronic lymphocytic leukemia is less well-studied.

Nonetheless, a visit with a medical geneticist is in order for your family. Even though it is a less well-studied disease, certain subtypes of CLL are associated with genetic abnormalities. A medical geneticist will first take a detailed family history of other diseases, including cancer, and ascertain patterns within your family. These clues will enable him or her to order tests that might pinpoint the abnormal gene.

If a known gene abnormality is discovered, your children might elect to have genetic testing. Alternatively, if no CLL-causing gene abnormality is discovered in your family, your children might choose to have more active surveillance for CLL (or other lymphomas) with blood work or other tests. There is even a possibility that your family might provide the clues to find a new gene associated with CLL!

On the other hand, please bear in mind that while your husband has CLL, your other family members may have had leukemia involving cells other than lymphocytes and that the relative with lymphoma also may have had an unrelated cell type. If those possibilities were true, then there might not be any genetic link among the illnesses. You may want to get more detailed and specific information on the exact types of cancers that these relatives had. That information would also be of help to the medical geneticist you consult.

To find a medical geneticist, I suggest you use an Internet search engine such as Google and put in the words “medical geneticist” and the name of your nearest major city. This should return a number of possibilities.

Learn more in the Everyday Health Leukemia Center.