When Alison Spodek was diagnosed with acute myeloid leukemia in 2013, she did what many new cancer patients do: wondered when the first potentially deadly mutation took place in her body. But as an environmental chemist, Spodek may have had more insight than most. "Maybe the first mutation occurred when I was 2 years old, wearing footie pajamas soaked in flame retardant, as was the norm in the mid 1970s," she writes at Nautilus. Or was it somehow related to her grandmother's work in the family's old dry-cleaning shop? Or maybe it happened when she was "careless with a solvent" as a college student in lab. The answer is unknowable, but she notes that advances since her diagnosis have shed some light.
Scientists have shown that her particular type of leukemia is not passed down from a parent or earlier generation—thus her "dry-cleaning ancestors (are) off the hook." Instead, the chain of events appears to have started within her own body, probably when she was a child. Her type of cancer "begins with a mutation in one of the hematopoietic stem cells, decades before illness," she explains. "Slowly, over these decades, some perverse version of survival of the fittest means that the clones of this stem cell overtake the bone marrow, and all the blood formed thereafter shares that mutation."
The good news in all this is that after a hematopoietic stem cell transplant, Spodek is now considered cured. She recounts her treatment—the transplant involving chemo is "brutal"—and notes that, for the time being, "nothing works as well as wiping the marrow clean and bringing in a new army of cells from another person." She doesn't expect that to change anytime soon. "No matter how much genetic knowledge we gain, we still need each other." (Read the full essay.)
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