Six Weeks is a 1982 American drama film directed by Tony Bill and based on the 1976 novel of the same name by Fred Mustard Stewart . It stars Dudley Moore , Mary Tyler Moore , and Katherine Healy .
59-472: Charlotte Dreyfus, a wealthy cosmetic tycoon, and her 12-year-old daughter Nicole (Nicky), who's dying from leukemia , strike up a sentimental friendship with a California politician, Patrick Dalton. Nicole has decided to abandon all further treatments for the disease because of the treatments' side effects. Charlotte is determined to help her daughter achieve various 'bucket list' goals including Nicole's desires to work for Dalton's dark-horse campaign. Dalton, who
118-418: A monoclonal antibody that attacks white blood cells, has been used in treatment with greater success than previous options. Some people who successfully respond to treatment also undergo stem cell transplantation to consolidate the response. Treatment for juvenile myelomonocytic leukemia can include splenectomy , chemotherapy , and bone marrow transplantation . The success of treatment depends on
177-525: A break from Los Angeles, but it's an excuse to create some distance from the ill-fated relationship. Impulsively, Dalton races to the airport and joins them on their vacation—leaving his family behind for the Christmas Holidays. During their time in New York, various events and places are crossed off Nicky's list of lifelong desires. As she reads her list to Dalton, she admits she regrets not having danced in
236-607: A disease affecting one will often affect the others as well, making aplasia , myeloproliferation and lymphoproliferation (and thus the leukemias and the lymphomas ) closely related and often overlapping problems. While uncommon in solid tumors, chromosomal translocations are a common cause of these diseases. This commonly leads to a different approach in diagnosis and treatment of hematological malignancies. Hematological malignancies are malignant neoplasms ("cancer"), and they are generally treated by specialists in hematology and/or oncology . In some centers "hematology/oncology"
295-645: A genetic abnormality called the Philadelphia translocation ; 95% of people with CML carry the Philadelphia mutation, although this is not exclusive to CML and can be observed in people with other types of leukemia. Whether or not non-ionizing radiation causes leukemia has been studied for several decades. The International Agency for Research on Cancer expert working group undertook a detailed review of all data on static and extremely low frequency electromagnetic energy, which occurs naturally and in association with
354-454: A greater risk of leukemia. For example, people with Down syndrome have a significantly increased risk of developing forms of acute leukemia (especially acute myeloid leukemia ), and Fanconi anemia is a risk factor for developing acute myeloid leukemia. Mutation in SPRED1 gene has been associated with a predisposition to childhood leukemia. Inherited bone marrow failure syndromes represent
413-403: A kind of premature aging of the bone marrow. In people with these syndromes and in older adults, mutations associated with clonal hematopoiesis may arise as an adaptive response to a progressively deteriorating hematopoietic niche, i.e., a depleting pool of Hematopoietic stem cells . The mutated stem cells then acquire a self-renewal advantage. Chronic myelogenous leukemia is associated with
472-464: A lack of blood platelets , which are important in the blood clotting process. This means people with leukemia may easily become bruised , bleed excessively, or develop pinprick bleeds ( petechiae ). White blood cells , which are involved in fighting pathogens , may be suppressed or dysfunctional. This could cause the person's immune system to be unable to fight off a simple infection or to start attacking other body cells. Because leukemia prevents
531-592: A major ballet troupe—partially because she dedicated too much time to his campaign. Guilty, the next day Dalton uses his political charm, gets Nicky a "try out" at the New York Metropolitan Ballet . The Ballet director, skeptical at first, admits that Nicky has professional potential and agrees to quickly train her for a full-dress rehearsal, stand-in part of the Nutcracker . Treating it as opening night, Dalton and Charlotte go to Lincoln Center . Before
590-505: A more advanced, uncontrolled state, when the person cannot tolerate imatinib, or if the person wishes to attempt a permanent cure, then an allogeneic bone marrow transplantation may be performed. This procedure involves high-dose chemotherapy and radiation followed by infusion of bone marrow from a compatible donor. Approximately 30% of people die from this procedure. Decision to treat People with hairy cell leukemia who are symptom-free typically do not receive immediate treatment. Treatment
649-513: A multi-drug chemotherapy regimen . Some are also treated with radiation therapy . In some cases, a bone marrow transplant is effective. Management of ALL is directed towards control of bone marrow and systemic (whole-body) disease. Additionally, treatment must prevent leukemic cells from spreading to other sites, particularly the central nervous system (CNS); periodic lumbar punctures are used for diagnostic purposes and to administer intrathecal prophylactic methotrexate. In general, ALL treatment
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#1732855324922708-519: A number of less common types. Leukemias and lymphomas both belong to a broader group of tumors that affect the blood, bone marrow, and lymphoid system , known as tumors of the hematopoietic and lymphoid tissues . Treatment may involve some combination of chemotherapy , radiation therapy , targeted therapy , and bone marrow transplant , with supportive and palliative care provided as needed. Certain types of leukemia may be managed with watchful waiting . The success of treatment depends on
767-565: A person is generally followed up at regular intervals to detect recurrence and monitor for "secondary malignancy" (an uncommon side-effect of some chemotherapy and radiotherapy regimens—the appearance of another form of cancer ). In the follow-up, which should be done at pre-determined regular intervals, general anamnesis is combined with complete blood count and determination of lactate dehydrogenase or thymidine kinase in serum. Hematological malignancies as well as their treatments are associated with complications affecting many organs, with
826-531: A positive correlation between exposure to formaldehyde and the development of leukemia, particularly myeloid leukemia . The different leukemias likely have different causes. Leukemia, like other cancers, results from mutations in the DNA . Certain mutations can trigger leukemia by activating oncogenes or deactivating tumor suppressor genes , and thereby disrupting the regulation of cell death, differentiation or division. These mutations may occur spontaneously or as
885-413: A result of brain stem pressure. All symptoms associated with leukemia can be attributed to other diseases. Consequently, leukemia is always diagnosed through medical tests . The word leukemia , which means 'white blood', is derived from the characteristic high white blood cell count that presents in most affected people before treatment. The high number of white blood cells is apparent when a blood sample
944-465: A result of exposure to radiation or carcinogenic substances. Among adults, the known causes are natural and artificial ionizing radiation and petrochemicals, notably benzene and alkylating chemotherapy agents for previous malignancies. Use of tobacco is associated with a small increase in the risk of developing acute myeloid leukemia in adults. Cohort and case-control studies have linked exposure to some petrochemicals and hair dyes to
1003-413: A simple injection under the skin, or six months of pentostatin , given every four weeks by intravenous infusion. In most cases, one round of treatment will produce a prolonged remission. Other treatments include rituximab infusion or self-injection with Interferon-alpha . In limited cases, the person may benefit from splenectomy (removal of the spleen ). These treatments are not typically given as
1062-470: A total of four main categories. Within each of these main categories, there are typically several subcategories. Finally, some rarer types are usually considered to be outside of this classification scheme. The most common symptoms in children are easy bruising , pale skin , fever , and an enlarged spleen or liver . Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in
1121-482: Is viewed under a microscope , with the extra white blood cells frequently being immature or dysfunctional. The excessive number of cells can also interfere with the level of other cells, causing further harmful imbalance in the blood count. Some people diagnosed with leukemia do not have high white blood cell counts visible during a regular blood count. This less-common condition is called aleukemia . The bone marrow still contains cancerous white blood cells that disrupt
1180-538: Is a single subspecialty of internal medicine while in others they are considered separate divisions (there are also surgical and radiation oncologists). Not all hematological disorders are malignant ("cancerous"); these other blood conditions may also be managed by a hematologist. Hematological malignancies may derive from either of the two major blood cell lineages : myeloid and lymphoid cell lines. The myeloid cell line normally produces granulocytes , erythrocytes , thrombocytes , macrophages and mast cells ;
1239-536: Is acute or chronic, the specific abnormal white blood cell type, the presence and severity of anemia or thrombocytopenia , the degree of tissue abnormality, the presence of metastasis and lymph node and bone marrow infiltration, the availability of therapies and the skills of the health care team. Treatment outcomes may be better when people are treated at larger centers with greater experience. In 2010, globally, approximately 281,500 people died of leukemia. In 2000, approximately 256,000 children and adults around
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#17328553249221298-435: Is demonstrated by family histories and twin studies . The affected people may have a single gene or multiple genes in common. In some cases, families tend to develop the same kinds of leukemia as other members; in other families, affected people may develop different forms of leukemia or related blood cancers . In addition to these genetic issues, people with chromosomal abnormalities or certain other genetic conditions have
1357-673: Is directed towards suppressing the disease for many years, rather than curing it. The primary chemotherapeutic plan is combination chemotherapy with chlorambucil or cyclophosphamide , plus a corticosteroid such as prednisone or prednisolone . The use of a corticosteroid has the additional benefit of suppressing some related autoimmune diseases, such as immunohemolytic anemia or immune-mediated thrombocytopenia . In resistant cases, single-agent treatments with nucleoside drugs such as fludarabine , pentostatin , or cladribine may be successful. Younger and healthier people may choose allogeneic or autologous bone marrow transplantation in
1416-433: Is divided into several phases: Hematologists base CLL treatment on both the stage and symptoms of the individual person. A large group of people with CLL have low-grade disease, which does not benefit from treatment. Individuals with CLL-related complications or more advanced disease often benefit from treatment. In general, the indications for treatment are: Most CLL cases are incurable by present treatments, so treatment
1475-444: Is generally considered necessary when the person shows signs and symptoms such as low blood cell counts (e.g., infection-fighting neutrophil count below 1.0 K/μL), frequent infections, unexplained bruises, anemia, or fatigue that is significant enough to disrupt the person's everyday life. Typical treatment approach People who need treatment usually receive either one week of cladribine , given daily by intravenous infusion or
1534-470: Is initially taken aback by Charlotte's generous campaign donation, allows Nicky to help at the campaign office after she alludes to Nicky having a terminal illness. Dalton, the mother, and daughter slowly grow closer over the short period of time and while watching Nicky practicing her ballet, Dalton confronts Nicky about her illness. Initially angry, Nicky admits to having leukemia after Dalton admits that he has secrets as well-including an extramarital affair in
1593-441: Is still questionable whether phototherapy is genuinely the cause of cancer or simply a result of the same underlying factors that gave rise to cancer. Large doses of Sr-90 (called a bone seeking radioisotope) from nuclear reactor accidents, increases the risk of bone cancer and leukemia in animals and is presumed to do so in people. Some people have a genetic predisposition towards developing leukemia. This predisposition
1652-522: Is uncommon. Despite the use of these methods to diagnose whether or not a person has leukemia, many people have not been diagnosed because many of the symptoms are vague, non-specific , and can refer to other diseases. For this reason, the American Cancer Society estimates that at least one-fifth of the people with leukemia have not yet been diagnosed. Most forms of leukemia are treated with pharmaceutical medication , typically combined into
1711-505: Is unknown. A combination of genetic factors and environmental (non-inherited) factors are believed to play a role. Risk factors include smoking , ionizing radiation , petrochemicals (such as benzene ), prior chemotherapy, and Down syndrome . People with a family history of leukemia are also at higher risk. There are four main types of leukemia— acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML)—and
1770-441: The bone marrow and produce high numbers of abnormal blood cells . These blood cells are not fully developed and are called blasts or leukemia cells . Symptoms may include bleeding and bruising , bone pain , fatigue , fever , and an increased risk of infections. These symptoms occur due to a lack of normal blood cells . Diagnosis is typically made by blood tests or bone marrow biopsy . The exact cause of leukemia
1829-438: The cancer is unlikely to return . In 2015, leukemia was present in 2.3 million people worldwide and caused 353,500 deaths. In 2012, it had newly developed in 352,000 people. It is the most common type of cancer in children, with three-quarters of leukemia cases in children being the acute lymphoblastic type. However, over 90% of all leukemias are diagnosed in adults, CLL and AML being most common. It occurs more commonly in
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1888-400: The developed world . Blood cancer Tumors of the hematopoietic and lymphoid tissues ( American English ) or tumours of the haematopoietic and lymphoid tissues ( British English ) are tumors that affect the blood , bone marrow , lymph , and lymphatic system . Because these tissues are all intimately connected through both the circulatory system and the immune system ,
1947-439: The developed world . Clinically and pathologically, leukemia is subdivided into a variety of large groups. The first division is between its acute and chronic forms: Additionally, the diseases are subdivided according to which kind of blood cell is affected. This divides leukemias into lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias : Combining these two classifications provides
2006-555: The United States 4th Edition NOS = "Not otherwise specified" Treatment can occasionally consist of "watchful waiting" (e.g., in CLL ) or symptomatic treatment (e.g., blood transfusions in MDS ). The more aggressive forms of disease require treatment with chemotherapy , radiotherapy , immunotherapy and—in some cases—a bone marrow transplant . The use of rituximab has been established for
2065-440: The analysis of a suspected hematological malignancy , a complete blood count and blood film are essential, as malignant cells can show in characteristic ways on light microscopy . When there is lymphadenopathy , a biopsy from a lymph node is generally undertaken surgically . In general, a bone marrow biopsy is part of the "work up" for the analysis of these diseases. All specimens are examined microscopically to determine
2124-412: The degree of liver and kidney damage or the effects of chemotherapy on the person. When concerns arise about other damages due to leukemia, doctors may use an X-ray , MRI , or ultrasound . These can potentially show leukemia's effects on such body parts as bones (X-ray), the brain (MRI), or the kidneys, spleen, and liver (ultrasound). CT scans can be used to check lymph nodes in the chest, though this
2183-406: The development of some forms of leukemia. Diet has very limited or no effect, although eating more vegetables may confer a small protective benefit. Viruses have also been linked to some forms of leukemia. For example, human T-lymphotropic virus (HTLV-1) causes adult T-cell leukemia . A few cases of maternal-fetal transmission (a baby acquires leukemia because its mother had leukemia during
2242-855: The first treatment because their success rates are lower than cladribine or pentostatin. Most people with T-cell prolymphocytic leukemia, a rare and aggressive leukemia with a median survival of less than one year, require immediate treatment. T-cell prolymphocytic leukemia is difficult to treat, and it does not respond to most available chemotherapeutic drugs. Many different treatments have been attempted, with limited success in certain people: purine analogues (pentostatin, fludarabine, cladribine), chlorambucil , and various forms of combination chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone CHOP , cyclophosphamide, vincristine, prednisone [COP], vincristine, doxorubicin, prednisone, etoposide, cyclophosphamide, bleomycin VAPEC-B ). Alemtuzumab (Campath),
2301-635: The generation, transmission, and use of electrical power. They concluded that there is limited evidence that high levels of ELF magnetic (but not electric) fields might cause some cases of childhood leukemia . No evidence for a relationship to leukemia or another form of malignancy in adults has been demonstrated. Since exposure to such levels of ELFs is relatively uncommon, the World Health Organization concludes that ELF exposure, if later proven to be causative, would account for just 100 to 2400 cases worldwide each year, representing 0.2 to 4.9% of
2360-445: The hope of a permanent cure. Many different anti-cancer drugs are effective for the treatment of AML. Treatments vary somewhat according to the age of the person and according to the specific subtype of AML. Overall, the strategy is to control bone marrow and systemic (whole-body) disease, while offering specific treatment for the central nervous system (CNS), if involved. In general, most oncologists rely on combinations of drugs for
2419-573: The hospital but she passes away en route. The final scene is Dalton taking Charlotte to the airport, where she plans to mourn in a family vacation spot in France. She walks away, hesitates, and then continues. The epilogue has Dalton writing to Charlotte saying that his campaign was successful and don't forget to "write your Congressman." Golden Globe -nominated actress and ballet dancer Anne Ditchburn choreographed Healy's dance scenes, as well as appearing on camera as an assistant choreographer. Six Weeks
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2478-410: The immune system from working normally, some people experience frequent infection , ranging from infected tonsils , sores in the mouth , or diarrhea to life-threatening pneumonia or opportunistic infections . Finally, the red blood cell deficiency leads to anemia , which may cause dyspnea and pallor . Some people experience other symptoms, such as fevers, chills, night sweats, weakness in
2537-425: The induction phase. There are many possible treatments for CML, but the standard of care for newly diagnosed people is imatinib (Gleevec) therapy. Compared to most anti-cancer drugs, it has relatively few side effects and can be taken orally at home. With this drug, more than 90% of people will be able to keep the disease in check for at least five years, so that CML becomes a chronic, manageable condition. In
2596-495: The initial, induction phase of chemotherapy. Such combination chemotherapy usually offers the benefits of early remission and a lower risk of disease resistance. Consolidation and maintenance treatments are intended to prevent disease recurrence. Consolidation treatment often entails a repetition of induction chemotherapy or the intensification of chemotherapy with additional drugs. By contrast, maintenance treatment involves drug doses that are lower than those administered during
2655-560: The limbs, feeling fatigued and other common flu-like symptoms . Some people experience nausea or a feeling of fullness due to an enlarged liver and spleen ; this can result in unintentional weight loss . Blasts affected by the disease may come together and become swollen in the liver or in the lymph nodes causing pain and leading to nausea. If the leukemic cells invade the central nervous system , then neurological symptoms (notably headaches ) can occur. Uncommon neurological symptoms like migraines , seizures , or coma can occur as
2714-572: The lungs being frequently affected. Chromosomal translocations are a major etiologic factor in hematologic malignancies. Such translocations usually arise in cells as the result of aberrant DNA double-strand break repair by an imprecise processes such as non-homologous end joining . Chromosome instability in chronic myeloid leukemia may be due to oxidative damage to DNA along with impairments of genetic surveillance leading to imprecise error prone DNA repair. Taken together, haematological malignancies account for 9.5% of new cancer diagnoses in
2773-499: The lymphoid cell line produces B , T , NK and plasma cells . Lymphomas, lymphocytic leukemias, and myeloma are from the lymphoid line, while acute and chronic myelogenous leukemia, myelodysplastic syndromes and myeloproliferative diseases are myeloid in origin. A subgroup of them are more severe and are known as haematological malignancies ( British English )/ hematological malignancies ( American English ) or blood cancer . They may also be referred to as liquid tumors . For
2832-575: The main dance scene of Clara and the Prince, Nicky slips into position and takes over as understudy. She has a triumphant performance in front of the rehearsal crowd and is again able to cross off another item from her wish list. On the way back to the hotel, Nicky says she has never been on the NYC Subway. Enjoying the ride, Nicky suddenly is overcome with pain and collapses of an acute stroke due to complications from leukemia. Dalton and Charlotte accompany her to
2891-416: The nature of the malignancy. A number of these diseases can now be classified by cytogenetics (AML, CML) or immunophenotyping (lymphoma, myeloma, CLL) of the malignant cells. Historically, hematological malignancies have been most commonly divided by whether the malignancy is mainly located in the blood ( leukemia ) or in lymph nodes ( lymphomas ). Relative proportions of hematological malignancies in
2950-403: The normal production of blood cells, but they remain in the marrow instead of entering the bloodstream, where they would be visible in a blood test. For a person with aleukemia, the white blood cell counts in the bloodstream can be normal or low. Aleukemia can occur in any of the four major types of leukemia, and is particularly common in hairy cell leukemia . Studies in 2009 and 2010 have shown
3009-627: The past. Much to the consternation of Dalton's wife, he develops more attachment to Charlotte and Nicole. She confronts him about having to share him with a second family. Meanwhile, Nicky has grown attached to Dalton as a father figure and has secret ambitions of Dalton and her mother developing more than a friendship. Swept up in Nicky's charm and terminal wishes, Dalton and Charlotte do admit to their mutual feelings for each other over dinner but agree to not take it any further so as to protect his wife and son. Charlotte decides to take Nicky to New York City as
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#17328553249223068-464: The pregnancy) have been reported. Children born to mothers who use fertility drugs to induce ovulation are more than twice as likely to develop leukemia during their childhoods than other children. In a recent systematic review and meta-analysis of any type of leukemia in neonates using phototherapy , typically to treat neonatal jaundice , a statistically significant association was detected between using phototherapy and myeloid leukemia. However, it
3127-536: The total incidence of childhood leukemia for that year (about 0.03 to 0.9% of all leukemias). Diagnosis is usually based on repeated complete blood counts and a bone marrow examination following observations of the symptoms. Sometimes, blood tests may not show that a person has leukemia, especially in the early stages of the disease or during remission. A lymph node biopsy can be performed to diagnose certain types of leukemia in certain situations. Following diagnosis, blood chemistry tests can be used to determine
3186-451: The treatment of B-cell–derived hematologic malignancies, including follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL). In addition to cure-directed treatment, people can benefit from self-care to manage symptoms. For example, aerobic exercise, such as walking , can reduce fatigue and feelings of depression in people with hematological malignancies. If treatment has been successful ("complete" or "partial remission"),
3245-408: The type of leukemia and the age of the person. Outcomes have improved in the developed world. Five-year survival rate was 67% in the United States in the period from 2014 to 2020. In children under 15 in first-world countries, the five-year survival rate is greater than 60% or even 90%, depending on the type of leukemia. In children who are cancer-free five years after diagnosis of acute leukemia,
3304-410: The type of leukemia and the age of the person. Outcomes have improved in the developed world. The average five-year survival rate is 65% in the United States. In children under 15, the five-year survival rate is greater (60 to 85%), depending on the type of leukemia. In children with acute leukemia who are cancer-free after five years, the cancer is unlikely to return. Outcomes depend on whether it
3363-401: The world developed a form of leukemia, and 209,000 died from it. This represents about 3% of the almost seven million deaths due to cancer that year, and about 0.35% of all deaths from any cause. Of the sixteen separate sites the body compared, leukemia was the 12th most common class of neoplastic disease and the 11th most common cause of cancer-related death. Leukemia occurs more commonly in
3422-437: The worst films of 1982. Gene Siskel however, liked the film, praising the performances from the leads and its go-for-broke sentiment. Ebert later related a story in which Siskel admitted that his review was influenced by his wife's pregnancy. Leukemia Leukemia ( also spelled leukaemia ; pronounced / l uː ˈ k iː m iː ə / loo- KEE -mee-ə ) is a group of blood cancers that usually begin in
3481-447: Was released on December 17, 1982, in the United States, where it opened in tenth place and grossed $ 6.7 million. The film was nominated for two Golden Globe Awards , one for Dudley Moore for Best Score and one for Katherine Healy as Best New Female Star of the Year. However, Mary Tyler Moore's performance earned a Razzie Award nomination for Worst Actress. Roger Ebert later named it one of
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