Leukemia

Overview

Leukemia is a form of cancer that affects the blood and bone marrow. The condition is similar to other types of cancer and results when mutated bone marrow cells replicate uncontrollably. Beginning with one cell, the leukemia cells will multiply and crowd out the healthy cells in the body.

With acute leukemia, the immature blood cells with replicate and inhibit healthy blood cells. This type of cancer progresses quickly, and the malignant cells will rapidly attack other organs in the body by traveling through the bloodstream. Children with leukemia tend to suffer from acute forms. This type of leukemia requires immediate and aggressive treatment.

Chronic leukemia causes mature red blood cells to replicate uncontrollably. This process occurs more slowly than with acute leukemia and can take months or years to progress and cause damage. Unlike acute leukemia, chronic leukemia can be treated slowly. The condition can affect people of all age groups but is most common among older adults.

Even though there is no cure for leukemia, extensive research is helping to create effective treatment options. Through a combination of radiation and chemotherapy, many leukemia patients have been able experience periods of remission and recover completely. In many situations, the condition can be fatal; however, treatment options are available.

Types

The four categories of leukemia include:

• Acute myelogenous leukemia (AML) results from bone marrow cell changes that are caused by risk factors that include exposure to benzene or radiation. It is possible to develop AML even without exposure to agents and environmental conditions that are linked with cancer.
• Acute lymphocytic leukemia (ALL) begins with a change in the bone marrow cells and is the most common type of leukemia affecting children under 15 years of age. In some cases, children can be treated successfully and cured of ALL.
• Chronic myelogenous leukemia (CML) occurs because of changes to the stem cells and is more common in adults than children.
• Chronic lymphocytic leukemia (CLL) results from changes in the lymphocytes, which are cells in bone marrow and lymph nodes.

Symptoms

Symptoms of acute leukemia generally include fatigue, shortness of breath, night sweats, paleness of skin or gums, tiny red blood spots under the skin, skin bruising, mild fever, and aching joints and bones.

Chronic leukemia may be asymptomatic for a long period of time since the disease progresses slowly. Usually, the first sign of chronic leukemia is an enlarged lymph node. People with chronic leukemia also feel tired, short of breath, and pain on the left side of the lower abdomen caused by an enlarged spleen. Unexplained weight loss and night sweats commonly occur as a result of the disease. In many situations, medical professionals diagnose leukemia while checking for other health disorders.

Causes/Risk Factors

Leukemia results from genetic mutations that cause abnormal and accelerated cell division. These cancer cells continue to accumulate and inhibit healthy cell production. Eventually, the cancer cells travel through the blood stream and affect the other organs, causing tumor growth and damage.

The precise causes of leukemia are unknown, and the condition can affect people of all ages. People with Down syndrome have a higher risk of developing leukemia. Exposure to secondhand smoke, benzene, natural and artificial ionizing radiation may cause leukemia.

In some cases, leukemia can occur as a secondary cancer that is caused by radiation or chemotherapy treatments for primary cancer.

Tests/Diagnosis

A complete blood count (CBC) test is the first level of diagnostic testing for leukemia. For this test, a lab will analyze a sample blood and count the white blood cells, red blood cells, and platelets. A sample with a high level of white blood cells and low levels of red blood cells can indicate leukemia.

Using flow cytometry, the doctor can examine the sample in a higher level of detail for a more accurate diagnosis.

If leukemia is a possibility, the doctor may perform a bone marrow biopsy to confirm whether the cells have been affected. During a bone marrow biopsy, the doctor will insert a needle into the patient to obtain a sample of bone and bone marrow. A patient might require sedation for this test.

Other tests include spinal taps, where a doctor takes a sample of spinal fluid using a needle, and cytogenetics, which examines chromosomes in cells.

A doctor may perform a series of X-rays, MRIs, and CT scans in order to visually examine the bones and organs to check for tumor growth and other abnormalities.

Treatments

Treatment plans are individualized to the needs of the patient and the extent of the disease. Important factors include the patient's age, general health, family medical history, and past cancer diagnoses.

In most situations, therapy involves a combination of chemotherapy and radiation. Especially with acute leukemia, patients need aggressive treatment as soon as possible. In many cases, bone marrow transplants are relatively successful. Even though there is no cure for leukemia, which can be a deadly condition, many patients are able to fight the disease with a positive prognosis for a long and healthy life.