Leukemia is cancer of the body’s blood-forming tissues, inclusive of the bone marrow and the lymphatic system.
Many kinds of leukemia exist. Some forms of leukemia are more common in children. Other forms of leukemia happen mostly in adults.
Leukemia usually involves the white blood cells. Your white blood cells are potent infection fighters — they always grow and divide in an orderly way, as your body requires them. But in people with leukemia, the bone marrow produces abnormal white blood cells, which don’t function properly.
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Treatment for leukemia can be difficult — depending on the type of leukemia and other factors. But there are strategies and resources that can assist to make your treatment successful.
Leukemia symptoms differ, depending on the type of leukemia. Common leukemia signs and symptoms are inclusive of:
- Fever or chills
- Persistent fatigue, weakness
- Frequent or severe infections
- Losing weight without trying
- Swollen lymph nodes, enlarged liver or spleen
- Easy bleeding or bruising
- Recurrent nosebleeds
- Tiny red spots in your skin (petechiae)
- Excessive sweating, especially at night
- Bone pain or tenderness
When to see a doctor
Make an appointment with your doctor if you have any persistent signs or symptoms that disturb you.
Leukemia symptoms are often vague and not specific. You may overlook early leukemia symptoms since they may resemble symptoms of the flu and other common illnesses.
Rarely, leukemia may be found during blood tests for some other condition.
Scientists don’t know the exact causes of leukemia. It seems to develop from a combination of genetic and environmental factors.
How leukemia forms
In general, leukemia is thought to happen when some blood cells need mutations in their DNA — the instructions inside each cell that guide its action. There may be other changes in the cells that have yet to be fully understood could add to leukemia.
Certain abnormalities make the cell to grow and divide more rapidly and to continue living when normal cells would die. Over time, these abnormal cells can crowd out healthy blood cells in the bone marrow, resulting in fewer healthy white blood cells, red blood cells and platelets, causing the signs and symptoms of leukemia.
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How leukemia is classified
Doctors classify leukemia based on its speed of progression and the type of cells involved.
The first type of classification is by how fast the leukemia progresses:
- Acute leukemia.In acute leukemia, the abnormal blood cells are immature blood cells (blasts). They can’t carry out their normal duties, and they multiply rapidly, so the disease worsens quickly. Acute leukemia needs aggressive, timely treatment.
- Chronic leukemia.There are many types of chronic leukemias. Some produce too many cells and some cause too few cells to be produced. Chronic leukemia involves more mature blood cells. These blood cells replicate or accumulate more slowly and can operate normally for a period of time. Some forms of chronic leukemia initially produce no early symptoms and can go unnoticed or undiagnosed for years.
The second kind of classification is by type of white blood cell affected:
- Lymphocytic leukemia.This type of leukemia affects the lymphoid cells (lymphocytes), which form lymphoid or lymphatic tissue. Lymphatic tissue makes up your immune system.
- Myelogenous (my-uh-LOHJ-uh-nus) leukemia.This class of leukemia affects the myeloid cells. Myeloid cells give rise to red blood cells, white blood cells and platelet-producing cells.
Types of leukemia
The major kinds of leukemia are:
- Acute lymphocytic leukemia (ALL).This is the most common type of leukemia in young children. ALL can also happen in adults.
- Acute myelogenous leukemia (AML).AML is a common type of leukemia. It happens in children and adults. AML is the most common type of acute leukemia in adults.
- Chronic lymphocytic leukemia (CLL).With CLL, the most common chronic adult leukemia, you may feel well for years without requiring treatment.
- Chronic myelogenous leukemia (CML).This type of leukemia mainly affects adults. A person with CML may have few or no signs for months or years before entering a phase in which the leukemia cells grow more quickly.
- Other types.Other, rarer kinds of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative disorders.
Factors that may increase your risk of developing some types of leukemia are inclusive of:
- Previous cancer treatment.People who’ve had some types of chemotherapy and radiation therapy for other cancers have an increased risk of developing certain types of leukemia.
- Genetic disorders.Genetic abnormalities seem to play a part in the development of leukemia. Certain genetic disorders, such as Down syndrome, are linked with an increased risk of leukemia.
- Exposure to certain chemicals.Exposure to certain chemicals, such as benzene — which is found in gasoline and is used by the chemical industry — also is also associated with an increased risk of some kinds of leukemia.
- Smoking cigarettes increases the risk of acute myelogenous leukemia.
- Family history of leukemia.If members of your family have been diagnosed with leukemia, your risk for the disease may be increased.
However, most people with known risk factors don’t get leukemia. And many people with leukemia have none of these risk factors.
Tests and diagnosis
Doctors may discover chronic leukemia in a routine blood test, before symptoms starts. If this happens, or if you have signs or symptoms that suggest leukemia, you may undergo the following diagnostic exams:
- Physical exam.Your doctor will chcek for physical signs of leukemia, such as pale skin from anemia, swelling of your lymph nodes, and enlargement of your liver and spleen.
- Blood tests.By looking at a sample of your blood, your doctor can tell if you have abnormal levels of white blood cells or platelets — which may suggest leukemia.
- Bone marrow test.Your doctor may recommend a procedure to take out a sample of bone marrow from your hipbone. The bone marrow is removed using a long, thin needle. The sample is sent to a laboratory to look for leukemia cells. Specialized tests of your leukemia cells may reveal certain characteristics that are used to know your treatment options.
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You may undergo additional tests to be sure of the diagnosis and to determine the type of leukemia and its extent in your body. Certain types of leukemia are classified into stages, showing the severity of the disease. Your leukemia’s stage helps your doctor determine a treatment plan.
Treatments and drugs
Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body.
Common treatments used to fight leukemia include:
- Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells.
Depending on the type of leukemia you have, you may get a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein.
- Biological therapy.Biological therapy works by using treatments that assist your immune system recognize and attack leukemia cells.
- Targeted therapy.Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells.
For example, the drug imatinib (Gleevec) prevents the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease.
- Radiation therapy.Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body.
You may get radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a stem cell transplant.
- Stem cell transplant.A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow.
Before a stem cell transplant, you get high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow.
You may receive stem cells from a donor, or in some situation you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant.