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LEUKEMIA or LEUKAEMIA

Leukemia is the cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.

White blood cells, red blood cells, and platelets are made from stem cells as the body needs them. When cells grow old or get damaged, they die, and new cells take their place.

 Blood Cells

Image: Division and maturing of blood cells

In normal conditions, most blood cells mature in the bone marrow and then move into the blood vessels. Blood flowing through the blood vessels and heart is called the peripheral blood.

In a person with leukemia, the bone marrow makes abnormal white blood cells. The abnormal cells are leukemia cells.

Unlike normal blood cells, leukemia cells don`t die when they should. They may crowd out normal white blood cells, red blood cells, and platelets. This makes it hard for normal blood cells to do their work.

Types of leukemia

The types of leukemia can be grouped based on how quickly the disease develops and gets worse. Leukemia is either chronic (which usually gets worse slowly) or acute (which usually gets worse quickly).

There are four common types of leukemia:

  • Chronic lymphocytic leukemia (CLL): CLL affects lymphoid cells and usually grows slowly. Most often, people diagnosed with the disease are over age 55. It almost never affects children.
  • Chronic myeloid leukemia (CML): CML affects myeloid cells and usually grows slowly at first. It mainly affects adults.
  • Acute lymphocytic (lymphoblastic) leukemia (ALL): ALL affects lymphoid cells and grows quickly. ALL is the most common type of leukemia in young children. It also affects adults.
  • Acute myeloid leukemia (AML): AML affects myeloid cells and grows quickly. It occurs in both adults and children.

Follow the links on the right to learn more about these types of leukemia.

Risk factors for leukemia

The risk factors for different types of leukemia may be different. They are discussed in detail in that particular type of leukemia (links to the right of this page). Following is a brief list of risk factors:

  • Radiation (for acute myeloid leukemia, chronic myeloid leukemia, acute lymphocytic leukemia)
  • Smoking (for acute myeloid leukemia)
  • Benzene (for acute myeloid leukemia, chronic myeloid leukemia, acute lymphocytic leukemia)
  • Chemotherapy (for acute myeloid leukemia, acute lymphocytic leukemia)
  • Down syndrome and certain other inherited diseases (for acute myeloid leukemia, acute lymphocytic leukemia))
  • Myelodysplastic syndrome and certain other blood disorders (for acute myeloid leukemia)
  • Family history of leukemia (chronic lymphocytic leukemia)

Signs and symptoms of leukemia

Common symptoms of chronic or acute leukemia may include:

  • Swollen lymph nodes that usually don`t hurt (especially lymph nodes in the neck or armpit)
  • Fevers or night sweats
  • Frequent infections
  • Feeling weak or tired
  • Bleeding and bruising easily (bleeding gums, purplish patches in the skin, or tiny red spots under the skin)
  • Swelling or discomfort in the abdomen (from a swollen spleen or liver)
  • Weight loss for no known reason
  • Pain in the bones or joints

Diagnostic tests and exams for leukemia

  • Physical exam to check for swollen lymph nodes, spleen, or liver
  • Blood tests for a complete blood count
  • Biopsy to remove tissue samples of bone marrow and bone to look for cancer cells
  • Other tests like Cytogenetics, Spinal tap and Chest x-ray may be done depending on the symptoms and the type of leukemia suspected

Treatment of leukemia

The choice of treatment depends mainly on the following:

  • Type of leukemia (acute or chronic)
  • Patient`s age
  • Whether leukemia cells were found in the cerebrospinal fluid
  • Symptoms
  • Patient`s general health

People with acute leukemia need to be treated right away. The goal of treatment is to destroy signs of leukemia in the body and make symptoms go away.

People with chronic leukemia without symptoms may not need cancer treatment right away. When treatment for chronic leukemia is needed, it can often control the disease and its symptoms.

Specialists who treat leukemia include hematologists, medical oncologists, and radiation oncologists. Pediatric oncologists and hematologists treat childhood leukemia.

Treatment options include:

  • Watchful waiting: May be suggested in cases of chronic lymphocytic leukemia when the symptoms have not surfaced
  • Chemotherapy: Use of drugs to destroy leukemia cells
  • Targeted Therapy: Targeted therapies use drugs that block the growth of leukemia cells. For example, a targeted therapy may block the action of an abnormal protein that stimulates the growth of leukemia cells. Targeted therapy is used for people with chronic myeloid leukemia and some with acute lymphoblastic leukemia.
  • Biological Therapy or Immunotherapy: Biological therapy for leukemia is treatment that improves the body`s natural defenses against the disease. One type of biological therapy is a substance called a monoclonal antibody which binds to the leukemia cells. One kind of monoclonal antibody carries a toxin that kills the leukemia cells. Another kind helps the immune system destroy leukemia cells. For some people with chronic myeloid leukemia, the biological therapy is a drug called interferon which can slow the growth of leukemia cells.
  • Radiation Therapy: Use of high-energy rays to kill leukemia cells. The radiation treatments are given usually before a stem cell transplant.
  • Stem Cell Transplant: A stem cell transplant allows you to be treated with high doses of drugs, radiation, or both. The high doses destroy both leukemia cells and normal blood cells in the bone marrow. After you receive highdose chemotherapy, radiation therapy, or both, you receive healthy stem cells through a large vein. New blood cells develop from the transplanted stem cells. The new blood cells replace the ones that were destroyed by treatment.

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