Leukemia

Leukemia is a cancer involving the white blood cells of the body. White blood cells are divided into myeloid cells, B cells and T cells, and are responsible for our immune system function. White blood cells are made from stem cells in the bone marrow which grow into mature cells such as white blood cells, red blood cells and platelets.

Abnormal white blood cells are created from the bone marrow in leukemia. The white blood cells have altered DNA and simply continue to grow and multiply. These cells crowd out other cells in the bloodstream and in the bone marrow.

There are various types of leukemia. Chronic leukemia is slow growing and often has no symptoms other than some fatigue. It gradually gets worse and involves the lymph nodes, which become swollen. The person is at higher risk of getting systemic infections. Acute leukemia is faster moving than chronic leukemia. The number of cells increases rapidly and acute leukemia usually worsens quickly.

The leukemia can also be defined as a myeloid or lymphoid leukemia. Lymphoid leukemia affects lymphoid cells and myeloid leukemia affects the myeloid cells. There are four different types of leukemia: 1) chronic lymphocytic leukemia, which accounts for 15,000 cases per year; 2) Chronic myeloid leukemia, which affects fewer people, about 5000 cases per year; 3) acute lymphocytic or lymphoblastic leukemia affect around 5000 people per year; 4) acute myeloid leukemia, which affects more than 13000 new cases per year.

Risk factors for getting leukemia include previous exposure to radiation, such as in atomic bomb explosions, having radiation therapy for another type of cancer, having diagnostic x-rays, having a smoking history, exposing oneself to benzene in a laboratory or construction industry, having had chemotherapy, having a history of Down syndrome or other inherited diseases, and having myelodysplastic syndromes or other blood disorders. Other risk factors include being infected with HTLV-1, a virus you can catch from another person, or having a family history of leukemia. Remember that most people with risk factors do not go on to develop leukemia but the risk is still there.

Symptoms of leukemia may be few. The individual may have malaise, fatigue, swollen lymph nodes and nausea, vomiting, headaches, confusion, loss of muscle control, or seizures. It can affect any body area and can have a variety of symptoms. You can have fevers or night sweats, frequent infections, weakness, easy bruisability, swelling of the abdomen from an enlarged liver or spleen, pain in the bones or joints and weight loss without a logical reason.

Diagnosis of leukemia is done by doing a physical examination. The doctor checks the liver, the spleen and the lymph nodes for enlargement. Blood tests can show cancerous cells in the blood. A bone marrow evaluation can show cancer among the cells of the marrow. A bone marrow aspiration uses a narrow needle to extract cells from the bone marrow. A bone marrow biopsy uses a thick needle that grabs a large chunk of the bone and bone marrow in one attempt. A spinal tap will show if the cancer has spread to the cerebrospinal fluid. A chest x-ray can see if there are swollen lymph nodes in the chest cavity.

Treatment of leukemia involves several choices. Some are mild enough so that watchful waiting can be done until the cancer becomes worse. Chemotherapy is a common treatment for leukemia. Biological therapy has recently been used to treat leukemia as has radiation therapy. Stem cell transplants are the latest in leukemia treatment and, if the spleen is enlarged, the doctor may remove it to keep it from sequestering the white blood cells.

The treatment depends on whether the leukemia is acute or chronic, how old you are and whether leukemia cells were found in the cerebrospinal fluid. The features of the cancer cells determine which treatment is used for the management of the leukemia. The treatment of acute leukemia needs to be done immediately as this is a more aggressive form of cancer. Treatment is intended to make sure the cancer goes into remission. Chronic leukemias may not need to be treated right away but can be watched to see if the cancer gets worse.