Leukemia

Overview

Leukemia is a cancer of the bone marrow or blood. Bone marrow generates blood cells, and leukemia happens typically when there is a problem with the production of the blood cells.

When invaded, the cell in the bone marrow experiences a change and becomes a type of leukemia. When such change occurs, the leukemia cells grow and survive better than the healthy cells. 

Over time, the leukemia cells that multiply faster suppress the development of normal cells. The rate at which leukemia multiply and its cells replace the normal bone marrow, and blood cells differ from one type of leukemia to another.

The leukemia cells mostly affect the leukocytes or the white blood cells. People with leukemia usually have their bone marrows producing abnormal leukocytes.

Treatment of leukemia largely depends on the type of leukemia and the severity or spread of the abnormal cells in both the bone marrow and the blood.

Symptoms

The signs and symptoms of leukemia vary depending on the type of leukemia. However, the general symptoms of leukemia include:

  • Losing weight without trying
  • Fever or chills
  • Anemia
  • Blood clotting
  • Severe or frequent infections
  • Persistent fatigue, weakness
  • Swollen lymph nodes
  • Enlarged spleen or liver
  • Easy bruising or bleeding
  • Tiny red spots in your skin (petechiae)
  • Bone pain and tenderness
  • Excessive sweating, especially at night

Classification

Doctors normally classify leukemia based on the progression speed and the type of cells involved. The initial type of classification is by the progression speed:

  • Acute leukemia: The abnormal cells are blasts or immature blood cells. They cannot perform their normal functions, but they multiply very fast, which makes the disease to worsen swiftly. It requires not just aggressive but also timely treatment. 
  • Chronic leukemia: It involves more mature blood cells that multiply and accumulate slower than the immature ones, and can function normally for quite some time. The majority of leukemia types belong to this class. Some of them do not produce signs and symptoms and may stay unnoticed for a long time.

The second type of classification is by type of white blood cell affected:

  • Lymphocytic leukemia: Affects the lymph nodes that form lymphatic tissue that makes up the immune system.
  • Myelogenous leukemia: Affects the myeloid cells that generate red blood cells, white blood cells, and platelet-producing cells.

Types of leukemia

  • Acute lymphocytic leukemia (ALL): The most common type of leukemia in young children and may also occur in adults.
  • Acute myelogenous leukemia (AML): It is the common type of leukemia, especially in adults but also occurs in children.
  • Chronic lymphocytic leukemia (CLL): It is the most common chronic adult leukemia where you may have no symptoms and go for years without noticing it.
  • Chronic myelogenous leukemia (CML): It mainly affects adults who show few or no symptoms for months or years before developing to an acute phase where the cells multiply rapidly. 
  • Other types: They include hairy cell leukemia, myeloproliferative disorders, and myelodysplastic syndromes.

Causes

Leukemia occurs when the DNA of immature blood cells, primarily leukocytes, become damaged in some way.

This makes the blood cells to grow and multiply continuously to make them excessive. In the process, healthy blood cells die and are replaced by abnormal cells.

The abnormal cells do not die when expected, and they accumulate as they occupy more space. The healthy white blood cells stop functioning normally because of overcrowding with the entire out space occupied by abnormal cells.

Risk Factors

The following factors are either known or suspected to increase the risk of developing leukemia:

  • Viruses such as human T-lymphotropic virus (HTLV-1) and HIV
  • Artificial ionizing radiation
  • Benzene and certain petrochemicals
  • Alkylating chemotherapy agents used in previous cancers
  • Smoking
  • Hair dyes
  • Genetic predisposition – fault in one or more genes
  • Down syndrome due to chromosomal changes
  • Exposure to extreme or frequent electromagnetic energy

Diagnosis

The doctor will conduct a physical examination and ask you a few questions about personal and family medical history.

The doctor will check for signs of anemia and feel for enlarged spleen or liver. They will equally take a blood sample for a laboratory test.

If the doctor suspects the presence of leukemia, he or she may carry out a bone marrow test. The bone marrow is normally taken from the hip using a long, fine needle.

The test helps to show the type of leukemia, if any, exists.

Treatment

The treatment you get depends on various factors among them being the spread of leukemia, the type, and your personal health.

The main options are chemotherapy, radiation, surgery, biological therapy, stem cell transplant, and targeted therapy.

  • Chemotherapy: It uses drugs to kill cancer cells in the blood and bone marrow. The medicine is administered through an injection, as a pill, or into the fluid around the spinal cord.
  • Radiation: It uses high-energy X-rays to keep leukemia cells from growing or to kill them. It is used on one part of the body where the cancer cells are accumulated, or sometimes all over.
  • Biological therapy/Immunotherapy: Helps the immune system find and destroy cancer cells. Drugs such as interferon and interleukins are administered to boost the natural defenses of the body against leukemia.
  • Targeted therapy: Uses drugs to block specific genes or proteins used by cancer cells to grow. The treatment helps to stop the signals of leukemia cells used to multiply in the body by cutting off their blood supply or killing them directly.
  • Surgery: The doctor may carry out surgery to remove the spleen if it is filled with cancer cells and is affecting the nearby organs. The procedure is termed as splenectomy.

For more information on diagnosis and/or treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.