Hematology and Oncology
Leukemia is classified according to how quickly it develops and worsens and the type of blood cell involved. The beginning of leukemia can be intense (abrupt onset) or constant (slow start).
The cells involved may be:
Lymphocytes: type of white blood cell that helps the body fight infection.
Myeloid cells: Immature cells that develop into white blood cells, red blood cells, or platelets.
The following are four main kinds of leukemia:
● Acute myeloid leukemia AML)
Acute myeloid leukemia (AML) is also called acute myeloblastic leukemia. It is the second most common type of leukemia that can affect children and adults. Acute myeloid leukemia (AML) is a cancer of the myeloid blood cell line marked by the rapid proliferation of abnormal cells in the bone marrow and blood, interfering with normal blood cell production. As to data shared by the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute (NCI), around 20,000 new cases of AML are diagnosed each year in the United States.
● Acute lymphocytic leukemia (ALL)
Acute lymphocytic leukemia, also known as acute lymphoblastic leukemia, is the most common leukemia affecting children and adults. The term "acute" relates to the fact that ALL progresses quickly and produces immature blood cells rather than mature ones, whereas "lymphocytic" refers to the white blood cells known as lymphocytes, which are affected by ALL.
● Chronic myeloid leukemia
Chronic myeloid leukemia (CML), also known as chronic myelogenous leukemia, is a type of white blood cell cancer marked by a rise in uncontrolled myeloid cell growth in the bone marrow and an accumulation of these cells in the blood. Around 9,000 new instances of CML are reported yearly, as per data shared by National Cancer Institute.
● Chronic lymphocytic leukemia
Chronic lymphocytic leukemia (CLL) is a malignant blood and bone marrow growth that gradually deteriorates. CLL is one of the most well-known kinds of adult leukemia and develops during or after middle age while rarely affecting children.
There is no specific risk factor but somehow following are some risk factors that may be the cause of leukemia;
● Smoking
● Chemotherapy and radiotherapy
● Genetic disorders, i.e., Downs syndrome
● Exposure to chemicals
● Family history of leukemia
● Slightly common in men than women
● Previous cancer treatment
● Immune-suppressor drugs
The exact causes of leukemia are unknown to researchers; however, It appears to result from a mix of hereditary and environmental factors. You may have a higher risk of developing leukemia if you:
● Are a smoker
● Are exposed to a great deal of radiation or certain chemicals
● Had radiation therapy or chemotherapy to treat malignant growth
● Have a family background of leukemia
● Have a hereditary disease like Down syndrome
The symptoms of leukemia are sometimes nonspecific and may be overlooked because they resemble the flu or other common illnesses while varying from person to person. Symptoms may include;
● Persistent Weakness and fatigue
● Excessive sweating
● Bone pain
● Swollen lymph nodes
● Enlarged spleen and liver
● Fever
● Red spots on the skin
● Frequent infections
● Frequently Bruising of the skin
● Easy bleeding
● Weight loss
● Headache
● Confusion
● Nausea
● Vomiting
● Seizures
● Loss of muscle control
● Shortness of breath
Leukemia may also affect other body organs, i.e., lungs, kidneys, heart, testicles, and gastrointestinal tract.
Leukemia has a wide range of types. A few types of intense leukemia are quickly developing, while other persistent types might require less intense therapies. A patient may be undergoing the following diagnosis steps:
● Physical examination: Physical indicators of leukemia include pale skin caused by anemia, swelling of your lymph nodes, and enlargement of your liver and spleen.
● Complete blood count (CBC): Your healthcare provider can tell whether you have abnormal levels of red, white, or platelets in your blood by looking at the blood picture indicating leukemia.
● Bone marrow test: A procedure to take a sample of bone marrow from your hipbone may be recommended by your doctor. A long, thin needle is used to extract the bone marrow. The sample is sent to a lab to test if it contains leukemia cells.
● Spinal tap (fluid from the spinal cord): Fluid from your spinal cord is taken by which the doctor analyses if your leukemia has progressed.
● Genetic tests: to detect changes in genes and chromosomes
● Imaging tests: Specialized CT, MRI, and PET scans can identify leukemia.
Medicines for leukemia rely upon the kind of leukemia you have, your age and general wellbeing, and if leukemia has invaded different tissues or organs. There are five standard treatment classifications. They include:
● Chemotherapy kills cancer cells in your blood and bone marrow with medications.
● Radiotherapy: This therapy utilizes strong light emissions (high energy x-rays) to kill leukemia cells or prevent them from developing. You may get it all over your body or just in one area with many cancer cells.
● Immunotherapy: This treatment, also called biologic treatment, utilizes certain medications to support your body’s defense mechanism. Drugs like interleukins and interferon can help boost your body's natural defenses against leukemia.
● Targeted treatment: Drugs that disrupt certain genes or proteins required for cancer cell growth are used in targeted therapy. This treatment can stop leukemia cells from growing and multiplying by cutting off their blood supply or killing them instantly. It includes monoclonal antibodies, (for example, Inotuzumab [Besponsa], Gemtuzumab, [Mylotarg], and Rituximab etc.
● Hematopoietic cell transplant: A stem cell transplant replaces your bone marrow's leukemia cells with new blood-producing cells. The new stem cells can come from your own body or a donor. Large doses of chemotherapy will first destroy the cancer cells in your bone marrow. Next, you’ll receive the new stem cells via an injection into one of your veins. They will develop into healthy new blood cells.
● Surgery: Your healthcare provider may recommend splenectomy (surgical removal of the spleen) If your spleen is loaded with cancer cells and pressing on adjacent organs.
Stages of leukemia therapy
● Induction therapy: The first phase of treatment kills many cancerous cells from blood or bone marrow and continues for four to six weeks.
● Consolidation therapy: is the second phase of therapy directed to kill undetected remaining leukemia cells from blood or bone marrow. It is given in a cycle of four to six weeks.
● Maintenance therapy: It lasts for two years to prevent the return of leukemia.
Treatment success is determined by the type of leukemia and the patient's age. In the United States, the average five-year survival rate is 61 percent. The five-year survival rate for children under 15 is higher (60 to 85 percent), depending on the type of leukemia. The cancer is unlikely to reappear in children with acute leukemia who have been cancer-free for five years.
There are no specific preventive measures, but you can reduce your risk of leukemia by making a few lifestyle changes. Other types of cancer can also be reduced by following these tips.
Quit smoking: Smoking raises your chances of getting a variety of cancers, including leukemia. You can reduce your risk of leukemia by not smoking or by quitting it.
Maintain a healthy weight: Obesity is another risk factor for leukemia that you can reduce. Taking steps to maintain a healthy weight can help you avoid leukemia. You can begin by eating a well-balanced diet and including physical activity in your daily routine.
Avoid inhaling certain chemicals: Benzene and formaldehyde have been linked to an increased risk of leukemia. Some workplaces and buildings contain these substances. Avoiding these pollutants as much as possible can reduce your risk of leukemia.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 24, 2023.
Leukemia—Patient Version - NCI (cancer.gov)
2020-04-38-hem-onc-pelcovits.pdf (rimed.org)
http://www.rimed.org/rimedicaljournal/2020/04/2020-04-38-hem-onc-pelcovits.pdf
Cancer is an abnormal and uncontrollable growth of any part of the body’s cells. Cancer of blood and bone marrow cells is called Leukemia. It is present in the bone marrow and invades the blood and slowly to the whole body. For the most part, leukemia usually involves White blood cells (WBC). White blood cells are a vital part of the body’s defense system; they protect from foreign antigens. Healthcare specialists don’t know the exact cause of leukemia, but some factors are present that may cause leukemia, i.e., radiations, chemicals, tobacco, etc., that increase the risk of leukemia. Treatment involves a combination of different therapies to eradicate the cancerous cells from the body.