The blood is made up of several different types of cells and proteins. Red blood cells are used to transport oxygen to body tissues, platelets help to stop bleeding by “clumping” together to form clots, white blood cells help to fight infection and serum or plasma contains proteins, electrolytes and water.
Leukemia is cancer of the blood system, including cancers originating in bone marrow where blood cells are made. It usually involves the white blood cells or “leukocytes” and there are many different types of both leukocytes and the cancers that infect them. Leukemia start when cells being manufactured in the bone marrow begin developing abnormal or dividing uncontrollably.
Some types of leukemia more commonly affect children, while others main affect adults. Symptoms of leukemia vary highly and may be hard to diagnose. Some types are highly curable, others are more difficult to eradicate but all are much easier to treat if the disease is caught early.
Leukemia describes a wide range of cancer types. Many symptoms such as tiredness and weight loss, frequent infections, swollen lymph nodes, easy bruising are easy to mistake as other illnesses. Some types of leukemia have additional symptoms such as excessive sweating, particularly at night, bone pain or tenderness and the development of petechiae or little red spots on the surface of the skin. Any illness that will not go away or abnormal blood testing should be immediately investigated as soon as possible so that treatment can begin immediately. Some types of leukemia and descriptions may include:
- Acute leukemia – blood cells are immature (lymphoblasts) which multiply rapidly. As the cells are immature, though there are many of these cells, they cannot perform their normal functions and the disease quickly becomes worse. Acute leukemia requires aggressive treatment.
- Chronic leukemia – describes many types of the disorder. Certain leukemias produce too many white blood cells, while others cause too few cells to be made in the bone marrow but in most cases, the cells are more mature. Some forms may go undetected for a long period of time.
- Lymphocytic leukemia – affects the lymphocytes or lymphoid that form from lymphatic tissue which makes up a large portion of the immune system.
- Myeloid leukemia – affects the myeloid cells which are precursors to red blood cells, white blood cells and platelets.
- Acute lymphocytic leukemia (ALL) – is the most common type of leukemia in children but may also occur in adults
- Acute myelogenous leukemia (AML) – also called acute myeloid leukemia is the most common type of leukemia in adults but may also occur in children.
- Chronic lymphocytic leukemia (CLL) – largely affects adults and may produce no symptoms for long periods of time, even years before diagnosis.
- Chronic myelogenous leukemia (CML) – also known as chronic myeloid leukemia and mainly affects adults. It may cause no symptoms until the disorder enters an acute phase.
- Other leukemias – other types of leukemia are much more rare including
- Hairy cell leukemia (HCL) – slow growing cancer where the bone marrow makes too many “B” cells which are abnormal and appear to be “hairy” under a microscope.
- Myelodysplastic syndrome (MDS) – describes a group of blood and bone marrow disorders. Stem cells (cells that make new blood cells) become damaged and produce immature cells (blasts), and abnormal cells (dysplastic), resulting in fewer normal cells, even though there may be a “normal” number of cells overall. In some cases, the disorder may progress to AML
- Myeloproliferative disorder – describes a group of blood and bone marrow disorders in which too many blood cells of several types are made. Depending on the type, they may pose significant risks but many people live for years after diagnosis. CML is one type of this disorder but others include polycythemia vera (too many red blood cells), essential thrombocytosis (too many platelet cells) and myelofibrosis or myelosclerosis (too much collagen protein which reduces the ability to produce red blood cells).
As leukemia describes a variety of blood disorder illnesses, each type is staged according to the specific order. Criteria include things like:
- Total number of cells (too high or too low)
- Number of abnormal cells
- Number of immature cells
- Types of abnormal or immature cells
- Bone marrow sampling
Accumulation of leukemia cells in other organs such as the liver, which removes wastes, and spleen, which captures and helps to dispose of “broken” or “damaged” cells.
In general, as with other cancers. Stages range from Stage 0 (zero) to Stage IV (four) with zero being early cancer with few detectable cells and four being advanced cancer with widespread activity in many organs or as a severe case.
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Some types of leukemia are easily treatable and considered “curable”, others are more challenging. When discussing leukemia, the physician may also discuss “prognosis” which is usually described as a percentage of living for a certain number of years. In addition to the “staging” factors above, prognosis will also include information about:
- Age of the patients
- History of prior blood disorders
- Known or discovered chromosome mutations
- Bone damage
- Liver enlargement and function
- Spleen enlargement
- Family history of leukemia and other cancers
Treatments for leukemia depend upon the type, stage and severity of the cancer. They may also depend upon patient specifics such as age, history of cancer, family history, medical history and other issues such as genetic factors.
Diagnosis of leukemia is done through physical exam including blood testing, symptoms, history of disease, family history along with more specific examinations such as biopsy of bone marrow, microscopic examination of blood cells and bone marrow and advanced diagnostics such as genomic testing. Success of treatment will depend on characteristics of the disease and patient specifics along with testing results but in all cases, the earlier treatment is started, the better the prognosis or outcome will be.
Common treatments are:
- Chemotherapy – treatment with cancer-killing chemotherapeutic drugs, chosen based on leukemia type and patient specifics. Medications may be limited in effectiveness depending on the type of leukemia, age and medical status of the patient.
- Radiation Therapy – Used to focus beams of energy such as X-ray and photons into specific areas of the bone marry to kill cancer cells or the cells that make them.
- Biological therapy – works by using treatments that help your immune system recognize and destroy abnormal or immature leukemia cells.
- Targeted therapy – uses medications that attack specific types of cancer cells at vulnerable points.
- Bone marrow ablation – high doses of radiation or chemo may be used to purposefully “kill” diseased bone marrow. After this procedure a stem cell or bone marrow transplant will be performed.
- Stem cell transplant – an injection of healthy stem cells (cells that make new blood cells) may be given from a donor or from your own healthy stem cells which have been sorted. These cells will help the body regenerate new bone marrow. Stem cell transplant may also be used in cases where the chemotherapy required for disease treatment causes the bone marrow to be weakened.
- Bone marrow transplant – similar to a stem cell transplant. It is an injection of healthy cells from a bone marrow “donor” who has had portions of bone marrow removed through surgery.
In many cases of leukemia, the chances for a good outcome or prognosis is high, particularly if treatment is started early. Other cases require immediate, aggressive attention with limited options. Only a leukemia specialist who is up-to-date with current treatment regimens and new developments can identify the best approach for a specific type of leukemia.
Have you or a loved one been diagnosed with leukemia?
If you or a loved one have been diagnosed with leukemia, you may have already talked to your doctor but still have a lot of questions. Cancer Expert Now specializes in helping cancer patients and their families clear up the confusion about leukemia diagnoses and treatment options. We can also talk to your doctor to help ensure that you have all the resources you need to achieve the best outcome. When you have leukemia, you have no time to waste and starting treatment right away is essential. Cancer Expert Now will schedule an individual consultation with one of our leukemia specialists within 24 hours so that you can get started right away.