Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Feb 01, 2018
Last Modified Date: Feb 01, 2018
Published Date: Feb 01, 2018
Testing for Cancer - Leukemia
What is leukemia?
Leukemia is a blood cell cancer that begins in the bone marrow where the blood cells are created. The cancer causes the bone marrow to create an unusual amount of abnormal white blood cells, which are responsible for helping the body fight off infections. Because the cells are abnormal, there are unable to perform this function, making even minor infections a life threatening health issue. As leukemia progresses, the normal white blood cells can be almost entirely replaced by the abnormal cells. This can lead to bleeding, anemia and can cause the cancer to spread to other parts of the body.
Who is diagnosed with leukemia?
Both children and adults can develop leukemia. The American Cancer Society estimates that over 20,000 men and 15,000 women develop leukemia every year in the United States alone. Of these, 11% will be under the age of 20, 35% will be between the ages of 20 and 64 and 54% will be 65 or older. Although doctors have yet to discover an exact cause of leukemia, there are some risk factors. Tobacco products and exposure to high levels of radiation can increase one's risk of developing leukemia. Certain chemicals, such as benzene and formaldehyde, have also been found to increase a person's risk. Those with a history of leukemia in their family, as well as those with chromosomal disorders such as Down syndrome, are at a higher risk of developing leukemia than those without these health issues. In some cases, the treatments used to treat other types of cancer, such as chemotherapy and radiation treatment, can cause leukemia to develop. Blood diseases and infections, such as certain types of HIV and myelodysplastic syndromes, are also considered risk factors.
What are the major types of leukemia?
There are four main types of leukemia, each affecting one of two types of white blood cells: lymphocytic and myelogenous cells. The acute forms progress quickly, while chronic forms progress slowly; acute leukemia is common in children, while chronic leukemia is mostly found in adults. The acute form of lymphoblastic leukemia (ALL) is the most common in children, although it is a possibility throughout adulthood. The acute form of myelogenous leukemia (AML) can affect both kids and adults, although it is more common in older adults. The chronic form of lymphocytic leukemia (CLL), is most common in older adults. It is exceedingly rare in children. The c hronic form of myelogenous leukemia (CML) affects the myelogenous white blood cells, progresses slowly, and almost always occurs in adults. There are also several subgroups of Leukemia.
What are the signs and symptoms of leukemia?
Symptoms of leukemia vary depending on whether it is acute or chronic. While symptoms of acute leukemia usually begin early on, those with chronic leukemia may not notice any symptoms until very late in the disease. Common symptoms include chronic infections, extreme fatigue and muscle weakness, hot flashes or fevers and headaches. Continual bruising of the skin without cause, bone pain, joint pain and unexplained bleeding from the gums are also common symptoms. It is also possible for swelling to develop in the stomach, left shoulder, armpit, neck or groin. A noticeable decrease in appetite, and subsequent weight loss, can also be a sign of leukemia.
How is leukemia treated?
Acute leukemia is typically treated with chemotherapy. The first stage, known as induction, aims to kill the abnormal white blood cells and force the body to produce normal ones. Once remission is obtained, the drugs are given in five day cycles for three months to ensure that all of the leukemia cells have been killed. The final stage is maintenance, where very low doses of the chemotherapy drugs are give for two to three years, in an effort to prevent the leukemia from returning. If the leukemia spreads to the brain or spine, radiation may be needed for treatment. When acute leukemia is not caught in time, causing there to be little to no good white blood cells left, a stem cell transplant may be needed.
Due to the slow progression of chronic leukemia, it is often not treated right away, and studies indicate that one of three people with the disease never need treatment at all. In some cases, a stem cell transplant may be used to destroy the leukemia cells and replace them with good cells. Some drugs can be used to force the body to fight the leukemia itself, while radiation therapy can be used to kill leukemia cells and shrink any swelling in the spleen or lymph nodes. Chronic leukemia can also be treated with the same chemotherapy regime as acute leukemia. For those who do not require treatment, they still must make regular visits with their doctors and watch out for any infections, especially pneumonia.