Leukemia is cancer of the blood-forming tissues of the body, including the bone marrow and the lymphatic system. There are many types of leukemia, with some forms more common in children, and other forms occurring mostly in adults. Leukemia usually involves the white blood cells. Your white blood cells are strong infection fighters. However, the bone marrow produces abnormal white blood cells, which don’t function properly in people with leukemia.
Causes of Leukemia
Scientists are yet to comprehend the exact causes of leukemia. It appears to develop from a combination of genetic and environmental factors. Leukemia occurs when the DNA of immature blood cells, mainly white cells, becomes impaired in some way. This causes the blood cells to grow and continuously divide so that there are too many.
Healthy blood cells die after a while and are replaced by new cells, which are produced in the bone marrow. The abnormal blood cells do not die when they should. They accumulate, occupying more space.
As more cancer cells are created, they stop the healthy white blood cells from growing and functioning normally, by crowding out space in the blood. Essentially, the bad cells crowd out the good cells in the blood.
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Symptoms of Leukemia
Leukemia symptoms differ, depending on the type. Common leukemia signs and symptoms include:
- Fever or chills
- Frequent infections
- Losing excess weight
- Bleeding or bruising easily
- Persistent fatigue
- Bone pain or tenderness
- Frequent nosebleeds
- Tiny red spots in your skin
- Excessive sweating, especially at night
- Swollen lymph nodes, enlarged liver or spleen
How leukemia forms
Leukemia occurs when some blood cells acquire mutations in their DNA. There may be other changes in the cells that have yet to be fully understood that could contribute to leukemia.
Certain irregularities cause the cell to grow and divide more speedily and to continue living when normal cells would die. These abnormal cells can outgrow healthy blood cells in the bone marrow, leading to fewer healthy white blood cells, red blood cells and platelets, causing the symptoms of leukemia.
How leukemia is classified
Doctors classify leukemia based on its speed of progression and the type of cells involved. The first type of classification is by how fast the leukemia progresses:
- Acute leukemia.This type of leukemia requires timely treatment. The abnormal blood cells are undeveloped blood cells (blasts). They can’t carry out their normal functions, and they rapidly multiply, so the disease rapidly deteriorates.
- Chronic leukemia.There are many types of chronic leukemias. Some produce too many cells and some cause too few cells to be produced. Chronic leukemia involves more mature blood cells. These blood cells duplicate or gather more slowly and can function normally for a period of time. Some forms of chronic leukemia produce no early symptoms initially and can go unnoticed for years.
The second type of classification is by type of white blood cell affected:
- Lymphocytic leukemia.This type of leukemia affects the lymphoid cells (lymphocytes), which form lymphoid or lymphatic tissue. The body’s immune system is made up of lymphatic tissue.
- Myelogenous leukemia.This type of leukemia affects the myeloid cells. Myeloid cells give rise to red blood cells, white blood cells and platelet-producing cells.
Types of leukemia
The major types of leukemia are:
- Acute lymphocytic leukemia (ALL).This is the most common type of leukemia which mostly affects young children. ALL can also occur in adults.
- Acute myelogenous leukemia (AML).AML is another common type of leukemia which occurs in children and adults.
- Chronic lymphocytic leukemia (CLL).This is the most common chronic adult leukemia, you may feel well for years without needing treatment.
- Chronic myelogenous leukemia (CML).This type of leukemia mainly affects adults. A person with CML may have little or no symptoms for months or years before entering a phase in which the leukemia cells grow more rapidly.
- Other types.Other, rarer types of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative disorders.
Factors that may increase your risk of developing some types of leukemia include:
- Family history of leukemia.Your risk of leukemia may likely increase if members of your family have been diagnosed with the disease.
- Genetic disorders.Genetic abnormalities appears to play a role in the development of leukemia. Certain genetic disorders, such as Down syndrome, are linked with an increased risk of leukemia.
- Exposure to certain chemicals.Exposure to certain chemicals, such as benzene, which is found in gasoline is linked to an increased risk of developing some kinds of leukemia.
- Smoking cigarettes increases the risk of acute myelogenous leukemia.
- Previous cancer treatment.People who’ve had certain treatments like chemotherapy and radiation therapy for cancers have an increased risk of developing certain types of leukemia.
Doctors may find chronic leukemia in a routine blood test, before symptoms may begin. If you have symptoms that suggest leukemia, you may undergo the following diagnostic exams:
- Blood tests.Your doctor can determine if you have abnormal levels of red or white blood cells or platelets by looking at a sample of your blood.
- Physical exam.Your doctor will look for physical signs of leukemia, such as pale skin from anemia, swelling of your lymph nodes, and enlargement of your liver and spleen.
- Bone marrow test.Your doctor may recommend a procedure to remove a sample of bone marrow from your hipbone. The bone marrow is removed using a long, thin needle. The sample is sent to a laboratory to look for leukemia cells. Specialized tests of your leukemia cells may disclose certain characteristics that are used to control your treatment options.
When to see a doctor
If you have recurring symptoms that disturbs you, make an appointment with your doctor. Leukemia symptoms are often vague and not specific. You may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses. Rarely, leukemia may be discovered during blood tests for some other condition.
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Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and general health, the type of leukemia you have, and whether it has spread to other parts of your body.
Common treatments used to fight leukemia include:
- Chemotherapy uses chemicals to kill leukemia. It is the major form of treatment for leukemia. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein.
- Biological therapy.Biological therapy works by using treatments that help your immune system identify and attack leukemia cells.
- Targeted therapy.Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells. For instance, the drug imatinib (Gleevec) prevents the action of a protein within the leukemia cells of people with chronic myelogenous leukemia.
- Radiation therapy.Radiation therapy uses X-rays or other high-energy beams to destroy leukemia cells and hinder their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to specific points on your body. The radiation may be targeted in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body.
- Stem cell transplant.This procedure is used to replace your diseased bone marrow with healthy bone marrow. Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow. Also, you may receive stem cells from a donor, or in some cases you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant.