Leukemia

What is Leukemia?
Leukemia is a cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system.

[Image of the bone marrow producing blood cells]

It typically involves the white blood cells. In a healthy body, white blood cells are potent infection fighters. In people with leukemia, the bone marrow produces excessive, abnormal white blood cells that don't function properly, eventually crowding out healthy red cells and platelets.

Symptoms

Leukemia symptoms are often vague and can easily be mistaken for the flu or other common illnesses. However, unlike a temporary virus, these signs persist and worsen over time:

• Recurrent fever or chills.
• Persistent fatigue and physical weakness that doesn't improve with rest.
• Frequent, severe, or unusual infections.
• Unexplained weight loss.
• Swollen lymph nodes (usually painless), an enlarged liver, or an enlarged spleen.
• Petechiae: Tiny, flat red spots on your skin caused by internal bleeding.
• Easy bleeding or bruising, including frequent or heavy nosebleeds.
• Excessive sweating, particularly drenching night sweats.
• Deep bone pain or tenderness.

⚠️ EARLY DETECTION IS KEY
Leukemia symptoms are easily overlooked in their early stages. Schedule an appointment with your doctor if you experience persistent fatigue that interferes with daily life, unexplained bruising, or a low-grade fever that refuses to break.

When to See a Doctor

Because many symptoms of leukemia are non-specific, they are often dismissed. You should seek a medical evaluation if you notice a cluster of the symptoms listed above, especially if they last longer than two weeks. Early diagnosis, particularly for acute forms of leukemia, is vital for the success of aggressive treatments. If you have a family history of blood cancers or have undergone previous radiation or chemotherapy, mention this to your physician.

How Leukemia is Classified

To determine the best treatment plan, doctors classify leukemia based on how fast it progresses and which type of blood cells are affected.

1. By Speed of Progression

• Acute Leukemia: The abnormal blood cells are immature (blasts) and cannot carry out their normal functions. They multiply rapidly, causing the disease to worsen very quickly. This type requires immediate, aggressive intervention.
• Chronic Leukemia: Involves more mature blood cells. These cells replicate or accumulate more slowly and can function normally for a period. Chronic leukemia may produce no symptoms and go unnoticed for years.

2. By Type of White Blood Cell

• Lymphocytic Leukemia: Affects the lymphoid cells (lymphocytes), which form lymphatic tissue. This tissue makes up your immune system.
• Myelogenous Leukemia: Affects the myeloid cells, which normally give rise to red blood cells, white blood cells, and platelet-producing cells.

The 4 Major Types

• Acute Lymphocytic Leukemia (ALL): The most common type of leukemia in young children, though it can also occur in adults.
• Acute Myelogenous Leukemia (AML): A common type of acute leukemia that affects both children and adults. It is the most common type of acute leukemia in adults.
• Chronic Lymphocytic Leukemia (CLL): The most common chronic adult leukemia. Patients may feel well for years without ever needing treatment.
• Chronic Myelogenous Leukemia (CML): This type mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase where leukemia cells grow more quickly.

Complications

Because leukemia fundamentally disrupts the balance of blood production in the bone marrow, it leads to several secondary health issues:

• Severe Infection: The lack of healthy, functional white blood cells leaves the body vulnerable to bacteria and viruses.
• Bleeding Disorders: A critical drop in platelets (thrombocytopenia) leads to difficulty forming clots, causing internal bleeding or excessive surface bleeding.
• Anemia: A shortage of red blood cells leads to chronic fatigue, pale skin, and shortness of breath.

Diagnosis

Chronic leukemia is frequently discovered during routine blood work for an unrelated issue. If leukemia is suspected, doctors use several diagnostic tools:

• Physical Exam: Searching for physical signs of leukemia, such as pale skin from anemia and swelling of the lymph nodes, liver, and spleen.
• Blood Tests (CBC): Looking for abnormal levels of white blood cells, red blood cells, or platelets.
• Bone Marrow Aspiration and Biopsy: A doctor uses a long, thin needle to remove a sample of bone marrow—usually from the hipbone—to identify leukemia cells and determine their specific characteristics.

Treatment Options

Your medical team will tailor treatment based on the specific type of leukemia, your age, and your overall health status.

1. Chemotherapy

This is the primary treatment for leukemia. It involves using powerful chemicals (administered via pill or IV) to kill cancer cells throughout the body.

2. Targeted Therapy

Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted treatments can cause cancer cells to die with significantly less damage to healthy surrounding cells.

3. Radiation Therapy

Uses high-energy beams, such as X-rays or protons, to damage leukemia cells and shrink an enlarged spleen or lymph nodes.

4. Stem Cell Transplant

A stem cell transplant (bone marrow transplant) replaces diseased bone marrow with healthy marrow. Before the transplant, you receive high doses of chemotherapy or radiation to destroy the diseased marrow. Then, you receive an infusion of blood-forming stem cells from a donor or your own stored cells.

Frequently Asked Questions (FAQs)

Is leukemia hereditary?

While most cases of leukemia are not directly inherited, certain genetic factors and syndromes (like Down syndrome) can increase the risk. Having a first-degree relative with certain types of leukemia may slightly increase your own risk, but it is not considered a strictly hereditary disease.

What is the survival rate for leukemia?

Survival rates have improved dramatically over the last few decades due to advances in targeted therapy and stem cell transplants. The prognosis varies widely depending on the type of leukemia (ALL, AML, CLL, or CML) and the age of the patient at diagnosis.

References

• Leukemia & Lymphoma Society (LLS)
• National Cancer Institute (NCI) - Leukemia Overview
• Mayo Clinic - Leukemia Symptoms and Causes