Cancer that starts in blood-forming tissues such as the bone marrow and
causes large numbers of blood cells to be produced and enter the blood
stream is called leukemia. In leukemia, the bone marrow makes abnormal
white blood cells. The abnormal cells are leukemia cells and like normal
blood cells, leukemia cells don’t die when they should. They may
crowd out normal white blood cells, red blood cells, and platelets, making
it hard for normal blood cells to do their work.
Types of leukemia can be grouped based on how quickly the disease develops
and gets worse. Leukemia is either chronic in which the disease usually
gets worse slowly, and the leukemia cells can still do some of the work
of normal white blood cells. Leukemia can also be acute in which the disease
gets worse quickly and the leukemia cells can’t do any of the work
of normal white blood cells. The types of leukemia can also be grouped
based on the type of white blood cell that is affected. The four common
types are chronic lymphocytic leukemia (CML), chronic myeloid leukemia
(CLL), acute lymphocytic leukemia (ALL), and acute myeloid leukemia (AML).
No one knows the exact cause of leukemia but there are certain risk factors
that increase the chance that a person will get this disease. Risk factors
include being exposed to high levels of radiation, atomic bomb explosions,
smoking, benzene, chemotherapy, down syndrome and certain other inherited
diseases, myelodysplastic syndrome and certain other blood disorders,
human T-cell leukemia virus type 1, and family history of leukemia.
The symptoms of leukemia depend on the number of leukemia cells and where
these cells collect in the body. With chronic leukemia people may not
have symptoms and the doctor may find the disease during a routine blood
test. With acute leukemia people usually go to the doctor because they
feel sick. Common symptoms of chronic or acute leukemia may include swollen
lymph nodes that usually don’t hurt, fevers or night sweats, frequent
infections, feeling weak or tired, bleeding and bruising easily, swelling
or discomfort in the abdomen, weight loss for no known reason, and pain
in the bone or joints.
During your appointment with a physician a personal and family medical
history will be taken. Additional tests include blood tests, physical
exam, cytogenetics, spinal tap, chest x-ray, and bone marrow biopsy. A
bone marrow biopsy is the only sure way to know if there are leukemia
cells in you bone marrow. During the biopsy a small amount of bone marrow
is removed for a pathologist to examine under a microscope to check for
leukemia cells. When final test results are received the doctor will discuss
treatment options consisting of watchful waiting, chemotherapy, targeted
therapy, biological therapy, radiation therapy, and stem cell transplant.
The choice of the treatment depends mainly on the type of leukemia, age,
and if leukemia cells were found in your cerebrospinal fluid. Your doctor
can describe your treatment choices, expected results, and possible side
effects. Together you and your healthcare team will develop a treatment
plan to meet your needs.
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