Leukemia

The term leukemia refers to cancers of the white blood cells (also
called leukocytes or WBCs). When someone has leukemia, large
numbers of abnormal white blood cells are produced in the bone
marrow. These abnormal white cells crowd the bone marrow and food
the bloodstream, but they cannot perform their proper role of
protecting the body against disease because they are defectie.
!s leukemia progresses, the cancer interferes with the body"s
production of other types of blood cells, including red blood cells and
platelets. This results in anemia (low numbers of red cells) and
bleeding problems, in addition to the increased risk of infection caused
by white cell abnormalities.
!s a group, leukemias account for about #$% of all childhood cancers
and a&ect more than #,$$$ !merican young people each year. 'uckily,
the chances for a cure are ery good with leukemia. With treatment,
most children with leukemia will be free of the disease without it
coming back.
Types of Leukemia
(n general, leukemias are classi)ed into acute (rapidly deeloping) and
chronic (slowly deeloping) forms. (n children, most leukemias are
acute.
!cute childhood leukemias are also diided into acute lymphoblastic
leukemia (!'') and acute myeloid leukemia (!*'), depending on
whether speci)c white blood cells called lymphyocytes or myelocytes,
which are linked to immune defenses, are inoled.
The !'' form of the disease most commonly occurs in younger children
ages + to ,, but it can a&ect all age groups. !*' can occur at any age,
but it is somewhat more common before the age of + and during the
teenage years.
*ost kids with leukemia hae !''- about +$% hae !*'. .ther types of
leukemia, like chronic myelogenous leukemia (C*') or /uenile
myelomonocytic leukemia (0**'), are much less common.
Leukemia is cancer of the body"s blood1forming tissues, including the
bone marrow and the lymphatic system.
*any types of leukemia e2ist. 3ome forms of leukemia are more
common in children. .ther forms of leukemia occur mostly in adults.
'eukemia usually starts in the white blood cells. 4our white blood cells
are potent infection )ghters 5 they normally grow and diide in an
orderly way, as your body needs them. But in people with leukemia,
the bone marrow produces abnormal white blood cells, which don"t
function properly.
Treatment for leukemia can be comple2 5 depending on the type of
leukemia and other factors. But there are strategies and resources that
can help to make your treatment successful.
Symptoms
'eukemia symptoms ary, depending on the type of leukemia.
Common leukemia signs and symptoms include6
7eer or chills
8ersistent fatigue, weakness
7re9uent or seere infections
'osing weight without trying
3wollen lymph nodes, enlarged lier or spleen
:asy bleeding or bruising
;ecurrent nosebleeds
Tiny red spots in your skin (petechiae)
:2cessie sweating, especially at night
Bone pain or tenderness
Causes
3cientists don"t understand the e2act causes of leukemia. (t seems to
deelop from a combination of genetic and enironmental factors.
How leukemia forms
(n general, leukemia is thought to occur when some blood cells ac9uire
mutations in their <=! 5 the instructions inside each cell that guide its
action. .r other changes in the cells that hae yet to be fully
understood could contribute to leukemia.
Certain abnormalities cause the cell to grow and diide more rapidly
and to continue liing when normal cells would die. .er time, these
abnormal cells can crowd out healthy blood cells in the bone marrow,
leading to fewer healthy blood cells and causing the signs and
symptoms of leukemia.
How leukemia is classifed
<octors classify leukemia based on its speed of progression and the
type of cells inoled.
The )rst type of classi)cation is by how fast the leukemia progresses6
Acute leukemia. (n acute leukemia, the abnormal blood cells
are immature blood cells (blasts). They can"t carry out their
normal work, and they multiply rapidly, so the disease worsens
9uickly. !cute leukemia re9uires aggressie, timely treatment.
Chronic leukemia. This type of leukemia inoles more mature
blood cells. These blood cells replicate or accumulate more
slowly and can function normally for a period of time. 3ome
forms of chronic leukemia initially produce no early symptoms
and can go unnoticed or undiagnosed for years.
The second type of classi)cation is by type of white blood cell a&ected6
Lymphocytic leukemia. This type of leukemia a&ects the
lymphoid cells (lymphocytes), which form lymphoid or lymphatic
tissue. 'ymphatic tissue makes up your immune system.
Myelogenous (my-uh-LH!-uh-nus" leukemia. This type of
leukemia a&ects the myeloid cells. *yeloid cells gie rise to red
blood cells, white blood cells and platelet1producing cells.
Types of leukemia
The ma/or types of leukemia are6
Acute lymphocytic leukemia (ALL". This is the most common
type of leukemia in young children. !'' can also occur in adults.
Acute myelogenous leukemia (AML". !*' is a common type
of leukemia. (t occurs in children and adults. !*' is the most
common type of acute leukemia in adults.
Chronic lymphocytic leukemia (CLL". With C'', the most
common chronic adult leukemia, you may feel well for years
without needing treatment.
Chronic myelogenous leukemia (CML". This type of leukemia
mainly a&ects adults. ! person with C*' may hae few or no
symptoms for months or years before entering a phase in which
the leukemia cells grow more 9uickly.
.ther, rarer types of leukemia e2ist, including hairy cell leukemia,
myelodysplastic syndromes and myeloproliferatie disorders.
Risk factors
7actors that may increase your risk of deeloping some types of
leukemia include6
#re$ious cancer treatment. 8eople who"e had certain types
of chemotherapy and radiation therapy for other cancers hae an
increased risk of deeloping certain types of leukemia.
%enetic disorders. >enetic abnormalities seem to play a role in
the deelopment of leukemia. Certain genetic disorders, such as
<own syndrome, are associated with increased risk of leukemia.
Certain &lood disorders. 8eople who hae been diagnosed
with certain blood disorders, such as myelodysplastic syndromes,
may hae an increased risk of leukemia.
'(posure to high le$els of radiation. 8eople e2posed to ery
high leels of radiation, such as suriors of a nuclear reactor
accident, hae an increased risk of deeloping leukemia.
'(posure to certain chemicals. :2posure to certain
chemicals, such as ben?ene 5 which is found in gasoline and is
used by the chemical industry 5 also is linked to increased risk
of some kinds of leukemia.
)moking. 3moking cigarettes increases the risk of acute
myelogenous leukemia.
*amily history of leukemia. (f members of your family hae
been diagnosed with leukemia, your risk of the disease may be
increased.
Tests and diagnosis
#hysical e(am. 4our doctor will look for physical signs of
leukemia, such as pale skin from anemia and swelling of your
lymph nodes, lier and spleen.
+lood tests. By looking at a sample of your blood, your doctor
can determine if you hae abnormal leels of white blood cells or
platelets 5 which may suggest leukemia.
+one marrow test. 4our doctor may recommend a procedure to
remoe a sample of bone marrow from your hipbone. The bone
marrow is remoed using a long, thin needle. The sample is sent
to a laboratory to look for leukemia cells. 3peciali?ed tests of
your leukemia cells may reeal certain characteristics that are
used to determine your treatment options.
Treatments and drugs
Treatment for your leukemia depends on many factors. 4our doctor
determines your leukemia treatment options based on your age and
oerall health, the type of leukemia you hae, and whether it has
spread to other parts of your body.
Common treatments used to )ght leukemia include
Chemotherapy. Chemotherapy is the ma/or form of treatment for
leukemia. This drug treatment uses chemicals to kill leukemia cells.
<epending on the type of leukemia you hae, you may receie a
single drug or a combination of drugs. These drugs may come in a
pill form, or they may be in/ected directly into a ein.
+iological therapy. Biological therapy works by helping your
immune system recogni?e and attack leukemia cells.
Targeted therapy. Targeted therapy uses drugs that attack
speci)c ulnerabilities within your cancer cells.
7or e2ample, the drug imatinib (>leeec) stops the action of a
protein within the leukemia cells of people with chronic
myelogenous leukemia. This can help control the disease.
,adiation therapy. ;adiation therapy uses @1rays or other high1
energy beams to damage leukemia cells and stop their growth.
<uring radiation therapy, you lie on a table while a large machine
moes around you, directing the radiation to precise points on your
body.
)tem cell transplant. ! stem cell transplant is a procedure to
replace your diseased bone marrow with healthy bone marrow.
Before a stem cell transplant, you receie high doses of
chemotherapy or radiation therapy to destroy your diseased bone
marrow. Then you receie an infusion of blood1forming stem cells
that help to rebuild your bone marrow.
4ou may receie stem cells from a donor, or in some cases you may
be able to use your own stem cells. ! stem cell transplant is ery
similar to a bone marrow transplant.