- What is leukaemia?
Blood cells are produced by the bone marrow. When there is a problem with the blood cells production then leukaemia can happen. Usually the white blood cells are affected in leukaemia. Like normal WBC they do not function and too quickly they divide and may crowd out the normal cells. Mostly in the bone marrow the WBCs are produced but certain types may also be produced in the spleen, thymus gland and the lymph node. In the blood and lymph they circulate throughout the body once formed and then they concentrate in the lymph nodes and spleen.
They are of following types:
- Acute myelogenous leukemia- it is the most common form that occurs in children and adults. Annually 21, 000 new cases in the United States are diagnosed.
- Acute lymphocytic leukemia- mostly it occurs in children and annually 6000 new cases are diagnosed as estimated by NCI.
- Chronic myelogenous leukemia- mostly it affects the adults and annually 9000 new cases are diagnosed.
- Chronic lymphocytic leukemia- usually people over the age of 55 are affected by it. In children it is seen very rarely. Annually 20,000 new cases are diagnosed.
- Risk factors
The following may increase the risk:
- Having a family history of leukemia
- The risk of acute myeloid leukemia may increase due to smoking
- Down syndrome or any other genetic disorder
- A blood disorders
- Body exposed to increased levels of radiation
- Body exposed to chemicals such as benzene
- Previous cancer treatment such as radiation or chemotherapy
The common symptoms include:
- Especially at night there is excess sweating
- The person may experience fatigue and tiredness which even after rest does not go away
- Weight loss that is unintentional
- Bones become tender and may pain
- Lymph nodes swell
- Liver or spleen may enlarge
- Easy bruising or bleeding
- Fever or chills
- Infection may occur frequently
- Can the condition spread to other areas of the body?
Other body parts may also be affected by leukemia. This includes the lungs, heart, the kidney, gastrointestinal tract and testes.
If you have certain risk factors or if you have the concerning symptoms then leukaemia may be suspected. First the doctor will take do physical examination and take complete history. To make a thorough diagnosis the doctor will ask for blood tests, imaging tests and biopsies.
In order to determine the outlook, staging is done. It will be staged once leukaemia is diagnosed. Under the microscope based on how the cancer cells look AML and ALL are staged. At the time of diagnosis based on the count of WBC ALL and CLL are diagnosed. AML and CML are diagnosed based on the presence of myeloblasts or blood cells in the bone marrow or blood.
- Assessing the progression of the disease
These tests include:
- Flow cytometry- the DNA of cancer cells can be determined and also helps to determine their growth rate.
- Liver function tests- it helps to determine whether the liver is invaded or affected by leukemia cells.
- Lumbar puncture- this is to determine whether the cancer cells have invaded the central nervous system.
- Imaging tests- this includes ultrasounds, CT scans, X-rays.
- Chemotherapy- leukemia cells are killed using drugs. This can include single drug or combination drugs.
- Radiation- leukemia cells are damaged using high-energy radiation. It can be applied on the entire body or specific area.
- Stem cell transplantation- the diseased bone marrow is replaced by healthy bone marrow.
- Immune therapy-this treatment enables the immune system to recognize the cancer cells and attack them.
- Targeted therapy- advantage of vulnerabilities in cancer cells is taken by these medications in this therapy.
Treatment is faster if it is recognized and diagnosed early. However some factors may negatively affect the prognosis. This includes past history of blood disorders, older age and chromosome mutations.