The term leukemia means white blood. White blood cells (leukocytes) are used by the body to fight infections and other foreign substances. Leukocytes are made in the bone marrow.
Leukemia leads to an uncontrolled increase in the number of white blood cells.
The cancerous cells prevent healthy red cells, platelets, and mature white cells from being made. Life-threatening symptoms can then develop as normal blood cells decline.
The cancer cells can spread to the bloodstream and lymph nodes. They can also travel to the brain, spinal cord and other parts of the body.
Leukemia can affect children and adults and can be either acute (quickly progressing) or chronic (slowly progressing).
The main types of leukemia are:
- Acute lymphocytic leukemia (ALL) - A fast-growing cancer of a type of white blood cell called a lymphoblast. ALL occurs when the bone marrow produces a large number of immature lymphoblasts that grow quickly and replace normal cells in the bone marrow. ALL prevents healthy blood cells from being made. Life-threatening symptoms can occur as normal blood counts drop. This type of leukemia usually affects children ages 3 to 7. ALL is the most common childhood cancer, but it can also occur in adults.
- Acute myelogenous leukemia (AML) – Cancer that starts inside bone marrow and grows from cells that would normally turn into white blood cells. AML is one of the most common types of leukemia among adults and is more common in men than women.
- Chronic lymphocytic leukemia (CLL) - Cancer that causes a slow increase in a certain type of white blood cells called B lymphocytes, or B cells. Cancer cells spread through the blood and bone marrow. CLL can also affect the lymph nodes or other organs such as the liver and spleen and can eventually cause the bone marrow to lose its function. CLL usually affects older adults, especially those over age 60 and is more common in men than in women.
- Chronic myelogenous leukemia (CML) – Cancer that causes an uncontrolled growth of immature and mature cells that make a certain type of white blood cell called myeloid cells. The diseased cells build up in the bone marrow and blood. Cause of CML is related to an abnormal chromosome called the Philadelphia chromosome and occurs most often in middle-age adults.
- Hairy cell leukemia – An unusual cancer of the blood caused by the abnormal growth of B cells. Hairy cell leukemia affects men more than women with 55 being the average age of diagnosis. Treatment may not be needed for the early stages of this disease. Some people may need an occasional blood transfusion. If blood counts are low and treatment is needed, chemotherapy drugs can be used.
Leukemia symptoms vary by type. Common symptoms include:
- Abnormal paleness
- Weight loss
- Shortness of breath
- Easy bruising
- Repeated infections
- Bone pain
- Abdominal pain
- Skin irritations or rashes
What Causes It?
Most causes of leukemia are not known. Several genetic and environmental factors are associated with childhood leukemia. The disease has also been linked to:
- Exposure to large amounts of high energy radiation (from nuclear bombs)
- Occupational exposure to the chemical benzene
- Viral infections
- Chemicals from cigarettes
Who Is Most At Risk?
Leukemia is linked to the following risk factors:
- Males are at greater risk than females
- Increasing age
- Genetic diseases, such as Fanconi anemia or Down syndrome
- Acquired diseases, such as Hodgkin disease
- First degree relative with leukemia
- Excessive exposure to ionizing radiation
- Chemical exposure (benzene)
- Certain drugs
- Chromosomal abnormalities
- Cigarette smoking
Your doctor will do a physical examination, checking for swelling in the liver, the spleen, and the lymph nodes, and will order certain laboratory tests. Scientists will examine the bone marrow for leukemia cells or to determine the type of leukemia. A lumbar puncture ("spinal tap") checks for leukemia cells in the fluid around the brain and spinal cord. Chest x-rays can reveal signs of the disease in the chest.
Leukemia Treatment Options
Leukemia is an extremely complex disease. Treatment depends on the type of leukemia, certain features of the leukemic cells, the extent of the disease, and whether the leukemia has been treated before. Whenever possible, a patient with leukemia should be treated at a medical center that specializes in the disease.
Some of the drug therapies used to treat leukemia include the following:
- Radiation therapy. The use of high energy rays to kill cancer cells and prevent them from growing.
- Chemotherapy. The use of drugs to kill cancer cells.
- Steroids. To suppress muscle inflammation and reduce the activity of the immune system.
- Bone marrow transplantation. A procedure in which cancerous bone marrow is destroyed with high doses of anticancer drugs or radiation, then replaced with healthy bone marrow.
- Biological therapy. Stimulates or restores the immune system's ability to fight infection and disease. May also help reduce side effects caused by other treatments.
Surgical and Other Procedures
Surgeries may include:
- Lumbar puncture
- Bone marrow transplant
- Splenectomy (removal of the spleen)
- Stem cell transplant
Because of our multidisciplinary approach to treatment for all cancers, Wake Forest Baptist has been designated by the National Cancer Institute as a Comprehensive Cancer Center, one of only 41 in the country.