Leukemia

Leukemia is a type of cancer that affects the blood and bone marrow, the spongy center of bones where our blood cells are formed. The disease develops when blood cells produced in the bone marrow grow out of control.

An estimated 48,610 new cases of leukemia are expected to be diagnosed in the United States in 2013.

Diagnosis

Diagnosing leukemia usually involves a series of tests. Blood tests and bone marrow tests are common tests that doctors use.

Your doctor needs to test your blood to make a diagnosis. Your blood is sent to a lab for:

  • A complete blood count (CBC), which shows the number of red cells, white cells and platelets in your blood. If you have AML, you’ll have lower than normal red cells and platelets.
  • A peripheral blood smear, which shows whether you have too many immature white cells (leukemic blast cells) in your blood.

Your doctor or oncologist (cancer specialist) tests your bone marrow. Bone marrow testing involves two steps usually performed at the same time in a doctor’s office or a hospital:

  • a bone marrow aspiration to remove a liquid marrow sample
  • a bone marrow biopsy to remove a small amount of bone filled with marrow

The tests’ purpose is to confirm a diagnosis and:

  • find out how many leukemic cells are in your marrow
  • examine the cell type and look for certain abnormal changes
  • identify the subtype by examining chromosomes and genes
  • develop a treatment plan

Living with Leukemia

An estimated 310,046 people in the US are living with, or are in remission from, leukemia. ALL and AML are diseases that progress rapidly without treatment. They result in the accumulation of immature, nonfunctional cells in the marrow and blood. The marrow often stops producing enough normal platelets, red cells and white cells. Anemia, a deficiency of red cells, develops in virtually all people who have leukemia. The lack of normal white cells impairs the body’s ability to fight infections. A shortage of platelets results in bruising and easy bleeding.

The four most common types of leukemia are:

Acute myeloid leukemia (AML)

Acute myeloid leukemia (AML) is a cancer of the bone marrow and the blood that progresses quickly without treatment. It affects mostly cells that aren’t fully developed. These cells can’t carry out their normal functions. That’s one reason why it’s important to get care and treatment as soon as possible.

The signs and symptoms of acute myeloid leukemia (AML) are common to other, less serious illnesses. However, if you’re troubled by any of the following symptoms, see your doctor:

  • pale skin
  • black-and-blue marks (bruises) with no clear cause
  • pinhead-size red spots under the skin (called petechiae)
  • prolonged bleeding from minor cuts
  • slow healing of cuts
  • tiredness or no energy
  • shortness of breath during normal physical activity
  • mild fever or night sweats
  • swollen gums
  • frequent minor infections, such as perianal sores (sores around the anus)
  • loss of appetite and weight loss
  • aches or discomfort in bones or joints such as knees, hips or shoulders

For many people with acute myeloid leukemia (AML), starting treatment helps them focus on moving ahead and looking forward to their disease’s remission.   Doctors use several types of treatment for adults with AML, some at different stages:

  • Chemotherapy. Most patients with AML start chemotherapy right away.
  • Stem cell transplantation. This may be used with a second phase of chemotherapy.
  • Other drug therapies. Some different anticancer drugs are used to treat acute promyelocytic leukemia (subtype M3).

Acute lymphoblastic leukemia (ALL)

Acute lymphoblastic leukemia (ALL) is a cancer of the bone marrow and blood that progresses rapidly without treatment. That’s why it’s important to start treatment soon after diagnosis.

Most children with ALL are cured of their disease after treatment. The numbers of adults and their remission lengths have grown significantly over the past 30 years.

Acute lymphoblastic leukemia’s (ALL’s) signs and symptoms are common to other, less serious illnesses. However, if you’re troubled by any of the following symptoms, see your doctor:

  • aches in the arms, legs or back
  • black-and-blue marks (bruises) for no clear reason
  • enlarged lymph nodes
  • fever without an obvious cause or a lasting, low-grade fever
  • headaches
  • pale skin
  • pinhead-size red spots under the skin (called petechiae)
  • prolonged bleeding from minor cuts
  • shortness of breath during normal physical activity
  • tiredness or no energy
  • vomiting
  • unexplained weight loss

Treatment

For many people with acute lymphoblastic leukemia (ALL), starting treatment helps them focus on moving ahead and looking forward to their diseases’ remission. Doctors use several types of approaches and treatment combinations for ALL:

  • chemotherapy
  • intrathecal therapy
  • stem cell transplantation
  • Ph-positive ALL therapy

Your doctor may suggest that you participate in a clinical trial. Clinical trials can involve therapy with new drugs and new drug combinations or new approaches to stem cell transplantation.

Chronic myeloid leukemia (CML)

Chronic myeloid leukemia (CML) is a cancer of the bone marrow and blood. CML is usually diagnosed in its chronic phase when treatment is very effective for most patients. CML has three phases.

People who have chronic myeloid leukemia (CML) may at first have no symptoms at all. Often, patients learn they have CML after a routine physical exam or a blood test. CML signs and symptoms tend to develop gradually.

When CML symptoms do appear, they’re common to other, less serious illnesses. However, if you’re troubled by any of the following symptoms, see your doctor:

  • tiredness or no energy
  • shortness of breath during normal physical activity
  • pale skin
  • discomfort or a “dragging” feeling on the upper left side of your stomach (caused by an enlarged spleen)
  • night sweats
  • an inability to tolerate warm temperatures
  • unexplained weight loss

With current drug therapies, most people diagnosed with chronic phase chronic myeloid leukemia (CML) can expect to live good-quality lives.

Your treatment and treatment goals depend on your CML phase: Your treatment and treatment goals depend on your CML phase:

  • chronic phase CML treatment
  • accelerated phase CML treatment
  • blast crisis phase CML treatment

Chronic lymphocytic leukemia (CLL)

Chronic lymphocytic leukemia (CLL) is a type of blood cancer that begins in the bone marrow. It can progress either slowly or quickly depending on the form it takes. Many people with CLL live good-quality lives for years with medical care.

When CLL symptoms do appear, they’re common to other, less serious illnesses. However, if you’re troubled by any of the following symptoms, see your doctor:

  • tiredness or no energy
  • shortness of breath during normal physical activity
  • enlarged lymph nodes
  • discomfort or a “dragging” feeling on the upper left side of your stomach (caused by an enlarged spleen)
  • frequent infections

Current therapies do not offer patients a cure for CLL, but there are treatments that help manage the disease.  Doctors use several types of approaches and treatment for adults with CLL, some at different stages:

  • watch and wait
  • drug therapy, including chemotherapy and monoclonal antibody therapy
  • white cell (neutrophil) growth factors
  • radiation therapy
  • splenectomy
  • supportive care

Source: Leukemia & Lymphoma Society, © 2011.

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