What is leukemia?

Leukemia is a type of cancer in which the number of white blood cells in either the blood or bone marrow increases abnormally. Leukemia may get worse quickly (acute leukemia) or slowly (chronic leukemia).

Symptoms of leukemia include:

• Low numbers of red blood cells (anemia). A person with leukemia may feel tired or weak or have a pale appearance.
• Low numbers of the cells that help blood to clot (platelets). The person may notice that he or she bruises more easily.
• Swollen glands (lymph nodes) and an enlarged spleen and liver.
• Frequent infections.
• Unexplained fever, pain, or night sweats.

In some forms of leukemia a person may have few or no symptoms.

There are four main types of leukemia in adults: acute lymphoblastic (ALL), acute myelogenous (AML), chronic lymphocytic (CLL), and chronic myelogenous (CML). The main types that affect children are ALL and AML. Each type of leukemia has subtypes. A doctor find out which type of leukemia is present by examining blood cells under a microscope.

Treatment for leukemia depends on the specific type of leukemia and the stage of the disease. It may include blood transfusions, chemotherapy, radiation, or a stem cell transplant.

Leukemia is cancer of the bone marrow and blood. The bone marrow is the soft, inner part of the bones that makes red and white blood cells. Leukemia is characterized by the uncontrolled accumulation of white blood cells (leucocytes).

Under normal circumstances, the blood-forming (hematopoietic) cells of the bone marrow make leukocytes to defend the body against infectious organisms, such as viruses and bacteria. Leukocytes fight infection through a process known as phagocytosis. During phagocytosis, the leukocytes surround and destroy foreign organisms. White blood cells also produce, transport, and distribute antibodies as part of the body's immune response. If some leukocytes are damaged and remain in an immature form, they become poor infection fighters that multiply excessively and do not die off as they should. Immature leukocytes are those that have just been formed in the bone marrow.

These damaged leukemic cells accumulate and lessen the production of oxygen-carrying red blood cells (erythrocytes), blood-clotting cells (platelets), and normal leukocytes. If untreated, the surplus leukemic cells overwhelm the bone marrow, enter the bloodstream, and eventually invade other parts of the body, such as the lymph nodes, spleen, liver, and central nervous system (brain, spinal cord). In this way, the behavior of leukemia is different than that of other cancers, which usually begin in major organs and ultimately spread to the bone marrow.

The four major types of leukemia are: acute lymphocytic leukemia (ALL); chronic lymphocytic leukemia (CLL); acute myelogenous leukemia (AML); and chronic myelogenous leukemia (CML).

The goal of treatment for leukemia is to bring about a complete remission. Complete remission means that there is no evidence of the disease and the individual returns to good health with normal blood and marrow cells. The cancer is not detectable in remission. Relapse indicates a return of the cancer cells and return of other signs and symptoms of the disease. Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after the diagnosis of their disease.

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