Leukemia

You may be surprised to find that leukemia isnt just one type of cancer but actually a category of multiple cancers that affect our blood cells. Both children and adults can be diagnosed with these cancers, which cause our bone marrow to produce abnormal white blood cells. These abnormal cells, called leukemic cells, can accumulate in the bone marrow and blood, crowding out any healthy white blood cells. The white blood cells exist to fight infection and disease. The leukemic cells also harm our platelets, which protects us from bleeding out, and the red blood cells that carry oxygen throughout our bodies. Leukemia can progress either rapidly (acutely) or slowly (chronically). Depending on its progression and the type of cell it affects, a leukemia diagnosis can fall into four broad categories. Regardless of the type, infection, anemia and bleeding are common effects of this cancer.

Recently Answered

QHow should I manage pain from leukemia?

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A Cancer Treatment Centers of America (CTCA) answered
Many leukemia patients experience bone or joint pain that results from the bone marrow being overcrowded with leukemia cells. Sometimes the side effects of leukemia treatments can result in pain. For example, some drug therapies and radiation therapy can damage the nerves and cause neuropathic pain.

Because of the complex nature of leukemia-related pain, successful cancer pain management usually involves a combination of techniques. To control pain, your team may use any of the following:

Medications (nonsteroidal anti-inflammatory drugs, anti-convulsants, narcotics)

Nerve blocks

Pain patches or pumps

Steroid injections

Acupuncture

Throughout your treatment, your leukemia pain management practitioner will reassess your pain and modify your plan accordingly.

Sometimes, pain medications can make you feel sedated and fatigued. Your pain management practitioner will adjust your medications to seek a balance between pain relief and quality of life. The goal is to help you achieve cancer pain control so you can fight the disease, while continuing to participate in activities you enjoy.
QWhat are some rehabilitation therapies for leukemia?

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A Cancer Treatment Centers of America (CTCA) answered
The following are some of the oncology rehabilitation therapies you may incorporate into your leukemia treatment:

Physical therapy: This type of oncology rehab combines range-of- motion training with light resistance exercises to help alleviate breathing problems, improve appetite, relieve constipation, reduce stress and increase energy.

Occupational therapy: These therapies can help you perform daily living activities, such as grooming, dressing, showering and eating, so you can continue to live as independently as possible.

Auriculotherapy: This non-invasive technique, which involves an electrical stimulation to the external ear, can help alleviate side effects, such as balance problems, nausea, shortness of breath and fatigue.

ReBuilder: This form of oncology rehab involves an electronic stimulation to an affected area (such as the hands and feet) to increase tactile sensory and awareness, can help improve peripheral neuropathy.

Massage therapy: This type of touch therapy can help restore a sense of harmony, relaxation and well-being during leukemia treatment.

Interactive metronome: This series of computer-generated sounds to measure a rhythmic beat and response can be used to increase concentration and improve balance, function and cognition during leukemia treatment.

Speech and language pathology: Some leukemia treatments may cause dry mouth or difficulty swallowing, which can limit your ability to eat. A speech therapist will work with other members of your care team to address these problems.
QHow can oncology rehabilitation help leukemia patients?

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A Cancer Treatment Centers of America (CTCA) answered
Sometimes, leukemia and/or its treatment can affect your physical functioning and energy. For instance, some leukemia treatments may cause fatigue and/or peripheral neuropathy (pain, numbness or tingling in the hands or feet), which can affect your ability to participate in your normal activities. Oncology rehabilitation can help in the following ways:

Overcome physical deficits (e.g., difficulty walking).

Reduce pain.

Alleviate muscle discomfort.

Improve strength and endurance.

Promote coordination.

Resolve swallowing difficulties.
QWhat are the stages of leukemia?

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A Cancer Treatment Centers of America (CTCA) answered
Most cancers are staged based on the size and spread of tumors. However, because leukemia already occurs in the developing blood cells within the bone marrow, leukemia staging is a little bit different. The stages of leukemia are often characterized by blood cell counts and the accumulation of leukemia cells in other organs, like the liver or spleen.

Leukemia stages vary based on disease type. Some of the leukemias may be broken out into subtypes during the staging process.

The acute types of leukemia (AML and ALL), are sometimes staged based on the type of cell involved and how the cells look under a microscope. This is called the French-American-British (FAB) classification system.

Lymphocytic leukemias (CLL and ALL) occur in a type of white blood cell called lymphocytes. The white blood cell count at the time of diagnosis may be used to help stage the leukemia. Likewise, staging for myeloid leukemias (CML and AML) is based on the number of myeloblasts (immature white blood cells) found in the blood or bone marrow.

The following are factors affecting leukemia staging and prognosis:

White blood cell or platelet count

Age (advanced age may negatively affect prognosis)

History of prior blood disorders

Chromosome mutations or abnormalities

Bone damage

Enlarged liver or spleen
QWhat are the types of leukemia?

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A Cancer Treatment Centers of America (CTCA) answered
Leukemia is cancer that originates in blood-forming tissue. The disease is characterized by the uncontrolled growth of blood cells, usually white blood cells (leukocytes), in the bone marrow. The leukemia cells crowd out and replace normal blood and marrow cells.

There are four main types of leukemia:

Acute myeloid leukemia (AML)

Chronic myeloid leukemia (CML)

Acute lymphocytic leukemia (ALL)

Chronic lymphocytic leukemia (CLL)

Another type of leukemia, hairy cell leukemia, is a rare subtype of chronic lymphocytic leukemia (CLL). It is caused by an increased number of lymphocytes and progresses very slowly. It is called “hairy” because of the appearance of the leukemia cells under a microscope.

Leukemia is classified in two ways. One way is by the type of white blood cell that is affected (lymphoid or myeloid cells). Another way is by how quickly the disease develops and gets worse, meaning whether it is acute (fast-growing) or chronic (slow-growing).

Lymphocytic leukemia (also known as lymphoid or lymphoblastic leukemia) develops in the white blood cells called lymphocytes within the bone marrow. Myeloid leukemia (also known as myelogenous leukemia) may also start in white blood cells other than lymphocytes (e.g., monocytes), as well as red blood cells and platelets.

Acute leukemia is rapidly progressing and results in the accumulation of immature, functionless blood cells in the bone marrow. With this type of leukemia, cells reproduce and build up in the marrow, decreasing the marrow’s ability to produce enough healthy blood cells. Chronic leukemia progresses more slowly and results in the accumulation of relatively mature, but still abnormal, white blood cells.
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QWhat are the symptoms of leukemia?

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A Cancer Treatment Centers of America (CTCA) answered
Many people often do not experience symptoms in the early stages of certain types of leukemia, or the symptoms develop slowly. Acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) progress much faster and symptoms may worsen more quickly than with the chronic leukemias (CML and CLL).

Some general symptoms of leukemia include the following:

Fever, chills

Fatigue, weakness

Loss of appetite, weight loss

Night sweats

Bone/joint pain

Abdominal discomfort

Headaches

Shortness of breath

Frequent infections

Easy bruising or bleeding

Petechiae (small red spots under the skin)

Some leukemia symptoms, like night sweats, fever, fatigue and achiness, often resemble flu-like symptoms. If you have the flu, symptoms will likely subside as you get better. Make an appointment to see your doctor if the symptoms persist longer than expected.

These symptoms may be attributed to a number of conditions other than cancer. It is important to consult with a medical professional for an accurate diagnosis.

Because some conditions coincide with the presence of the disease, the following may be also signs of leukemia:

Anemia: A low red blood cell count. Red blood cells carry oxygen around the body. This condition may contribute to weakness, fatigue or shortness of breath.

Leukopenia: A low white blood cell count. A decrease in the production of functional leukocytes (white blood cells) weakens the body's immune defense, which can make you more prone to infections.

Thrombocytopenia: A low blood platelet count. Platelets are the blood cells responsible for blood clotting. A shortage of bloods platelets may lead to easy bruising or bleeding.

Swollen lymph nodes: In some cases, the signs of leukemia may include noticeable swelling of the neck, armpit or groin. This occurs when leukemia has spread to the lymph nodes.

Enlarged liver or spleen: The build-up of abnormal blood cells in the liver or spleen may cause a feeling of fullness (loss of appetite) or swelling in the upper left side of the abdomen.

Myelodysplastic syndrome (MDS) is a condition in which the bone marrow does not produce enough normal blood cells for the body. Some cases of MDS may, over time, progress to leukemia (generally AML).
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QWhat are the risk factors for leukemia?

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A Cancer Treatment Centers of America (CTCA) answered
Although the risk factors for, and causes of, leukemia are largely unknown, scientists have identified some possible risk factors to be aware of. These include the following:

Exposure to high levels of radiation: Exposure to high-energy radiation (e.g., atomic bomb explosions) and intense exposure to low-energy radiation from electromagnetic fields (e.g., power lines).

Previous cancer treatment: Certain types of chemotherapy and radiation therapy for other cancers are considered leukemia risk factors.

Genetic diseases: Certain genetic abnormalities, such as Down syndrome, may play a role in the development of leukemia.

Chemical exposure: Long-term exposure to certain pesticides or industrial chemicals like benzene is considered to be a risk for leukemia.

Gender: Men are more likely to develop chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML) than women.

Age: The risk of most leukemias, with the exception of acute lymphocytic leukemia (ALL), typically increases with age.

Smoking: Although smoking may not be a direct cause of leukemia, smoking cigarettes does increase the risk of developing AML.

Family history: Most leukemias have no familial link. However, first degree relatives of CLL patients, or having an identical twin who has or had AML or ALL, may put you at an increased risk for developing the disease.
QHow is chronic lymphocytic leukemia diagnosed?

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A Spotsylvania Regional Medical Center answered

Chronic lymphocytic leukemia (CLL) is most often diagnosed during a routine blood test. This is because the disease rarely shows any symptoms in its early stages. Blood tests reveal abnormal numbers of white blood cells. A test called bone marrow aspiration uses a needle to remove marrow from the hipbone for analysis. A lymph node biopsy is not often performed for CLL, but may be helpful if it appears a lymph node is very swollen. Imaging tests like a CT scan are not usually needed but may help determine the course of the disease. Other tests, such as cytogenetic analysis and immunophenotyping, look at the cancerous cells in detail to help identify the specific form and stage of the disease.
QWhat causes leukemia?

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A Baptist Health South Florida answered

Leukemia begins when cells in the bone marrow malfunction and interrupt normal production of blood cells. The precise cause of this malfunction is unknown, but certain risk factors have been identified. The malfunctioning cells continue to grow and divide, unlike healthy cells, which eventually die and are replaced. Furthermore, the cancerous cells, which would have otherwise become healthy red or white blood cells or platelet cells, do not function properly once released into the blood stream and soon begin to upset the regular balance of blood cells.

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QWhat are the warning signs of leukemia?

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A PhRMA answered

The early warning signs of leukemia include paleness, fatigue, weight loss, a tendency to bruise easily, repeated infections, and heavy or uncontrolled bleeding, such as nosebleeds. Any of these symptoms can appear suddenly in acute leukemia. Normally, a person with acute leukemia will feel sick due to these symptoms and see their doctor. The progress of chronic leukemia can be slow and produce no symptoms for years. Chronic leukemia is often detected by a doctor during a routine checkup, before the patient is aware of any symptoms.

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