Leukemia is a type of cancer. It has got its name from the two Greek words, Leukos and haima. Leukos means white and haima means blood. So together it means white blood. Leukemia is a white blood cells (also called leucocytes) disorder in which, large number of defective, immature and abnormal white blood cells are produced in the body.
It is often found in children. It is more common in men as compare to women.
Normal count of white blood cells (leukocytes):
Number of white blood cells in a normal and healthy person’s blood are 4000 t0 11000 per micro Liter of blood.
Leukemia white blood cells (leukocytes) count:
The Number of white blood cells in Leukemia patient increase 11000 per micro liter of blood.
What system makes white blood cells?
White blood cells are formed in skeletal system’s part called bone marrow.
How increased white blood cells (leukocytes) count causes Leukemia?
Increase in count of white blood cells is due to mutation (change in base sequence in DNA).Following mutations occur that causes Leukemia
These mutations make bone marrow produce immature, defective, abnormal and malfunctioning leucocytes. Normal white blood cells are part of our immune system, The defense system. It defends the body against foreign invaders like virus and bacteria. Leukemia cells are not able to defend the body against these invaders hence the patient develops infections.
Body’s 8% of weight consists of blood. Blood is composed of blood cells and plasma. Blood cells are of three types which include
- Red blood cells called erythrocytes.
- White blood cells called leucocytes.
Plasma is fluid in which blood cells are suspended.
When count of white blood cells exceeds the normal count, it interferes with red blood cells which transport oxygen and platelets which help in blood clots. When they interfere with other blood cells they can not function properly, resulting oxygen will not be transported and blood clots will not form. It will cause anemia and infections.
Types of Leukemia
Acute Myelogenous Leukemia (AML)
Acute Lymphocytic Leukemia (ALL)
Chronic Myelogenous Leukemia (CML)
Chronic Lymphocytic Leukemia (CLL)
Leukemia may start with Acute Leukemia or chronic Leukemia. Leukemia is categorized on the basis of type leukemia cell. Leukemia have following types
- Acute Myelogenous Leukemia (AML)
- Chronic Myelogenous Leukemia (CML):
- Acute Lymphocytic Leukemia (ALL)
- Chronic Lymphocytic Leukemia (CLL)
- Prolymphocytic leukemia (PLL)
- Hairy cell leukemia (HCL)
- Plasma cell leukemia
- Large granular lymphocytic leukemia
- T-cell prolymphocytic leukemia (T-PLL)
Leukemia cells develop rapidly and symptoms are revealed early.
In Chronic leukemia, leukemia cells are developed slowly and its symptoms also revealed slowly and are mild.
Acute Myelogenous Leukemia (AML):
It involves myeloid cells. It has a rapid and sudden onset. It often occurs in children and adults. Almost 13,000 new cases of Acute Myelogenous Leukemia are diagnosed each year.
Chronic Myelogenous Leukemia (CML):
It involves myeloid cells. It onsets slowly and affects mostly adults. Almost 5,000 new cases of Chronic Myelogenous Leukemia are diagnosed each year..
Acute Lymphocytic Leukemia (ALL)
It has a rapid and sudden onset. It mostly occurs in children. Almost 5,000 new cases of Acute Lymphocytic Leukemia are diagnosed annually
Chronic Lymphocytic Leukemia (CLL)
It has slow onset. It is mostly affects people who are over the age of 55. It is rarely seen in children. Almost 15,000 new cases of Chronic Lymphocytic Leukemia are diagnosed each year.
Hairy cell leukemia:
In this type of leukemia too many B cells are formed. It is rare seen type of leukemia.
Risk Factors for Leukemia:
The causes of leukemia are not well known. However, several factors have been identified which may increase your risk of developing leukemia. These include are listed below:
- Family history.
- Genetic disorders like
- Down syndrome
- Bloom syndrome.
- Fanconi syndrome..
- Klinefelter syndrome
- Blood disorders like myelodysplastic syndromes, sometimes known as pre-leukemia.
- Prior treatment for cancer with chemotherapy or radiation or some other way.
- Exposure to high levels of radiation.
- Exposures to chemicals like benzene.
- Signs of Leukemia and Symptoms of Leukemia:
The symptoms of leukemia and symptoms of leukemia are listed below:
- Excessive sweating more specifically at night time.
- Fatigue and weakness that does not go away even though you take.
- Weight loss.
- Osteoporosis and pain in bones.
- Swollen lymph nodes (especially in the neck and armpits).
- Liver or spleen enlargement.
- Formation of red spots on the skin.
- Bleeding and bruising.
- Fever and chills.
- Lack of muscle control.
- Shortness of breath
- Rapid heartbeat.
You may be suffering from Leukemia if you have certain risk factors or symptoms. Its diagnosis begins with a complete history and physical examination. Physical examination checks for pale skin, tender bones, enlarged and swollen lymph nodes and enlargement of the liver or spleen. Leukemia could not be fully diagnosed by physical examination. Doctors can use following ways to diagnose leukemia
- Blood tests.
- Bone marrow aspiration
- Imaging studies.
- Complete blood count.
- Tissue biopsies.
- Flow cytometry.
- Lumber puncture.
- Liver function test.
Complete Blood Counts:
By complete blood count the numbers of red blood cells, white blood, and platelets in the blood are determined. Blood of patient is examined under microscope.
Tissue biopsies: In tissue biopsies, tissues are taken from the bone marrow or lymph nodes of patient to check for evidence of leukemia. By this test type of leukemia and its growth rate can be determined. Moreover Biopsies of other organs such as the liver and spleen can show whether the cancer has spread or not.
Flow Cytometry: determines the characteristics of cells and their growth rate. In addition it examines the DNA of cells. In this test blood is passed through laser. Furthermore it counts the number of cells and sorts the cells.
Liver Function Test: It shows whether leukemia cells are or invading the liver. It tests elevated liver enzymes and bilirubin ( a substance which is made by the liver by the breakdown of red blood cells) level.
Lumbar puncture: Lower spine is called lumber region. In lumber puncture a thin fine needle is inserted between the vertebrae of your lumber region. In this way doctor extracts fluid from and determine to check whether cancer has spread in central nervous system.
Imaging studies: It helps doctor to look for damage that leukemia has caused in other organs. This includes
- CT scan.
- PET scan.
- 2D echocardiogram
- pulmonary function tests
When leukemia is diagnosed, it will be staged. Staging helps the doctor to determine prognosis. AML and ALL are staged based on how cancer cells look under the microscope and the type of cell involved. ALL and CLL are staged based on the white blood cells count at the time of diagnosis. To stage AML and ACL, the presence of immature white blood cells in the blood and bone marrow is used
Treatment of Leukemia:
Leukemia is usually treated by a hematologist-oncologist, a physician and a doctor who is physician who specialized in diagnosis, treatment and prevention of blood disorders, diseases and cancers such as leukemia, iron-deficiency anemia, hemophilia, sickle-cell disease, and lymphoma. He is trained in hematology (the study of blood), and oncology (the study of cancer). The Treatment of Leukemia depends upon type and stage of the cancer at which it was diagnosed. Types of leukemia that grow slowly and steadily Slow does not need immediate treatment. However, treatment of leukemia usually involves
- Remission induction therapy.
- Hematopoietic stem cell transplant.
- Drug therapy.
Remission induction therapy:
Remission induction therapy aims to kill leukemia cells in the blood and bone marrow. However it does not kill all the leukemia cells , therefore patient needs to get his further treatment done.
Consolidation therapy is also called post remission therapy. Purpose of this phase of treatment is to kill and wipe out the remaining leukemia cells. It decreases the risk of relapse.
Following therapies are included in this phase.
Chemotherapy: It is the form of remission induction therapy. It is also used for consolidation therapy. Chemotherapy makes use of chemicals to kill cancerous cells in the body. Patients who are suffering from AML stay in the hospital during chemotherapy treatments because the drugs destroy many normal blood cells in the process of killing leukemia cells. If the first cycle of chemotherapy does not results in remission, it is repeated.
Drug therapy: Arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) are anti-cancer drugs and they can be used alone or along with chemotherapy for remission induction of a certain subtype of AML called promyelocytic leukemia. These drugs cause the leukemia cells which have a specific gene mutation to mature and die, or cause them to stop dividing.
Stem cell transplant:
In stem cell transplant, which is also called bone marrow transplant, consolidation therapy is done. Stem cell transplant helps re establish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells donated by a healthy donor, that regenerate healthy bone marrow. Before stem cell transplant, patient receives very high dose of chemotherapy or radiation therapy so that it can destroy leukemia-producing bone marrow. After that, patient receives inf
Cells in bone marrow are known as stem cells. Transplantation of cells of stem cells replaces your stem cells with cells taken from a healthy donor. It stops your body from making more cancerous cells. Diseased bone marrow is destroyed before a stem cell transplant can be performed. It is done by chemotherapy and radio therapy. Radio therapy is directed to a specific part of the body or to the entire body. This is also called whole body radiation.
Biological therapy is used to treat leukemia. It makes use of medication to boost immune system.
Factors affecting recovery from leukemia:
It is often said that you must have regular or routine checkup and you must see your doctor once in six months even if you are healthy. There are many diseases which do not show their symptoms early on, and hence they are diagnosed at a later stage where chances of recovery are reduced. Therefore earlier a disease is diagnosed, easier will be the treatment and faster will be its recovery. Beside earlier diagnosis there are many other factors that negatively contribute to the recovery from leukemia.
- Age, greater your age is, difficult will be for you to recover and more time recovery will take.
- Greater White blood cells count.
- Less Platelet count.
- History of blood disorder.
- Enlargement of the liver.
- Enlargement of the spleen.
- Presence of bone damage.
- Mutation in chromosome.
According to a survey conducted, more than 280,000 people are diagnosed with leukemia in US. Leukemia causes 4% of all cancer deaths. Among them 5% are under the age of 5 years.1 to 3 % people over the age of 50 are died with leukemia.