The cancer of white blood cells is known as Leukemia. It occurs in the bone marrow and spreads into the blood and other organs of the body. This disorder is of several types. These types are grouped in two ways: by how quickly the disease occurs (acute vs. chronic leukemia) and by the type of blood cells affected.
Lymphocytic and myeloid leukemia are the most common types. In acute leukemia, bone marrow cells are immature and can’t function properly. The number of affected cells increases quickly. In the case of chronic leukemia, cells are more mature and can perform some of their normal functions. The number of affected cells increases quite slowly.
Around 61,000 new cases of leukemia or about 14 per 100,000 males and females are diagnosed in the United States per annum. It is the 10th most common cancer newly diagnosed every year. Leukemia is about 3.5% of all new cancer cases in the USA.
Causes
Leukemia occurs when the DNA of a single cell in the bone marrow changes (mutates) and is unable to develop and perform a normal function. DNA is the instruction code for the growth of the cell and its function. Segments of DNA make up genes, which are arranged on larger structures named chromosomes. All cells produced from that initial mutated cell also have the mutated DNA.
It is still not known what leads to damage to the DNA initially. However, scientists have been successful to find out certain changes in chromosomes of those diagnosed with various types of leukemia.
Symptoms
Symptoms of leukemia can include:
- Weakness and fatigue
- Fever, chills, and other flu-like symptoms
- Loss of appetite
- Weight loss
- Frequent infections
- Swollen lymph nodes, spleen, or liver
- Tiny red spots under the skin
- Easy bleeding or bruising
- Sweating at night
- Swollen or bleeding gums
- Anemia
- Bone or joint pain
The above symptoms can also be seen in other less serious conditions. Your healthcare provider can determine the precise cause of your symptoms.
Types of leukemia
The most common types of leukemia are:
- Acute lymphocytic leukemia (ALL)
- Acute myeloid leukemia (AML)
- Chronic lymphocytic leukemia (CLL)
- Chronic myeloid leukemia (CML)
Acute myeloid leukemia (AML):
AML being the most common type of acute leukemia, it is more common in those over 65 years of age. It is more prevalent in males compared with females. Around 21,400 or about 4.3% of males and females register new cases of AML per annum in the USA.
Acute lymphocytic leukemia (ALL):
Acute myeloid leukemia is the most commonly occurring type in adults, followed by chronic lymphocytic leukemia.
It is more common in young adults, teens, children, and those up to 39 years of age. Around 54% of new cases are diagnosed in those under the age of twenty. It is also more common in those of white or Hispanic origin. Nearly 5,900 or around 1.7% out of 100,000 males and females cases of ALL per annum are reported in the USA.
Chronic myelogenous leukemia (CML):
This type of leukemia is more common in older male adults over 65 years of age. It is rarely diagnosed in children. Around 8,900 new cases of CML or about 1.9 per 100,000 males and females are diagnosed in the United States per year.
Chronic lymphocytic leukemia (CLL):
This is the most common type of chronic leukemia diagnosed in adults over 65 years of age. It is more reported in males than females, especially in whites. Around 20,700 new cases of CLL or about 4.9 per 100,000 males and females are diagnosed per annum in the United States.
Subtypes of leukemia
In addition to above mentioned four main types of leukemia, there also are several subtypes of leukemia, including:
- Subtypes of lymphocytic leukemia include hairy cell, lymphoma cell, Waldenstrom’s macroglobulinemia, and prolymphocytic leukemia.
- Subtypes of myelogenous leukemia include myelogenous, promyelocytic, monocytic, erythroleukemia, and megakaryocytic leukemia.
Diagnosis
Your physician can recommend one or more of the following procedures to ascertain whether you’ve leukemia:
- Physical exam
- Blood cell exam
- Complete medical history
- Complete blood count
- Bone marrow biopsy
- Lumbar puncture
- Surgical lymph node biopsy
Treatment
Leukemia is commonly treated by a hematologist-oncologist. These doctors are specialists in blood diseases and cancer. The treatment will depend on the type and stage of the disorder and the overall health and other medical conditions of the patient.
Some types of leukemia develop slowly and don’t require urgent treatment. Treatment of leukemia can involve one or more of the following:
- Chemotherapy - Chemotherapy consists of drugs that kill leukemia cells. The patient may be given either a single drug or a combination of drugs depending on the type and severity of leukemia.
- Radiation therapy - High-energy radiation is used to kill leukemia cells and restrict their further growth. Keeping in view the medical condition of the patient, radiation can be applied to a specific area or the entire body.
- Stem cell transplantation - Diseased bone marrow is replaced with healthy bone marrow through stem cell transplant, either your own (autologous transplantation) or from a donor (allogeneic transplantation). This procedure is also known as a bone marrow transplant.
- Biological or immune therapy - Biological or immune therapy involves treatments that enable the immune system to recognize and eliminate cancer cells.
- Targeted therapy - Targeted therapy uses drugs that take advantage of vulnerabilities in cancer-affected cells. Targeted therapy medications include Imatinib (Gleevec), which is a targeted drug vastly used against CML.
Prevention
At the moment, there is no way to prevent many types of leukemia, especially among children. Smoking is the most common avoidable risk factor among adults. Acute myeloid leukemia is attributed to smoking in about 20% of adults. Avoiding chemicals linked with leukemia, for example, benzene, can reduce the risk of occurring leukemia. Those who have been treated previously for cancer with chemotherapy and radiation, who are using immune-suppressing drugs, or those having certain genetic conditions such as Down’s syndrome are more vulnerable to developing acute leukemia. Anyone worried about developing this form of cancer should promptly address their concerns with their physician, rather than waiting for its onset.
Works cited
- Leukemia, 2022. Mayo Clinic. Leukemia - Symptoms and causes - Mayo Clinic
- A Guide to Leukemia, 2023. Healthline.com. Leukemia: Symptoms, Types, Treatment, and More
- Leukemia, 2022. Cleveland Clinic. Leukemia: Symptoms, Types, Causes & Treatments