What Is Leukemia?
Leukemia is cancer that starts in the tissue that forms blood. To understand cancer, it helps to know how normal blood cells form.
Normal Blood Cells
Most blood cells develop from cells in the bone marrow called stem cells. Bone marrow is the soft material in the center of most bones.
Stem cells mature into different kinds of blood cells. Each kind has a special job:
White blood cells help fight infection. There are several types of white blood cells.
Red blood cells carry oxygen to tissues throughout the body.
Platelets help form blood clots that control bleeding.
White blood cells, red blood cells, and platelets are made from stem cells as the body needs them. When cells grow old or get damaged, they die, and new cells take their place.
The picture below shows how stem cells can mature into different types of white blood cells. First, a stem cell matures into either a myeloid stem cell or a lymphoid stem cell:
- A myeloid stem cell matures into a myeloid blast. The blast can form a red blood cell, platelets, or one of several types of white blood cells.
- A lymphoid stem cell matures into a lymphoid blast. The blast can form one of several types of white blood cells, such as B cells or T cells.
The white blood cells that form from myeloid blasts are different from the white blood cells that form from lymphoid blasts.
In a person with leukemia, the bone marrow makes abnormal white blood cells. The abnormal cells are leukemia cells.
Unlike normal blood cells, leukemia cells don't die when they should. They may crowd out normal white blood cells, red blood cells, and platelets. This makes it hard for normal blood cells to do their work.
Types of Leukemia
The types of leukemia can be grouped based on how quickly the disease develops and gets worse. Leukemia is either chronic or acute
Chronic Leukemia: Early in the disease, the leukemia cells can still do some of the work of normal white blood cells.
Acute Leukemia: The leukemia cells can't do any of the work of normal white blood cells.
There are four common types of leukemia:
- Chronic Lymphocytic Leukemia : CLL affects lymphoid cells and usually grows slowly. It accounts for more than 15,000 new cases of leukemia each year. Most often, people diagnosed with the disease are over age 55. It almost never affects children.
- Chronic Myeloid Leukemia (CML): CML affects myeloid cells and usually grows slowly at first. It accounts for nearly 5,000 new cases of leukemia each year. It mainly affects adults.
- Acute Lymphocytic (Lymphoblastic) Leukemia (ALL): ALL affects lymphoid cells and grows quickly. It accounts for more than 5,000 new cases of leukemia each year. ALL is the most common type of leukemia in young children. It also affects adults.
- Acute Myeloid Leukemia (AML): AML affects myeloid cells and grows quickly. It accounts for more than 13,000 new cases of leukemia each year. It occurs in both adults and children.
The following symptoms of leukemia are common to all types:
- Unexplained fevers
- Frequent infections
- Night sweats
- Fatigue (feeling tired or washed out)
- Weight loss
- Easy bleeding or bruising
Collection of leukemia cells in certain parts of the body may cause the following symptoms:
- Balance problems
- Blurred vision
- Painful swellings in the neck, under the arms, or in the groin
- Shortness of breath
- Nausea or vomiting
- Abdominal pain and/or swelling
- Testicular pain and/or swelling
- Pain in the bones or joints
- Weakness or loss of muscle control
Specialists who treat blood disorders and other kinds of cancer are either hematologists or hematologist-oncologists. These specialists treat leukemia.
The choice of treatment depends mainly on the following :
- The type of leukemia (acute or chronic)
- Your age
- Whether leukemia cells were found in your cerebrospinal fluid
It also may depend on certain features of the leukemia cells. Your doctor also considers your symptoms and general health.
- Children are usually treated by a specialist in childhood cancers (pediatric hematologist or hematologist-oncologist).
- These specialists are usually identified by the primary care physician, or less often, by a friend or relative.
- On other occasions, more than one opinion may be sought by the patient or by the referring primary care physician whenever there is doubt or uncertainty, or whenever personalities are at odds.
- Leukemia patients often find it helpful to take a family member or close friend along to these consultations in order to take notes and assist in remembering some of the points of the discussion. For children with leukemia, such is always the case.
- Most patients are treated in major medical centers with state-of-the-art cancer treatment programs.
- Leukemia treatment depends almost exclusively on the type. Modifying factors may be age, overall health, and prior therapy. Treatment is almost always carried out as part of carefully controlled multi-center programs so that information from many different areas may be constantly analyzed and altered if the results appear to necessitate changes. The patient is always kept abreast of ongoing treatment activities and changes in the treatment plan.
- Treatment commences only if the patient or the patient's guardian concurs.
- In addition to the blood specialist, the patient's medical care team usually includes a specialist nurse or physician assistant, social worker (and for children, child-life worker), and sometimes a member of the clergy, all of whom play major roles in furthering well being.
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