Leukemia

What is leukemia?

Leukemia is cancer of the white blood cells. White blood cells help your body fight infections. Inside your bones is a substance called bone marrow. This is where the blood cells are made. When you have leukemia, the bone marrow makes abnormal white blood cells. The abnormal cells build up and crowd out healthy blood cells. This makes it hard for your blood to do what it is supposed to do.

There are 4 main types of leukemia:

• Acute lymphocytic leukemia
• Acute myeloid leukemia
• Chronic lymphocytic leukemia
• Chronic myeloid leukemia

Acute types develop and grow quickly. Chronic types grow slowly. Lymphocytic or myeloid refers to which kind of white blood cells are abnormal. Each type of leukemia has different symptoms and is treated differently.

Leukemia is most common in adults over age 60. But it also happens to children. It is among the most common forms of cancer in children under age 15.

Symptoms

The symptoms of leukemia depend on which kind it is. Symptoms of chronic leukemia tend to come on slowly over time. They include:

• Fatigue
• Shortness of breath
• Swollen lymph nodes
• Frequent infections

Some people with chronic leukemia don’t have any symptoms. They don’t know they have it until they get a blood test incidentally.

Symptoms of acute leukemia include:

• Fatigue, lack of energy
• Shortness of breath
• Pale skin
• Low-grade fever
• Night sweats
• Unexplained bruises
• Achy bones or joints

Tiny red spots under the skin

What causes leukemia?

In many cases, the cause of leukemia is not known. There are some factors that can increase your risk of developing one or more of the types. These include:

• Previous cancer treatment. Certain types of chemotherapy and radiation used for other cancer treatments can increase your risk.
• Some genetic disorders can increase your risk, such as Down syndrome.
• Certain chemicals. Excess exposure to some chemicals can increase your risk. One example is benzene, which is found in gasoline.
• Cigarette smoking increases the risk of one type of leukemia.
• Family history. Having a family member with leukemia raises your risk.

How is leukemia diagnosed?

Your doctor will ask you a lot of questions about your symptoms. They will do a physical exam to look for signs of leukemia. These signs might include pale skin or swollen lymph nodes. They will likely order blood tests. These tests can look for abnormal levels in your blood that could indicate leukemia. They may also order a test of your bone marrow. In this test, a sample of bone marrow is removed and looked at under a microscope.

If your doctor thinks you have leukemia, they will probably order further tests. These can confirm the diagnosis. They can also determine what kind of leukemia you have, and how far it has spread in your body.

Can leukemia be prevented or avoided?

In most cases, there is nothing you can do to prevent or avoid leukemia. Most people who have the risk factors don’t get leukemia. Most people who get leukemia don’t have the risk factors.

Treatment

There are several treatment options for leukemia. Your doctor may recommend more than one type of treatment. What is best for one person may not be the best treatment for you. Your doctor will make the decision based on several things, including:

• Your age
• Your general health
• The type of leukemia
• Where the cancer has spread

Common available treatments include:

Chemotherapy – Powerful medicines are used to kill cancer cells. They are given through an IV (directly into the vein) or in pill form. This is the primary treatment for leukemia. Chemotherapy can cause unpleasant side effects. These include weakness, exhaustion, and hair loss.

Radiation therapy – High-energy rays are used to kill cancer cells. You lie on a table while a large machine moves around you. It directs the radiation into your body. It is a painless procedure. Radiation can cause some side effects as well, including fatigue, skin problems, and a low blood count.

Targeted therapy – Special medicines block the growth and spread of specific cancer cells. They can be given in an IV or as a pill. Common side effects of targeted therapy include diarrhea and liver problems. Other side effects might include problems with blood clotting and wound healing, high blood pressure, fatigue, mouth sores, nail changes, the loss of hair color, and skin problems, such as rash or dry skin.

Stem cell transplant – This procedure removes your cancerous bone marrow and replaces it with healthy bone marrow. You may be able to use your own stem cells. You may need a donor. It is very similar to a bone marrow transplant. It normally follows chemotherapy or radiation therapy. Side effects can include mouth and throat pain, nausea and vomiting, and infection.

Living with leukemia

With treatment, leukemia can go into remission. How well you do after treatment depends on many things. This includes how early the cancer was diagnosed. Left untreated or undetected, cancer can spread to other parts of the body. This could cause serious health problems or be fatal. It is important to get treatment as soon as possible.

Living with cancer during treatment can be stressful. Treatments can have different side effects on your body. Take good care of yourself. Eat a healthy diet, get plenty of sleep, and try to keep your energy up by staying mildly active. Living with leukemia can affect your emotions. Get support where you need it. Family, friends, counselors, or support groups can all help you emotionally.

Even after your cancer is gone, you are at higher risk of cancer returning. You will need to get regular follow-up care and check-ups for years after your treatment.

Questions to ask your doctor

• What type of leukemia do I have?
• Will I need more tests?
• What kind of treatment do I need?
• Can my leukemia be cured?
• How will my treatment affect my life?
• Can I work or go to school?

Resources

National Institutes of Health, MedlinePlus: Leukemia

National Cancer Institute: Leukemia — Patient Version