What is Leukemia?
Leukemia is a cancer of white blood cells which are produced in the bones of human body. Unlike other cancers which present as a tumor or mass, leukemia is mostly devoid of such presentation.
Bones are not entirely compact and hard; they have a spongy cavity inside called the bone marrow. Bone marrow is responsible for the production of various kinds of blood cells like red blood cells, white blood cells, platelets, etc. These cells transport oxygen, provide immunity, help in promoting healing and clotting of blood.
In Leukemia, there is an uncontrolled multiplication of any of these lines of cells (most commonly white blood cells). As these cells keep growing in number, they occupy bone marrow space and hamper the production of other cells. Moreover, these rapidly dividing cells (also called leukemic cells) are not able to function normally. This ultimately leads to pooling of non-functioning or dysfunctioning cells in the blood and decreased production of normal cells severely affecting the normal body physiology.
Classification of Leukemia:
Leukemia is classified based on:
- The cell line affected: There are different categories of cells in the blood mainly divided into myeloid and lymphoid.
- The onset of disease: Sudden onset (acute) or slow onset (chronic).
Therefore, types of leukemia are:
- Acute myeloid leukemia: A sudden onset leukemia that affects the myeloid cells. This type of leukemia is seen in all ages but its incidence is more in adults and more so after 60 years of age.
- Acute lymphoid leukemia: A sudden onset leukemia affecting the lymphoid cells. Most commonly seen in children.
- Chronic myeloid leukemia: Most commonly affects adults.
- Chronic lymphoid leukemia: Rarely seen in children and commonly seen in old age.
How common is Leukemia?
Leukemia affects fewer than 1 million cases per year in India. And as per a report published by NCBI, Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in elderly people.
What are the causes and risk factors for Leukemia?
The exact cause of leukemia is unknown. Some known or suspected risk factors are:
- Family history of the disease
- Exposure to radiations
- Chemotherapy used in previous cancer treatment
- Viral infections such as HIV and Human T-lymphotropic virus (HTLV-1)
- Genetic disorders like Down’s syndrome
- Exposure to chemicals such as benzene
What are the symptoms of Leukemia:
Following are the common symptoms for leukemia:
- Bone pain
- Unintentional weight loss
- Fever with night sweats
- Frequent infections
- Fatigue and weakness
- Swollen lymph nodes
- Increased bleeding tendency or easy bruising
- Involvement of other organs might be seen like enlargement of spleen or liver
- Small red or purple spots on the skin
How is Leukemia Diagnosed?
The common investigations required for diagnosis are as follows:
- Blood tests (complete blood count and microscopic examination of cells – The blood count, especially, the WBCs get abnormally increased in number)
- Lymph node biopsy
- Bone marrow examination (Bone marrow needle aspiration)
- Biopsy of other organs involved
How is Leukemia treated?
Treatment is based on the staging of cancer and a combination of treatment strategies can be used. The various treatment options are as follows:
- Radiotherapy: High energy radiations are used to kill or stop the growth of leukemic cells. This can be used along with chemotherapy or as a preparation for transplant.
- Chemotherapy: Drugs are used to kill leukemic cells. A combination of drugs can be given for an effective treatment. Other drugs aimed at boosting the immune system can also be given to fight off cancer.
- Bone marrow transplantation: In this method, patient’s bone marrow is replaced with a healthy bone marrow from a suitable donor. This method will be preceded by a chemotherapy or radiotherapy session to destroy the malfunctioning bone marrow.
What are the complications involved with Leukemia?
- Enlargement of liver, spleen or testicles can take place, leading to discomfort
- In some form of ALL, difficulty in breathing and swallowing may occur
- Cancer can spread to the brain and cause symptoms like headache and vomiting
- Hypertension, gastric problems and gout can be seen in CML
- As the immunity of the people under treatment is low, they get prone to contracting infections like flu, respiratory infections, etc. Hence, they might be asked to stay in isolation.
How can you take care of someone with Leukemia?
- Help them with their doctor’s visits, medications and chemotherapy sessions
- Ensure they eat well and exercise daily, if recommended
- Be there for them and show love and support