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Dr. Navneet Sharda provides this information as an educational source. It is not intended as a substitute for a consultation with a qualified healthcare provider.

Leukemia is a cancer of the blood-forming tissues (such as the bone marrow) characterized by an increased number of abnormal white blood cells.

Normal blood cells are produced by bone marrow. The bone marrow can be found in the center of most bones and produces a type of cell called stem cells. These stem cells are immature cells that develop into three types of mature blood cells.

  • Red blood cells, which carry the oxygen to all the body tissues.
  • White blood cells, which fight against infections.
  • Platelets, which control the bleeding by forming blood clots.


Leukemia occurs when too many stem cells develop into abnormal white blood cells (immature white blood cells) called leukemia cells or blasts. A high number of immature white blood cells affect the normal production of all blood cells (red and white cell, and platelets) causing an impaired blood function. An increased number of cancerous white blood cells cause the lymph nodes, liver, and spleen to enlarge, and the body stops fighting against infections.

There are 5 types of Leukemia which include:

Chronic Lymphocytic Leukemia Chronic Myelogenous Leukemia Acute Lymphocytic Leukemia Acute Myeloid Leukemia Hairy Cell Leukemia


Leukemia Signs and Symptoms

Leukemia symptoms can vary from patient to patient depending on (1) the number of leukemia cells, (2) the area of the body where leukemia cells collect, and (3) the leukemia type.

General & Common Symptoms are:

Fever, chills, night sweats. Fatigue, weakness and tiredness. Frequent and recurrent infections (caused by an impaired white blood cells function). Easy bruising and bleeding (caused by a decrease number of platelets which helps the blood to clot). Loss of appetite. Weight loss. Headache (caused by an increased number of leukemia cells in the brain). Anemia (caused by a low concentration of healthy red blood cells). Tender or swollen lymph nodes (in the neck and armpit area). Tender or swollen liver. Discomfort or swelling in the abdomen cavity (caused by a tender or swollen spleen). Swollen or bleeding gums. Small red spots under the skin. Bone or joint pain. Breathing difficulties (short breathing).   Severe forms of leukemia symptoms for acute types of leukemia include: Severe infections Nose bleeds Vomiting Loss of muscle control (caused by an increased number of leukemia cells in the spinal cord) Confusion (caused by an increased number of leukemia cells in the brain) Seizures (caused by an increased number of leukemia cells in the brain)


Medical Tests, Diagnosis & Detection

In order to establish a correct diagnosis of leukemia, the doctor follows several steps.

Anamnesis (detailed medical review of past health state): One of the first steps in establishing a leukemia diagnosis is a detailed and complex medical review of a patient’s past health problems and general health state, family medical history, leukemia risk factors, and symptoms.

Physical examination: During a physical examination, the doctor looks for modifications of the internal organs like swelling of the liver, spleen, or lymph nodes from the neck, underarms, and groin area.


Laboratory Tests

Blood test: A blood test allows the pathologist to examine the blood cells under a microscope.

Bone marrow test: This test allows the pathologist to examine the marrow cells. It usually confirms the presence or absence of leukemia and the leukemia type.

Spinal tap: This test allows the pathologist to examine the cerebrospinal fluid (the fluid located in and around the brain and spinal cord), and to confirm the presence of leukemia cells.

Immunophenotyping: An immunopheno type test helps identify the chemicals located on the cells’ surface and diagnose the disease by placing various sorts of strain on bone marrow, blood, or lymph nodes cells.

Cytogenetics or chromosome analysis:This test analyzes the shape and number of the chromosomes from the leukemia cell, and can identify the chromosome alteration and sometimes the gene mutation.


Imaging Techniques

The purpose of these techniques is to locate masses of leukemia cells inside the body. Some of the most used imaging techniques are:

Chest X-rays: An x-ray test uses high energy electromagnetic radiation to penetrate the body and create an image of the body’s interior on film. An x-ray can reveal any possible mass of leukemia cells in the chest

Ultrasounds: Ultrasound imaging is a medical technique that uses high-frequency sound waves to create an interior image of the body on a special computer screen. This image is formed from the echoes of the sound waves on the surface of the organs. Abnormal tissue masses and organs reflect sound waves differently.

Bone or Gallium Scan: This is usually used to detect whether or not the bone pain (a symptom of leukemia) is caused by a tumor. This type of bone scan uses a radioactive form of gallium which collects in the areas where there are leukemia cells or infections.

Computed Tomography (CT): This imaging test is similar with an x-ray test, and creates a detailed cross-sectional image of the body.

Magnetic Resonance Imaging (MRI): This imaging technique uses radio waves and strong magnets to reveal a complete image of the body targeted area. The energy from the radio waves is absorbed by the tissues and then revealed into a recognizable pattern on a special monitor.


Treatment Options

The treatment approach differs from patient to patient, from one leukemia type to another, and from a leukemia stage or phase to another.

Chemotherapy: Most of the patients that suffer from leukemia receive chemotherapy. Chemotherapy is a systemic treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the leukemia cells, or to kill the leukemia cells.

Targeted Therapy: This treatment option is a new approach in the battle against leukemia. The advantage of this type of treatment is that it blocks the production of leukemia cells without killing healthy cells, like the chemotherapy approach does.

Biological Therapy or Immunotherapy: This is another new type of leukemia treatment used to improve the body’s natural defenses. This treatment uses the body’s immune system either to fight against cancer, or to decrease the side effects caused by the cancer treatment.

Radiation Therapy or Radiotherapy is a cancer treatment which uses high-energy rays or particles to destroy cancerous cells (leukemia cells). Leukemia patients can receive either an external radiation therapy where several organs like the spleen, brain, or other organs where leukemia cells have been collected in, are radiated, or total-body irradiation where the body is irradiative through a bone marrow transplant.

Stem Cell Transplantation or Bone Marrow Transplant: This is a treatment option for some leukemia patients. During this procedure, the patient receives healthy bone marrow cells from a donor, either yourself as a donor or someone else.

Surgery: The only type of surgery used as a treatment option for leukemia is splendectomy (the surgical removal or the spleen), an alternative used when the spleen has colleted a high amount of leukemia cells, and its swelling causes an increased level of discomfort for the patient.

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