What is Leukemia?
Leukemia is an umbrella term for cancers which affect your blood cells. Abnormal blood cells are produced and released into your bloodstream. (1)
These irregularities can spread to other areas of the body, such as the lymph nodes or liver. The condition can progress rapidly (acute) or slowly (chronic).
Certain variations of leukemia are more likely to afflict different groups of people. For example, acute lymphocytic leukemia (ALL) is more prevalent in children. (2, 3)
Symptoms
The blood comprises four key components. Each one has a specialized role which contributes to various vital functions in your body.
Red bloods cells consist of almost half of your blood’s total volume – between 40 to 45 percent.
Oxygen from your lungs is transported around your body by hemoglobin. This is a type of protein found in red blood cells.
Plasma makes up the liquid element of the blood. Blood cells are carried throughout the body by this mixture of salts, fat, protein, sugar and water.
White blood cells, or leukocytes, defend your body from infection. The two primary types of white blood cells are neutrophils and lymphocytes.
Finally, platelets support blood clotting at the location of a wound. They also promote healing. (4)
White and red blood cells, as well as platelets, are produced in your bone marrow. Leukemia results in excess growth or involvement of one or more of these cells.
The exact cause of leukemia is not known. Factors with potential links to the onset of this cancer include genetics, race, age and gender.
Certain disorders of the blood, exposure to toxins and smoking can also increase your risk. (5)
The symptoms of leukemia manifest due to decreased levels of normal blood cells. They can include the following signs: (6)
Fatigue
Leukemia can cause you to feel tired and weaker than what you consider as normal. Fatigue is not relieved by rest or sleep.
Unusual Bleeding
Unusual or excessive bleeding can be a sign of leukemia. You might suffer from nosebleeds, heavier menstrual periods or bloody gums.
Bruising
If you notice you are bruising easier than usual, it could be leukemia. Low platelet counts can make you more sensitive than normal.
Frequent Infections
If you are experiencing more frequent infections of any sort, leukemia could be the culprit. An excess of abnormal white blood cells can make you more vulnerable.
You may also notice infections you contract lasting for longer. They may be more resistant and harder to treat.
Malaise
Malaise is defined as a general sensation of feeling unwell. It is a common early warning sign of various illnesses, including leukemia.
Stages
There are four primary types of leukemia. These consist of either acute or chronic lymphocytic, or acute or chronic myelogenous.
Lymphocytic leukemia results in abnormal growth of white blood cells called lymphocytes. The myelogenous form impacts the bone marrow cells that develop into platelets, red blood cells, and white blood cells. (7)
The fifth type of leukemia is called hairy cell leukemia (HCL). It is the rarest variation, comprising approximately two percent of all leukemias. As with acute and chronic lymphocytic leukemia, HCL results in excessive white blood cell production. It also develops quite slowly. (8)
Each type of leukemia is classified differently according to multiple unique traits.
For this reason, we will address the most prevalent form afflicting adults, which is acute myelogenous leukemia (AML). (9, 10)
Acute Myelogenous Leukemia (AML)
AML does not have stages (e.g. stage 1, 2, etc) like most other cancers. Instead, it has subsets according to the French American British (FAB) classification. This system details which blood cells are abnormal, meaning cancerous.
It accounts for how different the affected cells appear compared to normal cells, and also how mature the cells are. (11)
M0 to M5 AML begins in white blood cells, both mature and immature. M6 begins in immature red blood cells and M7 affects immature platelet cells. (12)
The FAB classification for AML is as follows: (13, 14)
M0
This classification is referred to as undifferentiated AML. This means the cells haven’t altered greatly from normal white blood cells.
M1
White blood cells affected by M1 AML are described as minimally mature. These cells are just beginning to advance.
M2
The abnormal white blood cells have now matured. 25 percent of adults with AML suffer from this subset.
M3
M3 refers to acute promyelocytic leukemia (APL). An excess of white blood cells known as promyelocytes collect in your bone marrow.
This abundance of promyelocytes results in shortages of normal platelets, including white and red blood cells. (15)
M4
M4 is also known as acute myelomonocytic leukemia (AMML). Approximately 20 percent of adult AML cases are M4.
M4 Eos
This subtype is acute myelomonocytic leukemia (AMML) with eosinophilia.
Eosinophilia describes an unusually high amount of eosinophils, a type of white blood cell.
M5
M5 is known as acute monocytic leukemia. It results in an increase of white blood cells known as monocytes.
M6
Acute erythroid leukemia is a rare type of AML. It is characterized by high numbers of immature red blood cells, known as erythroids. (16)
M7
M7 is known as acute megakaryocytic leukemia. As with M6, it is also quite rare and typically occurs in children with down’s syndrome. (17)
Treatment
Leukemia is diagnosed through a blood test called a complete blood count (CBC).
This test can reveal unusually low counts of platelets or red blood cells, an indication of leukemia. Another telltale sign is abnormal white blood cell levels.
If your CBC returns with irregularities, a biopsy will be performed. This will enable your doctor to determine which specific type of leukemia you have. (18)
Treatment for leukemia can vary significantly depending on the type, your age and overall health.
You may also be prescribed complementary treatments, such as antibiotics to reduce the risk of infection. (19)
The goal of leukemia treatment is to reduce or eliminate cancerous cells in the body. Treatment options typically include one or more of the following:
Chemotherapy
Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. This form of medication can be given intravenously or as tablets.
Acute myelogenous and (AML and ALL) are usually treated with intensive chemotherapy. This is because they are both known as aggressive types of cancer. (20, 21)
Chronic lymphocytic leukemia (CLL) may be treated with chemotherapy in later stages. It is also the primary treatment for hairy cell leukemia (HCL). (22)
Chemotherapy can cause side effects such as hair loss, weight changes and vomiting. (23)
Imatinib
Imatinib is a medication prescribed for chronic myelogenous leukemia (CML) and ALL. This drug blocks the growth signals inside cancerous cells, killing them over time.
If it’s successful in treating CML, it will typically be prescribed for life. Treatment for acute lymphocytic leukemia (ALL) with imatinib can range from several weeks to months.
Side effects may include vomiting, muscle cramps and diarrhea. (24, 25)
Bone Marrow and Stem Cell Transplants
This procedure involves transplanting healthy bone marrow or stem cells from a donor. These cells encourage the production of white blood cells which are healthy rather than abnormal.
Bone marrow and stem cell transplants can cure chronic myelogenous or lymphocytic leukemia (CML and CLL) in some individuals.
However, they are only suitable for individuals of a younger age in overall good health. It is also preferable if the donor is related to you. (26, 27)
This treatment can also be used to manage advanced acute myelogenous leukemia (AML) and acute lymphocytic leukemia (ALL). (28, 29)
FAQ
What is leukemia? Leukemia is a cancer of your blood. It originates in your bone marrow, which is responsible for producing blood cells. It can spread to other systems and organs in your body.
What are the signs of leukemia? The signs of leukemia can include fatigue, unusual bleeding, bruising, and malaise. You may also develop infections more frequently.
How do you develop leukemia? The causes of leukemia are not fully understood. Exposure to certain toxins or tobacco can play a role. Other factors include genetics, gender, race, age and existing blood conditions.
How are you diagnosed for leukemia? Leukemia is diagnosed through a blood test called a complete blood count (CBC). A bone marrow biopsy will determine what type you have.
What is the best treatment for leukemia? Treatment for leukemia depends on the type and severity. Options can include: chemotherapy, imatinib and bone marrow or stem cell transplants. You may also be offered complementary therapies, such as antibiotics to lower infection risk.
What are the long term complications of leukemia? Complications of leukemia due to a weakened immune system can be extremely dangerous. Infections that you contract can become severe if untreated. (30, 31, 32, 33)
Is leukemia considered a disability? If you have an acute form of leukemia you can qualify for disability. Chronic forms of leukemia may also apply if you meet certain requirements which render you unable to work. (34, 35, 36)
Is there any cure for leukemia? Certain types of leukemia can be cured with treatment. Other types cannot be cured entirely, instead go into remission – you may still have cancer but with reduced symptoms. (37)
Is leukemia life threatening? Yes, in certain cases it can be. Infection and excessive bleeding are common causes of death in acute leukemia patients. (38)
Summary
If you suspect you are experiencing symptoms of leukemia, schedule an appointment with your doctor as soon as possible.
In the unfortunate event you are diagnosed with the condition, your prognosis for recovery depends on many factors, such as your age and health.
Leukemia cannot be prevented, the exact cause is not yet known. However, you can reduce your risk by avoiding smoking and exposure to dangerous toxins (e.g. benzene). (39)