What is Leukemia ?
Leukemia is a form of cancer that begins in the blood-forming cells of the bone marrow—the soft, inner part of the bones. Leukemia, which literally means "white blood" in Greek, occurs when there is an excess of abnormal white blood cells in the blood. Known as leukocytes, these cells are so plentiful in some patients that the blood actually has a whitish tinge.

Under normal circumstances, the blood-forming (hematopoietic) cells of the bone marrow make leukocytes to defend the body against infectious organisms, such as viruses and bacteria. If some leukocytes are damaged and remain in an immature form, they become poor infection fighters that multiply excessively and do not die off as they should.

These damaged leukemic cells accumulate and lessen the production of oxygen-carrying red blood cells (erythrocytes), blood-clotting cells (platelets), and normal leukocytes. If untreated, these leukemic cells overwhelm the bone marrow, enter the bloodstream, and eventually invade other parts of the body, such as the lymph nodes, spleen, liver, and central nervous system (brain, spinal cord). In this way, the behavior of leukemia is different than that of other cancers, which usually begin in major organs and ultimately spread to the bone marrow.

There are more than a dozen varieties of leukemia, but the following 4 types are the most common:

• Acute myelogenous leukemia (AML)
• Chronic myelogenous leukemia (CML)
• Acute lymphocytic leukemia (ALL)
• Chronic lymphocytic leukemia (CLL)

Acute leukemias usually develop suddenly, whereas some chronic types may exist for years before they are diagnosed.

Leukemia Signs and Symptoms
In many cases, the first signs and symptoms of leukemia are nonspecific (vague). Early signs also may occur with other types of cancer or with other medical conditions. Although leukemia signs and symptoms vary depending on the type of disease, there are some general features. Broad symptoms of leukemia include the following:

• Fatigue
• Malaise (vague feeling of bodily discomfort)
• Abnormal bleeding
• Excessive bruising
• Weakness
• Reduced exercise tolerance
• Weight loss
• Bone or joint pain
• Infection and fever
• Abdominal pain or "fullness"
• Enlarged spleen, lymph nodes, and liver

Chronic leukemia often goes undetected for many years and may be identified in a routine blood test. In fact, nearly one in five chronic leukemia patients do not report symptoms at the time of diagnosis. Most symptoms of acute leukemia are caused by low levels of normal blood cells, which is due to overcrowding of the blood-forming bone marrow by leukemia cells.

Leukemia Treatment
Leukemia is not a single disease. Instead, the term leukemia refers to a number of related cancers that start in the blood-forming cells of the bone marrow. There are both acute and chronic forms of leukemia, each with many subtypes that vary in their response to treatment. In addition, children with leukemia have special needs that are best met by care in pediatric cancer centers. Such centers have trained medical professionals whose sole purpose is to address the unique concerns of children.

Leukemia treatment plans often are personalized and geared toward each individual patient. In general, there are five major approaches to the treatment of leukemia:

1. chemotherapy to kill leukemia cells using strong anti-cancer drugs;
2. interferon therapy to slow the reproduction of leukemia cells and promote the immune
    system's anti-leukemia activity;
3. radiation therapy to kill cancer cells by exposure to high-energy radiation;
4. stem cell transplantation (SCT) to enable treatment with high doses of chemotherapy
    and radiation therapy; and
5. surgery to remove an enlarged spleen or to install a venous access device (large plastic
    tube) to give medications and withdraw blood samples.

Oncologists administer these treatments in a variety of combinations. Each method has its advantages and drawbacks. It usually is worthwhile to get a second opinion about treatment before entering into a specific program; in some instances, a second opinion may be required by the patient's insurance company. For example, stem cell transplantation (SCT) is very costly and entails a long stay in the hospital. Some insurance companies still consider this to be an "experimental" procedure and will not pay for SCT-related expenses.

The treatment of leukemia depends on a number of factors. The most important of these are the histopathologic (diseased tissue) type of leukemia, its stage, and certain prognostic features, such as the patient's age and overall health.




 

  Acute Myeloid Leukemic