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Leukemia: Symptoms, Types, Treatment, and More

Written by Resurchify | Updated on: January 11, 2023

Leukemia: Symptoms, Types, Treatment, and More

Leukemia is a type of cancer that affects the body's blood-forming tissues, as well as the lymphatic system and bone marrow.

Leukemia comes in a variety of forms. Children are more likely to get certain types of leukemia. Most cases of additional leukemia are in adults. White blood cells are typically affected by leukemia. Your white blood cells can fight infections, and they typically grow and divide in an organized manner when your body requires them. However, the bone marrow overproduces faulty white blood cells in leukemia patients, and these abnormal white blood cells are dysfunctional.

Leukemia is a subset of blood malignancies that frequently begins in the bone marrow and produces an abundance of abnormal blood cells. Blasts or leukemia cells are another names for these unformed blood cells. It is a specific kind of malignancy that interferes with blood cell growth and function. In addition to a swelling of the lymph nodes, this also results in frequent nosebleeds, fatigue, frequent infections, weight loss, bleeding, and bone discomfort.

Two pathways are the only options. Both acute and chronic leukemia is possible. The proliferation of cancer cells is accelerated in acute leukemia. On the other hand, chronic leukemia advances gradually and may have minor early symptoms. Because of this, the type of attack on the patient affects the type of leukemia treatment.

Symptoms and Signs of Leukemia

Fever or chills, persistent weariness, weakness, and anemia are typical leukemia symptoms. severe or persistent infections, not making an effort to lose weight, lymph node swelling, liver or spleen growth, Simple bruising or bleeding Chronic nosebleeds, tiny red spots on your skin (petechiae), excessive perspiration, especially at night, aching or painful bones are some more symptoms to watch out for. Children typically have simple bruises, pale complexion, fever, and enlarged liver or spleen.

By replacing healthy bone marrow cells with more immature white blood cells, damage to the bone marrow prevents the production of blood platelets, which are essential in the clotting process. Accordingly, those who have leukemia are more prone to bruise easily, bleed a lot, or get pinprick bleeding (petechiae).

White blood cells, which aid in the fight against infections, might be deficient or repressed. This might impair the immune system's ability to fight off a straightforward infection or trigger the immune system's destruction of healthy body tissues.

Because leukemia makes it difficult for the immune system to operate normally, some people get frequent infections. These infections can range from minor ones like swollen tonsils, mouth sores, or diarrhea to serious ones like pneumonia or opportunistic infections.

Last but not least, anemia is brought on by a deficiency of red blood cells and might result in pallor and dyspnea.

Feeling unwell, rising temperatures, chills, night sweats, fatigue, and other flu-like symptoms are many of the flu's symptoms. Some persons who have enlarged livers and spleens may feel nauseous or full, which can result in accidental weight loss. Pain and nausea might be experienced when the diseased blasts congregate and swell in the lymph nodes or liver.

Other signs and symptoms that some people encounter include fevers, chills, night sweats, limb weakness, feeling worn out, and other flu-like symptoms that are prevalent. A swollen liver and spleen can cause some people to feel sick or bloated, which can cause them to lose weight unintentionally. Disease-related blasts may congregate and swell in the lymph nodes or the liver, which can hurt and make you feel sick.

Invasion of the central nervous system by leukemic cells can result in neurological symptoms, including headaches. Brain stem pressure can lead to uncommon neurological symptoms such as migraines, seizures, or comas. Leukemia-related symptoms can all be ascribed to different illnesses. As a result, leukemia is always identified using diagnostic procedures.

Causes of Leukemia

No single factor can be linked to all kinds of leukemia. Only a small number of cases are linked to the few identified triggers, which are not always variables outside the normal person's control. Most cases of leukemia are undetermined causes. Different leukemias are likely to have unique causes.

Leukemia is typically assumed to develop when some blood cells have alterations (mutations) in their DNA or genetic makeup. The instructions that inform a cell what to do are encoded in its DNA. The DNA often instructs the cell to develop at a specific rate and to die at a specific time. Some mutations can cause leukemia by upsetting the control over cell death, differentiation, and division. This can be done by turning on oncogenes or turning tumor suppressor genes off. These mutations may occur naturally or as a result of exposure to radiation or carcinogens.

The manufacturing of blood cells then spirals out of control. Leukemia signs and symptoms are brought on by less healthy white blood cells, red blood cells, and platelets over time as a result of these abnormal blood cells crowding out good blood cells in the bone marrow.

Ionizing radiation from both natural and manmade sources, a few viruses, including the human T-lymphotropic virus, and a few chemicals, including benzene and alkylating chemotherapeutic drugs for prior malignancies, are all recognized causes in adults.

Adults who smoke are at a slightly increased risk of getting acute myeloid leukemia. In cohort and case-control studies, some petrochemicals and hair dyes have been linked to the emergence of leukemia. While increasing your vegetable intake may offer a tiny protective advantage, overall, diet changes may have little to no impact. Smoking increases the chance of developing acute myelogenous leukemia.

In other instances, viruses have also been linked to leukemia. Adult T-cell lymphoma is brought on by HTLV-1, the human T-lymphotropic virus. Certain varieties of leukemia are more likely to develop in people who have undergone specific forms of radiation and chemotherapy for other cancers.

The emergence of leukemia appears to be influenced by chromosomal anomalies. There is a higher risk of leukemia in those with specific genetic abnormalities, such as Down syndrome. A higher risk of several types of leukemia has been associated with exposure to specific chemicals, such as benzene, which is used in the chemical industry and is present in gasoline. Your risk of developing the disease may increase if you have relatives who have been diagnosed with leukemia.

Types of Leukemia

  • Leukemia Acute Lymphocytic (ALL) - The most typical form of leukemia in young children is this one. Adults are also susceptible to ALL.
  • Myelogenous Leukemia Acute (AML) - One typical form of leukemia is AML. Both adults and children can get it. The most prevalent form of acute leukemia in adults is AML.
  • Leukemia Chronic Lymphocytic (CLL) - The most prevalent chronic adult leukemia, CLL, can cause years to pass without symptoms requiring treatment.
  • Myelogenous Leukemia Persistent (CML) - Most people with this kind of leukemia are adults. Before entering a phase in which the leukemia cells develop more rapidly, a person with CML may have few or no symptoms for months or years.

There are other, more uncommon kinds of leukemia, such as myelodysplastic syndromes, hairy cell leukemia, and myeloproliferative disorders.

The first classification is based on how quickly leukemia develops:

Acute Leukemia- Immature blood cells are the aberrant blood cells in acute leukemia (blasts). Because they swiftly multiply and are unable to do their regular duties, the condition quickly gets worse. Treatment for acute leukemia must be aggressive and prompt.

Chronic Leukemia- The many forms of chronic leukemia are diverse and some trigger the production of either too few or too many cells. More advanced blood cells are involved in chronic leukemia. For a while, these blood cells can continue to operate normally despite their slower rate of replication or accumulation. Initially, certain types of chronic leukemia don't show any symptoms, and they might go unreported or untreated for years.

The second classification method is based on the affected type of white blood cell:

Lymphocytic Leukemia- Lymphocytes, which make up lymphoid or lymphatic tissue, are impacted by this type of leukemia. Your immune system is made up of lymphatic tissue.

Myelogenous Leukemia- Myeloid cells are affected by this form of leukemia. Red blood cells, white blood cells, and platelet-producing cells all develop from myeloid cells.

Uncommon Types of Leukemia

Prolymphocytic leukemia (PLL) can develop alongside regular CLL or on its own, however, it typically advances more quickly. Immature lymphocytes proliferate in large numbers, identifying it. If symptoms appear, they could resemble those of other kinds of leukemia (flu-like symptoms, easy bruising, unexplained weight loss). Bone marrow aspiration and biopsy are two procedures that may be used in the diagnosis. PLL often responds well to therapy, and CLL-like treatments might be available. Relapse, however, is frequent.

The body produces unusually big lymphocytes when it has large granular lymphocytic (LGL) leukemia, a chronic form of the disease. Patients typically already have flu-like symptoms, repeated infections, and unexplained weight loss by the time they are diagnosed with this disorder. A higher risk of LGL tends to exist in individuals with autoimmune illnesses.

Chronic lymphocytic leukemia (CLL) has an uncommon subtype called hairy cell leukemia (HCL), which advances slowly. The American Society of Clinical Oncology estimates about 700 persons are given HCL diagnoses each year. Too many B cells (lymphocytes), a kind of white blood cell that fights infection, are produced by the bone marrow, which results in HCL. Less healthy white blood cells, red blood cells, and platelets are created as the number of leukemia cells rises.

The term "myelodysplastic syndromes" (MDS) refers to a group of closely related diseases in which the bone marrow fails to produce enough functional red blood cells, white blood cells, platelets, or any combination of the three. Red blood cells carry oxygen; white blood cells fight infection; platelets stop bleeding. Diagnoses for the various myelodysplastic syndromes are made based on specific alterations in the bone marrow and blood cells. Myelodysplastic syndromes get their name from the fact that the bone marrow and blood cells, also known as myself, typically have aberrant or dysplastic appearances.

Diagnosis of Leukemia

A diagnosis is typically made based on repeated full blood counts and a bone marrow test after reports of the symptoms. Leukemia may occasionally go undetected by blood testing, especially in its early stages or while it is in remission. Some types of leukemia may occasionally be diagnosed with a lymph node biopsy.

After a diagnosis, blood chemistry tests can be used to evaluate the severity of liver and kidney damage as well as the patient's response to chemotherapy. If a doctor is worried about other leukemia-related impairments, they can utilize ultrasound, MRI, or X-ray.

These can indicate the effects of leukemia on the brain (MRI), the kidneys, the spleen, and the liver (liver biopsy), as well as the bones (X-ray) (ultrasound). Although it is uncommon, chest lymph nodes may be examined with a CT scan.

By using these techniques to ascertain whether or not someone has the disease, many people have not been diagnosed with leukemia because many of the symptoms are vague, non-specific, and may be related to other conditions. As a result, at least one-fifth of those who have leukemia have not yet received a diagnosis, according to the American Cancer Society.

Tests for Leukemia

Before symptoms appear, a regular blood test by the doctor may identify persistent leukemia. If this occurs, or if you exhibit symptoms or signs that point to leukemia, you could have one of the following diagnostic tests:

Exam of the Body- Your doctor will examine you for physical indicators of leukemia, including anemia-related pale skin, swollen lymph nodes, and enlarged liver and spleen.

A Blood Test- Your doctor can examine a sample of your blood to see if you have abnormally high or low amounts of platelets, red blood cells, or white blood cells, which may indicate leukemia. Although not all forms of leukemia cause leukemia cells to circulate in the blood, a blood test can nevertheless detect the presence of leukemia cells. Leukemia cells can occasionally remain in the bone marrow.

A Bone Marrow Test- A procedure to take a sample of bone marrow from your hipbone may be advised by your doctor. Use of a lengthy, thin needle is used to extract the bone marrow. The sample is delivered to a lab for leukemia cell detection. Your treatment options may be based on traits that specialized tests of your leukemia cells may reveal.

Stages of Leukemia

Leukemia will be staged after a diagnosis. Staging reveals the extent of cancer's spread and progression and aids a doctor in estimating your prognosis. AML and ALL are staged according to the types of cells present and how the cancer cells appear under a microscope. Based on the WBC count at the time of diagnosis, ALL and CLL are staged. AML and CML are also staged based on the presence of immature white blood cells, or myeloblasts, in the blood and bone marrow.

Evaluating the development

Other tests that can be used to track the disease's development include:

  • Flow cytometry analyses the cancer cells' DNA to calculate their growth rate.
  • Tests of liver function can determine whether leukemia cells have an impact on the liver.
  • A lumbar puncture is a procedure in which a tiny needle is inserted between the lower back vertebrae. Your doctor will be able to gather spinal fluid as a result and check to see if cancer has spread to the central nervous system.
  • Imaging tests like X-rays, ultrasounds, and CT scans assist medical professionals in searching for any leukemia-related damage to other organs.

Treatment of Leukemia

There are several different medical approaches used to treat leukemia. Treatment will vary depending on the type of leukemia, the patient's age and general condition, and whether or not the disease has migrated to the cerebrospinal fluid. The best kind of treatment is chosen by the genetic alterations or unique qualities of the leukemia cells as identified in the lab.

Leukemia treatment options include chemotherapy (the most common kind of treatment), radiation therapy, biological therapy, targeted therapy, and stem cell transplant. Combining these treatments is an option. Surgery may be used to remove the spleen if it is enlarged as part of the treatment.

Treatment for acute leukemia must aim for complete remission (absence of Leukemia cells in the body). Medication can be used to stop leukemia from recurring after remission. This is known as consolidation of maintenance therapy. A cure for acute leukemias is also a possibility with treatment.

Although they can suppress malignancy and treat symptoms, long-term leukemia treatments are unlikely to be able to cure the disease. A stem cell transplant may be an option for some people with chronic leukemia, which could cure them.

Several individuals look for a second opinion before beginning treatment for leukemia. Most of the time, there is sufficient time to investigate different treatments without jeopardizing the efficacy of the current one. However, in a small percentage of cases, treatment for particularly aggressive leukemias must begin right away. The possibility of getting a second opinion as well as any potential treatment delays should be discussed with a doctor. The majority of doctors agree that getting a second opinion is a good idea, and they shouldn't take it personally if a patient asks for one.

Chemotherapy

Chemotherapy is the practice of administering medications to kill rapidly dividing cells, such as those found in leukemia and other malignancies. Chemotherapy can be administered intravenously or taken orally as a pill or tablet. It can also be administered intravenously or as an injection straight into the bloodstream. The practice of using multiple medications at once is known as combination chemotherapy. Step-by-step, with rests in between, the drugs are given.

The drugs utilized, the dose, and the regimen used all affect the side effects of chemotherapy differently. Some of the negative effects of chemotherapy medications include hair loss, nausea, vomiting, mouth sores, lack of appetite, fatigue, rapid swelling or bleeding, and an increased risk of infection because of the destruction of white blood cells. The usage of drugs can be used to treat the side effects of chemotherapy.

Biological Therapy

Cancer treatments that involve live things, medications derived from them, or synthetic versions of them are referred to as biological therapies. These treatments help the immune system identify and target damaged cells. Examples of biological cancer treatments include cytokines, tumor vaccines, and antibodies (substances that are produced within the body to control the immune system).

Contrary to chemotherapy, which might result in a rash or swelling at the injection site from IV infusions of therapeutic substances, biological therapies have fewer side effects. Other adverse effects include fatigue, fever, body aches, headaches, and fever.

Targeted Therapy

Targeted therapies interfere with a specific characteristic or function of a cancer cell as opposed to destroying all rapidly proliferating cells without discrimination. This means that compared to chemotherapy, targeted therapy causes less harm to healthy cells. By interfering with particular chemicals that support cancer development, targeted therapies can cause the target cell to stop growing rather than perish and can prevent cancer cells from spreading. Precision medicines, molecularly targeted pharmaceuticals, or molecularly targeted therapies are other terms for molecularly targeted cancer therapies.

Injections or pills are used to provide targeted medications. Weight gain, bloating, and swelling is further potential adverse effects. Others include muscle cramps, rash, nausea, vomiting, diarrhea, and diarrhea.

Radiation Therapy

In radiation therapy, cancer cells are the target of high-energy radiation. Leukemia that has expanded to the brain, the spleen, and other organs where leukemia cells have concentrated can all be treated with radiation therapy.

Even though they are unlikely to last, radiation therapy can have side effects. The negative effects are dependent on where on the body the radiation is being applied. For instance, radiation to the abdomen might result in nausea, vomiting, and diarrhea. Radiation therapy can cause the skin in the treated area to become red, dry, and painful. Being generally exhausted when receiving radiation therapy is also typical.

Stem Cell Transplant

In stem cell transplantation, high doses of chemotherapy and/or radiation are utilized to kill leukemia cells as well as healthy bone marrow. Then, intravenous infusion is used to give transplant stem cells. The bone marrow is where the stem cells travel after which they start to form new blood cells. It is possible to employ the patient's stem cells or stem cells from a donor.

Immunotherapy

Your immune system is used in immunotherapy to combat cancer. Due to the cancer cell's ability to create proteins that aid in their concealment from immune system cells, your body's disease-fighting immune system may not attack your cancer. Immunotherapy affects that process to work.

Engineering Immune Cells To Fight Leukemia

Chimeric antigen receptor (CAR)-T cell therapy is a specialist procedure that employs your body's immune system's T cells to attack cancer by genetically modifying them to do so. For some forms of leukemia, CAR-T cell treatment may be a possibility.


         

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