Leukemia

What are the different types of Leukaemia?

Doctors categorize the various types of leukemia based on the following:

1. The specific type of blood cell in which they originate.

2. Whether they progress rapidly (acute) or slowly (chronic).

3. Whether they occur in children or adults.

1. Acute and chronic leukemia:

• Acute leukemia involves rapidly multiplying immature cells, accumulating in the bone marrow and bloodstream. A blood test typically reveals that over 20% of blood cells are blasts, indicating their immature state.
• Chronic leukemia progresses more gradually, allowing for the production of mature, functional cells. In a blood test, fewer than 20% of cells are blasts.

2. Lymphocytic and myelogenous leukemia:

• Lymphocytic leukemia arises when cancerous changes affect the bone marrow responsible for producing lymphocytes, a type of white blood cell crucial for immune function.
• Myelogenous leukemia occurs when alterations affect bone marrow cells that generate blood cells.

Common types of leukemia include:

1. Acute lymphocytic leukemia (ALL), which primarily affects children under 5 years old but can also occur in adults, especially those over 50.

2. Chronic lymphocytic leukemia (CLL) is most prevalent in individuals over 70 but is occasionally found in younger adults. It accounts for about 25% of new leukemia cases and is more common in males.

3. Acute myelogenous leukemia (AML) is more frequently diagnosed in adults than children and is more prevalent among males. Although rare overall, it is the most common acute leukemia in adults.

4. Chronic myeloid leukemia (CML) comprises approximately 15% of all leukemia cases and rarely occurs in children.

5. Hairy cell leukemia (HCL), a rare form affecting middle-aged and older adults, is characterized by slow growth and is identifiable under a microscope by fine, hair-like strands in cancer cells.

What are the causes of Leukaemia?

Leukemia initiates when the DNA within a solitary cell in your bone marrow undergoes alteration (mutation). DNA is the cellular "instruction code," dictating growth, development, and programmed cell death. Due to this mutation or coding error, leukemia cells undergo unchecked proliferation. Subsequently, all descendant cells originating from the initial mutated cell carry the same mutated DNA.

The precise trigger for these cellular mutations remains unknown to scientists. However, they have identified specific common mutations shared among individuals diagnosed with various types of leukemia.

What are the risk factors of Leukaemia?

Leukemia can affect anyone, but several factors may heighten the risk, including:

• Previous cancer treatment: Undergoing radiation or chemotherapy for prior cancer treatments may elevate the risk of developing certain types of leukemia.

• Smoking: A history of smoking or exposure to second-hand smoke can increase the likelihood of developing acute myelogenous leukemia.

• Exposure to industrial chemicals: Benzene and formaldehyde, prevalent in various building materials and household products, are known carcinogens. Benzene is used to produce plastics, rubbers, pesticides, and detergents, while formaldehyde is found in soaps, shampoos, and cleaning agents.

• Certain genetic disorders: Conditions like neurofibromatosis, Klinefelter syndrome, Schwachman-Diamond syndrome, and Down syndrome may raise the risk of leukemia.

• Family history of leukemia: While some types of leukemia may have a familial component, merely having a relative with leukemia doesn't guarantee its development in other family members. However, informing your healthcare provider about any genetic conditions in your family can prompt genetic testing to assess individual risks.

What are the symptoms of Leukaemia?

Various types of leukemia can manifest diverse symptoms. In the initial stages of certain forms, symptoms may not be apparent. However, when present, they could encompass:

1. Weakness or fatigue

2. Easy bruising or bleeding

3. Fever or chills

4. Recurrent or severe infections

5. Bone or joint pain

6. Headaches

7. Vomiting

8. Seizures

9. Weight loss

10. Night sweats

11. Shortness of breath

12. Swelling of lymph nodes or organs, such as the spleen

How is Leukemia diagnosed?

Chronic leukemia may be detected through a routine blood test or if symptoms prompt further investigation. Diagnostic procedures may include:

1. Physical examination: Your doctor will conduct a physical assessment to detect signs of leukemia, such as pallor from anemia, swollen lymph nodes, and enlargement of the liver and spleen.

2. Blood tests: Analysis of a blood sample can reveal abnormal levels of red or white blood cells and platelets, indicating possible leukemia. Leukemia cells may also be identified in the blood, although not all types of leukemia lead to their circulation. In some cases, leukemia cells remain confined to the bone marrow.

3. Bone marrow biopsy: A procedure may be performed to extract a sample of bone marrow from the hipbone using a thin needle. The sample is then examined in a laboratory to detect leukemia cells. Advanced tests can reveal specific characteristics of the leukemia cells, which inform treatment decisions.

What is the treatment for Leukemia?

Leukemia treatment varies based on age, overall health, leukemia type, and its spread. Common treatments include:

1. Chemotherapy: This involves using chemicals to kill leukemia cells, administered either orally or intravenously. Single or combination drug therapy may be used.

2. Targeted therapy: Targeted drugs focus on specific abnormalities in cancer cells, causing them to die. Testing can determine if targeted therapy is suitable.

3. Radiation therapy: High-energy beams are directed at leukemia cells to damage and halt their growth. It can be targeted or applied to the entire body, sometimes preceding a bone marrow transplant.

4. Bone marrow transplant: Also known as stem cell transplant, this procedure replaces diseased bone marrow with healthy stem cells to regenerate it. It may involve donor cells or the patient's cells.

5. Immunotherapy: It harnesses the immune system to combat cancer by interfering with cancer cells' ability to evade immune response.

6. CAR-T cell therapy: This specialized treatment engineer the body's T cells to target and destroy cancer cells, offering a potential option for certain leukemia types.

7. Clinical trials: These trials explore new cancer treatments or novel uses of existing treatments. While they offer access to cutting-edge therapies, risks and benefits should be discussed with a doctor.

When to see a doctor

If you experience any persistent signs or symptoms that concern you, you must schedule an appointment with your doctor promptly.

Leukemia symptoms can be nonspecific and easily overlooked, as they may resemble those of the flu or other common illnesses. Occasionally, leukemia is detected incidentally during blood tests for other medical reasons.