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Blood Cancer or Leukemia

Its types, causes, symptoms, diagnosis and treatment

What is Blood Cancer or Leukemia?

Leukemia is the cancer of early blood-forming cells. Leukemia cells spread in blood and lymph nodes quickly and reach every part of the body including brain and spine (central nervous system).

Most cases of leukemia begin at bone marrow (soft inner part of the bone) and are usually related to early white blood cells, but leukemia may start in other early blood cell types too.

Another type of cancer that can affect the white blood cells largely is lymphoma. Unlike leukemia, lymphoma mainly affects the lymphatic system (lymph nodes) and may or may not involve bone marrow. Sometimes, the bone marrow and the lymph nodes both may be involved.

What are the types of Blood Cancer or Leukemia?

Leukemia is categorized into several types based on the growth rate, type of cells they affect, people they affect, and how they are treated. Based on the progress, leukemia is categorized as acute chronic (grow quickly) or chronic leukemia (grow slowly).

According to American Cancer Society, types of leukemia are:

Acute lymphocytic leukemia(ALL): The most common type of leukemia in small children. ALL is pertaining to early versions of lymphocytes, a type of white blood cells.
Acute myeloid leukemia(AML): The most common type in adults. AML is the cancer that develops in early versions of any blood cells (myeloid that form RBCs, WBCs, platelets) developing in the bone marrow.
Chronic lymphocytic leukemia(CLL): The most common longstanding adult leukemia. This is a rapidly growing cancer of early forms of lymphocytes.
Chronic myelomonocyticleukemia (CMML): Mainly seen in older adults, and is characterized by excessive monocytes, a type of white blood cells.

What are the symptoms of Blood Cancer or Leukemia?

Symptoms may vary, depending upon the type of leukemia. However, some commonly observed symptoms are:

Chills with fever
Enlargement of lymph nodes (which feel as bumps under the skin), liver or spleen
Excess sweating at night
Fatigue and weakness
Frequent nosebleeds
Pain or tenderness in bones
Severe and frequent infections
Small red spots on skin
Tendency to bleed or bruise easily
Unintended weight loss

What are the causes of Blood Cancer or Leukemia?

The cause of leukemia remains unclear. Although the patient may have certain risk factors, there is no certain way to confirm it to be the actual causative agent. The DNA changes responsible for leukemia may either be inherited, or acquired due to exposure to certain cancer-causing radiation and chemicals.

What are the risk factors for Blood Cancer or Leukemia?

Some factors that can increase the risk of developing leukemia include:

Previous cancer treatment
Genetic disorders
Exposure to certain chemicals
Smoking
Certain viral infections
Inherited genetic conditions such as Down syndrome, Klinefelter syndrome, Fanconi anemia, Bloom syndrome etc.
Family history of leukemia

What are the stages of Blood Cancer or Leukemia?

Staging of cancer is done to diagnose the spread of cancer across the body. Acute leukemia is fast growing cancer and is usually identified after it has spread systemically (all over the body).

Chronic lymphocytic leukemia progresses slowly and takes time to spread across the body. Rai system and Binet system are two systematic staging methods used to identify and stage the disease.

Rai system:

For the purpose of staging, diagnosis of CLL is substituted for lymphocytosis.

Rai stage 0: Lymphocytosis with no involvement of lymph nodes, spleen or liver, and near normal RBC and platelet count.

Rai stage I: Lymphocytosis with enlarged lymph nodes. There is no enlargement of spleen or liver and RBC and platelet count are near normal.

Rai stage II: Lymphocytosis with enlarged spleen and with or without enlarged lymph nodes. RBC and platelet count are near normal.

Rai stage III: Lymphocytosis with anemia (too few RBCs), with or without enlarged lymph nodes, spleen or liver. Platelet count is near normal.

Rai stage IV: Lymphocytosis plus thrombocytopenia (too few blood platelets), with or without anemia, enlarged lymph nodes, spleen, or liver.

The risk involved at different stages of CLL is as below:

Stage 0 – low risk
Stage I & II – intermediate risk
Stage III & IV – high risk

Binet system:

Binet stage A: Enlargement of fewer than 3 areas of lymphoid tissue without anemia and thrombocytopenia.

Binet stage B: Enlargement of 3 or more areas of lymphoid tissue without anemia and thrombocytopenia.

Binet stage C: Anemia and thrombocytopenia.

Along with the staging of leukemia, there are certain factors that influence the outlook (prognosis) for the patient such as age (adverse for male), advanced age, features of CLL cells and pattern of bone marrow involvement (adverse for diffuse pattern).

How is Blood Cancer or Leukemia diagnosed?

At times, leukemia may be detected during a routine blood test, even in absence of any symptoms. However, if there is any sign or symptom and/or risk factor suggesting leukemia, visit a hematologists or oncologists immediately. The diagnosis of leukemia is confirmed with:

Detailed medical history
Physical examination
Tests:
- – Blood tests: For CLL, the patient must have at least 5,000/mm³of monoclonal lymphocytes (sometimes called a monoclonal lymphocytosis).
- – Bone marrow test/biopsy: A sample of bone marrow of the hipbone is removed and tested for the presence of leukemia cells.

How is Blood Cancer or Leukemia treated?

Treatment of leukemia depends on many factors, such as its type, as well as the age and medical condition of the patient. Based on the treatment necessary your healthcare team includes hematologists, medical oncologists and radiation oncologists. The team will suggest the best treatment plan, which may include:

Chemotherapy
Biological therapy
Targeted therapy
Radiation therapy
Bone marrow/stem cell transplant

Follow-up care: After treatment for leukemia, the patient needs a follow-up care which may involve physical examination, blood tests, bone marrow tests and tests to detect problems resultant of cancer treatment.

What is the survival rate for Blood Cancer or Leukemia?

The survival rate is an estimate that can guide you if you can live through a few years. The percentage of survival rates indicate how many people have lived at least so far after diagnosis. For example, a 5-year survival rate of 90% indicates 9 in 10 cancer patients lived for a minimum 5 years after being diagnosed.

Survival rates for childhood leukemia:

5-year survival rate for acute lymphocytic leukemia (ALL) – more than 85%.
5-year survival rate for acute myelogenous leukemia (AML) – 60 – 70%. Acute promyelocytic leukemia (APL), a subtype of AML, has a higher survival rate of 80%.
5-year survival rate for juvenile myelomonocytic leukemia (JMML): 50%.
5-year survival rate for chronic leukemias: For chronic leukemias, which are rare in children, 5-year survival rates are less helpful. Furthermore, with effective medicines, survival rates are higher than previously reported values (60% to 80%).

Survival Rates for Chronic Myeloid Leukemia: Highly effective medicines are available only since 2001. According to the large CML study, 90% of the patients showed normal WBCs and chromosome after 5 years on medication.

To know more about leukemia (blood cancer) and its treatment, you can request a callback and our leukemia specialist will call you and answer all your queries.

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References

American Cancer Society. Available at: https://www.cancer.org/cancer/leukemia.html. Accessed on 16th May 2018.
American Cancer Society. Survival Rates for Childhood Leukemias. Available at: https://www.cancer.org/cancer/leukemia-in-children/detection-diagnosis-staging/survival-rates.html. Accessed on 16th May
American Cancer Society. Survival Rates for Chronic Myeloid LeukemiaAvailable at: https://www.cancer.org/cancer/chronic-myeloid-leukemia/detection-diagnosis-staging/survival-rates.html. Accessed on 16th May
National Cancer Institute, US Department for Health and Human Services. What you need to know about Leukemia. Available at: https://www.cancer.gov/publications/patient-education/leukemia.pdf. Accessed on 3rd January 2018.
Mayo Clinic. Leukemia. Available at: https://www.mayoclinic.org/diseases-conditions/leukemia/diagnosis-treatment/drc-20374378. Accessed on 3rd January

Disclaimer: The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.