Leukemia is a type of blood cancer. Blood is made up of different types of cells. These cells are made in the middle of your bones, in a part called the bone marrow.
When people have leukemia, their bone marrow makes abnormal blood cells instead of normal blood cells. These abnormal blood cells grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body.
When the bone marrow makes abnormal blood cells, it does not make the normal blood cells a person’s body needs. This can cause symptoms.
There are different types of leukemia. Some types grow very slowly, and others grow much faster. Sometimes, people have a type of leukemia that is slow growing at first and later becomes fast growing.
What are the symptoms of leukemia?
— Leukemia does not always cause symptoms, especially at first. When it does cause symptoms, the most common ones include:
¡Feeling very tired and weak
¡Bleeding more easily than normal
¡Getting sick from infections more easily than normal
These symptoms can also be caused by conditions that are not leukemia. But if you have these symptoms, you should let your healthcare provider know.
Is there a test for leukemia?
— Yes. Your healthcare provider can use different tests to diagnose leukemia. These include:
¡Blood tests
¡Bone marrow biopsy – A medical specialist will take a very small sample of the bone marrow. Then another specialist will look at the cells under a microscope to see if cancer cells are present.
Your healthcare provider will also do an exam and ask about your symptoms.
What are the types of leukemia?
Of the four common types of leukemia in adults, acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) occur most frequently.
Acute Lymphocytic Leukemia (ALL): This is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Adult acute lymphoblastic leukemia (ALL; also called acute lymphocytic leukemia) is a cancer of the blood and bone marrow.
Acute Myeloid Leukemia (AML): This is the most common leukemia among the adult population and accounts for about 80% of all cases. It is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage.
Chronic Lymphocytic Leukemia (CLL): A type of cancer of the blood and bone marrow. B-cell chronic lymphocytic leukemia (CLL) develops from a type of white blood cell called B cells. It progresses slowly, usually affecting older adults. CLL may not cause any symptoms for years. When symptoms do occur, they may include swollen lymph nodes, fatigue, and easy bruising. Chronic lymphocytic leukaemia is a relatively common haematological malignancy affecting older adults, accounting for about 20% of haematological malignancies in Nigeria.
Chronic Myeloid Leukemia (CML): A slowly progressing and uncommon type of blood-cell cancer that begins in the bone marrow. Chronic myelogenous leukemia typically affects older adults. It’s caused by a chromosome mutation that occurs spontaneously. Doctors aren’t sure what causes the mutation. Many people don’t develop symptoms until later stages and the diagnosis is only made through routine blood work. When symptoms do occur, they include bleeding easily, feeling rundown or tired, weight loss, pale skin, and night sweats.
Chronic Myelomonocytic Leukemia (CMML): This is cancer of the blood. CMML is considered to be one of the myeloproliferative neoplasms (MPNs), a type of chronic blood cancer in which a person’s bone marrow does not make blood effectively.
Myeloproliferative Neoplasms (MPNs): Myeloproliferative neoplasms are a group of diseases in which the bone marrow makes too many red blood cells, white blood cells, or platelets. There are 6 types of chronic myeloproliferative neoplasms. Tests that examine the blood and bone marrow are used to diagnose chronic myeloproliferative neoplasms.
How is leukemia treated?
— Healthcare providers can treat leukemia in different ways. Sometimes, healthcare provider treat leukemia right away. Other times, if the leukemia is slow-growing and not causing symptoms, healthcare providers might watch it closely until treatment is needed.
The right treatment for you will depend on the type of leukemia you have, where it has spread, your age, and your other health problems.
Treatment for leukemia can include one or more of the following:
¡Chemotherapy – Chemotherapy is the term healthcare providers use to describe a group of medicines that kill cancer cells.
¡Radiation therapy – Radiation kills cancer cells.
¡Bone marrow transplant – This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. These “donor” cells can come from different places, including:
8You – Your cells can be taken out of your bone marrow before your treatment is completed and put back in after you have completed chemotherapy or radiation treatment.
8People who are related to you, and whose blood matches yours.
8People who are not related to you, but whose blood matches yours.
8Blood (which matches yours) from a newborn baby’s umbilical cord.
¡Surgery – Sometimes, treatment includes surgery to remove an organ called the spleen.
What happens after treatment?
— After treatment, you will be checked every so often to see if the leukemia comes back. Regular follow up tests include talking with your healthcare provider, exams, and blood tests. Sometimes, the healthcare provider will also do a bone marrow biopsy.
What happens if the leukemia comes back?
— If the leukemia comes back, you might have more chemotherapy, radiation, or bone marrow transplantation.
What else should I do?
— It is important to follow all your healthcare providers’ instructions about visits and tests. It’s also important to talk to your healthcare provider about any side effects or problems you have during treatment.
Getting treated for leukemia involves making many choices, such as what treatment to have and when.
Always let your healthcare provider know how you feel about a treatment. Any time you are offered a treatment, ask:
¡What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
¡What are the downsides to this treatment?
¡Are there other options besides this treatment?
¡What happens if I do not have this treatment?
MKO Abimbola holds a doctoral degree in physician associate studies from the United States of America. He is a Harvard Medical School scholar, affiliated with Parkland Memorial Hospital, Dallas, Texas. He specializes in Internal medicine, Acute care, Emergency Medicine, Geriatrics, Psychiatry, and Surgical services.
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