What is Leukemia?

Leukemia is a type of cancer that affects the blood-forming tissues of the body, primarily the bone marrow and the lymphatic system. It involves the rapid production of abnormal white blood cells (leukocytes). These abnormal cells, called leukemia cells, do not function properly to fight infection, and they crowd out the production of healthy blood cells (red blood cells, normal white blood cells, and platelets).

A type of cancer that affects the blood cells, leukaemia hinders the body’s immunity. In blood cancer, there is a rapid production of white blood cells in the bone marrow, which in turn, affects the production of red blood cells and platelets in the body.

There are four main types of Leukemia which are segregated into two groups viz. Acute and Chronic. Acute Leukemias develop quickly and get worse rapidly, whereas Chronic Leukemias develop at a slower pace and get worse over a long time.

How leukemia forms

In general, leukemia is thought to occur when some blood cells acquire changes (mutations) in their genetic material or DNA. A cell’s DNA contains the instructions that tell a cell what to do. Normally, the DNA tells the cell to grow at a set rate and to die at a set time. In leukemia, the mutations tell the blood cells to continue growing and dividing.

When this happens, blood cell production becomes out of control. Over time, these abnormal cells can crowd out healthy blood cells in the bone marrow, leading to fewer healthy white blood cells, red blood cells and platelets, causing the signs and symptoms of leukemia.

How leukemia is classified

Doctors classify leukemia based on its speed of progression and the type of cells involved.

The first type of classification is by how fast the leukemia progresses:

• Acute leukemia. In acute leukemia, the abnormal blood cells are immature blood cells (blasts). They can’t carry out their normal functions, and they multiply rapidly, so the disease worsens quickly. Acute leukemia requires aggressive, timely treatment.
• Chronic leukemia. There are many types of chronic leukemias. Some produce too many cells and some cause too few cells to be produced. Chronic leukemia involves more-mature blood cells. These blood cells replicate or accumulate more slowly and can function normally for a period of time. Some forms of chronic leukemia initially produce no early symptoms and can go unnoticed or undiagnosed for years.

The second type of classification is by type of white blood cell affected:

• Lymphocytic leukemia. This type of leukemia affects the lymphoid cells (lymphocytes), which form lymphoid or lymphatic tissue. Lymphatic tissue makes up your immune system.
• Myelogenous (my-uh-LOHJ-uh-nus) leukemia. This type of leukemia affects the myeloid cells. Myeloid cells give rise to red blood cells, white blood cells and platelet-producing cells.

The Four Main Types of Leukemia

Leukemia is classified based on two key factors:

1. Acute Lymphoblastic Leukemia (ALL)

ALL is an acute form of cancer and is characterized by overproduction of immature lymphocytes (white blood cells) by the bone marrow. It is more common in children but can affect adults as well. This is the most common type of leukemia in young children. ALL can also occur in adults.

2. Acute Myeloid Leukemia (AML)

Acute Myeloid Leukemia specifically affects the myeloid line of blood cells. It occurs when a myeloblast goes through genetic changes and freezes at an immature stage.AML is a common type of leukemia. It occurs in children and adults. AML is the most common type of acute leukemia in adults.

3. Chronic Lymphocytic Leukemia (CLL)

Chronic Lymphocytic Leukemia is the most common form of leukaemia in adults. In case of CLL, the abnormal and immature cells develop from early blood cells which are known as lymphoid blood stem cells. With CLL, the most common chronic adult leukemia, you may feel well for years without needing treatment.

4. Chronic Myeloid Leukemia (CML)

Chronic Myeloid Leukemia occurs when cancerous cells develop from myeloid blood stem cells. An early genetic change in stem cells leads to the development of BCR-ABL which turns a normal myeloid cell to a CML cell. This type of leukemia mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukemia cells grow more quickly.

Early Signs and Symptoms

It is necessary to identify the symptoms of Leukemia at the earliest so that the person can consult an oncologist at the earliest for early diagnosis & improved outcomes.

Here are the early signs and symptoms that indicate the onset of leukaemia:

1. Weakness and Fatigue: Extreme fatigue and weakness that does not go away with time can be a sign of leukaemia. If the concerned person has extreme tiredness that is not getting better with rest or supplements, it may indicate leukaemia.
2. Recurring Infections: A person with leukaemia is likely to get affected by infections more frequently than other people. This is due to the inability of white blood cells to fight the infections. Some infections that can be recurring at regular intervals will include symptoms like a persistent cough, fever, loose motions etc. which may not improve even after taking medicines.
3. Weight Loss: Leukemia cells may build up and grow in the abdomen affecting liver, spleen and lymph nodes, thereby increasing their size and occupying more space in the abdomen. This coupled with cancer-related cachexia can lead to loss of appetite which in turn, leads to weight loss in the patients.
4. Swelling: People can experience swelling in the neck, armpit or groin when leukaemia starts affecting the lymph nodes.
5. Shortness of Breath: A person who has leukaemia may experience trouble breathing. Breathing issues can be a result of swollen lymph nodes inside the chest compressing windpipe. If the person experiences any pain during breathing, immediate medical attention is required.
6. Fever: Fever is a general symptom seen in cases of Leukemia. A person may also experience chills and night sweats frequently.
7. Pain in bones: Leukemia causes the body to start producing marrow cells in the bone marrow at an accelerated rate. This leads to aches and pains in the joints and bones.
8. Anemia: Anemia is a condition that is commonly seen in people who have Leukemia. It leads to a reduction in the number of red blood cells and thus haemoglobin in the body which makes the person experience weakness, fatigue and rapid breathing.
9. Bruising and bleeding: Bruises and bleeding can occur even with a minor injury, especially in children. If a child bleeds even from a minor injury it is necessary to get blood tests done well before time. This will help to determine if there is an abnormally low platelet count and may indicate Leukemia.
10. Presence of tiny red spots on the skin: The person may also develop small red spots on the skin called petechiae. These happen due to bleeding in the tiny blood vessels.

Anyone witnessing the symptoms as mentioned above should seek immediate medical attention at any of the best cancer hospitals in India. If the tests reveal blood cancer, then they can also get effective cancer treatment in India at Max Healthcare and fortis, Medicover hospital

Leukemia requires a more personalized treatment tailored to the needs of an individual. Chemotherapy combined with a team approach to intensive care is employed in all cases. In certain cases of acute leukaemia, a bone marrow transplant is done as a potentially curative treatment option. Bone marrow transplant is also used in treatment of bone marrow cancer.

Risk factors

Factors that may increase your risk of developing some types of leukemia include:

• Previous cancer treatment. People who’ve had certain types of chemotherapy and radiation therapy for other cancers have an increased risk of developing certain types of leukemia.
• Genetic disorders. Genetic abnormalities seem to play a role in the development of leukemia. Certain genetic disorders, such as Down syndrome, are associated with an increased risk of leukemia.
• Exposure to certain chemicals. Exposure to certain chemicals, such as benzene — which is found in gasoline and is used by the chemical industry — is linked to an increased risk of some kinds of leukemia.
• Smoking. Smoking cigarettes increases the risk of acute myelogenous leukemia.
• Family history of leukemia. If members of your family have been diagnosed with leukemia, your risk of the disease may be increased.

However, most people with known risk factors don’t get leukemia. And many people with leukemia have none of these risk factors Bone Marrow Transplant.

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