Leukemia A Malignancy (Cancer) of Blood Cells

By Dr. Balkrishna Padate in Centre for Haematology & Bone Marrow Transplant

Apr 24 , 2023 | 3 min read

What is Leukemia

Leukemia is a malignancy (cancer) of blood cells. In leukemia, abnormal blood cells are produced in the bone marrow. The white blood cells are responsible for fighting infection. However, the abnormal cells in leukemia do not function in the same way as normal white blood cells. The leukemia cells continue to grow and divide, eventually crowding out the normal blood cells. The end result is that it becomes difficult for the body to fight infections, control bleeding, and transport oxygen.

What are the types of Leukemia?

There are different types of leukemia, based upon how quickly the disease develops and the type of abnormal cells produced. Leukemia is called an acute leukemia if it develops rapidly. Large numbers of leukemic cells accumulate very quickly in the blood and bone marrow, leading to symptoms such as tiredness, easy bruising, and susceptibility to infections. Acute leukemia requires fast and aggressive treatment.

Chronic leukemias develop slowly over time. These leukemias may not cause specific symptoms at the beginning of their course. If left untreated, the cells may eventually grow to high numbers, as in acute leukemias causing similar symptoms.

What causes Leukemia

The exact cause of leukemia is not known, but it is thought to involve a combination of genetic and environmental factors. Leukemic cells have acquired mutations in their DNA that cause them to grow abnormally and lose functions of typical white blood cells.

Radiation, smoking, certain viruses such as HTLV-1, exposure to certain chemicals such as benzene are some of the risk factors for the development of leukemia.

Having risk factors does not mean that a person will definitely get leukemia and most people with risk factors will not develop the disease. Likewise, not everyone who develops leukemia has an identifiable risk factor.

What are the signs and symptoms of Leukemia?

Fever
Easy bleeding or bruising
Night sweats
Frequent infections
Swollen lymph glands
Bone or joint pain
Lethargy
Tiredness
Weight loss
Feelings of fatigue
Loss of appetite
Enlargement of the spleen or liver, which can lead to abdominal pain or swelling

How Leukemia is diagnosed?

Diagnosis is usually based on repeated complete blood counts and a bone marrow examination. A blood sample is also examined under the microscope to see if the cells appear abnormal. In bone marrow examination, a sample of bone marrow is taken from the hip bone, under local anaesthesia.

How Leukemia is treated?

Chemotherapy

chemotherapy is the administration of drugs that kill cancer cells. Chemotherapy may be taken orally in pill or tablet form, or it may be delivered via a catheter or intravenous line directly into the bloodstream. Combination chemotherapy is usually given for leukemia treatment. Drugs are given in cycles with rest periods in between.

Some side effects from chemotherapy drugs include hair loss, nausea, vomiting, mouth sores, loss of appetite, tiredness, easy bruising or bleeding, and an increased chance of infection. There are medications available to manage the side effects of chemotherapy. Infertility can be one of the side effects of chemotherapy.

Targeted therapy:

Targeted therapies are drugs that selectively kill cancer cells. This means there is less damage to normal cells with targeted therapy than with chemotherapy.

Radiation therapy:

Radiation therapy uses high energy radiation to target cancer cells. Radiation therapy may be used in the treatment of leukemia that has spread to the brain, or it may be used to target the spleen or other areas where leukemic cells have accumulated.

Stem cell transplant:

In stem cell transplantation, high doses of chemotherapy and/or radiation are given to destroy leukemic stem cells. Then, new normal stem cells are delivered by an intravenous infusion. The stem cells travel to the bone marrow and begin producing new blood cells. Stem cells may come from the patient or from a donor.

Also Read About Radiation Therapy for Breast Cancer

What is the prognosis of Leukemia?

In many cases, leukemia can be managed or cured with treatments available today. The prognosis of leukemia depends upon the type of leukemia and the age and health status of the patient. Mortality (death) rates for leukemia are higher in the elderly than in younger adults and children.