Leukemia: Information on Causes, Diagnosis & Treatments

Blood Cancer Leukemia Leukemia is caused by the development of cancerous blood-forming tissues in different areas of the body including in the lymphatic system and bone marrow. Leukemia is more than just a single disease but takes many forms occurring in adults and children. These conditions include acute myeloid leukemia, acute lymphoblastic leukemia, and chronic lymphocytic leukemia. The disease involves white blood cells – the body’s infection fighters.

At the early stages of the disease, bone marrow begins making an overabundance of leukemia cells, which are abnormal white blood cells that do not function like typical white blood cells. Because of the abnormalities, the cells grow significantly faster and do not die off after reproducing. In time, the cancerous cells overtake normal blood cells causing significant problems including infections, bleeding, and anemia. If left unchecked, leukemia cancer can spread (metastasize) to various organs and lymph nodes and cause significant pain and/or swelling.

Leukemia Types

In addition to three different forms of leukemia, the cancer is also categorized into three different types based on how quick the condition becomes worse and the types of white blood cells that are affected. The three main leukemia types involve:

  • Acute/Chronic – Some leukemia conditions are categorized as acute, meaning they become much worse very fast, making the patient extremely ill right away. Alternatively, chronic leukemia slowly progresses becoming worse over time. Many patients are unaware of the common symptoms associated with chronic leukemia until many years after suffering the other effects of the disease.

  • Lymphocytic – Lymphoblastic (lymphocytic) leukemia is a common form of the disease caused by lymphocytes that attack white blood cells.

  • Myelogenous – This form of leukemia affects other blood cells in the body that include platelets, red blood cells, and granulocytes (granule secreting white blood cells).

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Who Is at Risk for Leukemia?

Many believe that leukemia is a child’s condition. However, significantly more adults than children suffer from the disease. In fact, male and female Caucasians are more apt to develop leukemia compared to African-Americans. According to statistics released by the National Cancer Institute, nearly 53,000 new cases of leukemia are diagnosed every year. Of these cases, approximately 41 percent will involve chronic myelogenous leukemia and chronic lymphocytic leukemia.

On average, individuals between 40 and 50 years old develop chronic myelogenous leukemia more than any other age group. In addition, patients 70 years of age or older tend to develop chronic lymphocytic leukemia more than any other age group.

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Causes and Risk Factors

Doctors, researchers, and scientists have not determined the actual cause of leukemia. However, there have been specific risk factors identified in its development including exposure to benzene and radiation. Some forms are the result of environmental and genetic factors. Common risk factors associated with the development of leukemia include:

  • Prior Cancer Treatments – Adults and children who have undergone previous radiation chemotherapies for the treatment of other cancers have an increased potential risk of developing some forms of leukemia.

  • Genetic Disorder – Researchers believe that genetic abnormalities play a significant role in developing some forms of leukemia. This includes specific genetic disorders, like Down syndrome, which are known to be related to the increased potential risk of leukemia.

  • Chemical Exposure – Benzene and other chemicals found in gasoline and products used in the chemical industry have been linked to the increased potential risk of leukemia.

  • Smoking Tobacco Products – Studies indicate that smoking cigarettes and other tobacco products can significantly increase the potential risk of developing acute myelogenous leukemia.

  • Genetics – If a patient’s family member was diagnosed with any form of leukemia, the individual likely has a significant potential risk for developing the disease.

Most of these risk factors are common in individuals who never developed leukemia. Additionally, individuals suffering from leukemia can have other risk factors not mentioned here.

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Symptoms

Every case of leukemia is different, with different patients experiencing different symptoms. However, common leukemia symptoms involve:

  • Chills or fevers

  • Recurring nosebleeds

  • Persistent weakness

  • Ongoing fatigue

  • Overall malaise (the sensation of discomfort)

  • Unexpected weight loss

  • Severe and frequent infections

  • Easy bruising

  • Easy bleeding

  • Reduced tolerance to exercise

  • Petechiae (tiny red spots) skin condition

  • Excessive sweating

  • Abdominal pain

  • Joint pain

  • Enlarged spleen or liver

  • Swollen lymph nodes

Many common symptoms associated with chronic leukemia go undetected for years. Typically, patients are diagnosed with the condition after a routine blood test that identifies the disease. Nearly one out of every twelve patients suffering from chronic leukemia never report symptoms before they were diagnosed.

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Diagnosing

The initial stages of diagnosis of leukemia typically appear during a physical examination or from the results of routine blood tests. Once the doctor suspects of blood disorder, they will typically recommend bone marrow and blood tests to rule out or verify the disease. The most common blood tests used to diagnose leukemia will involve evaluations to determine blood chemistry, the quantity of red and white blood cells, and other important factors.

  • Full Blood Count – The doctor will recommend a full blood count including the number of red and white blood cells that could identify leukopenia or anemia. If the number of bacteria-destroying white blood cells (mature neutrophils) is low, the test might reveal the patient is suffering from granulocytopenia or neutropenia.

  • Differential Blood Count – This test identifies the relative proportion of the bloodstream’s blood cell types. In some forms of the disease, the patient has too few platelets, too few red blood cells, too many white blood cells, or immature “blast” cells (leukocytes).

  • Hematocrit Assay – This test identifies how many red blood cells occupy the bloodstream. In addition, hemoglobin level test can determine oxygen-carrying pigment in the red blood cell.

  • Blood Coagulation – This test determines clotting factors or the amount of time it takes for blood to coagulate to see if any problems are occurring.

  • Blood Staining and Morphology – The test can identify any abnormality in the condition, shape, or structure of the cell nucleus.

  • Blood Chemistry Tests – The doctor will order blood chemistry tests to determine the levels of minerals, enzymes, and other essential substances in the bloodstream. The test can identify problems associated with damage to the liver or kidneys that might be caused by leukemia.

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Treatments

Doctors have various medical approaches to treat leukemia effectively. The recommended treatment is often dependent on the form of leukemia, the health status of the patient along with their age and whether the leukemia has spread (metastasized) to the body’s cerebral spinal fluid. In addition, if it has been determined that there are specific characteristics of genetic changes to leukemia cells, the doctor will likely change the form of treatment that provides the most successful outcome.

Many individuals who suffer from chronic leukemia never display symptoms, and without close monitoring, may never know when the symptoms develop. Even so, doctors will perform “watchful waiting” to look for any early signs of the disease. Without any form of treatment though, leukemia can become significantly worse and out of control.

The most common forms of treatment involve:

  • Chemotherapy

  • Radiation therapy

  • Targeted therapy

  • Biological therapy

  • Stem cell transplant

The most successful treatment may be a combination of two or more of the therapies listed above. Some doctors may recommend surgical spleen removal if testing shows the organ has become enlarged. An individual suffering from acute leukemia will require immediate treatment once the diagnosis is conclusive.

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Sources:

https://my.clevelandclinic.org/health/articles/leukemia

http://www.mayoclinic.org/diseases-conditions/leukemia/basics/definition/con-20024914

https://www.cancer.gov/types/leukemia

https://www.cdc.gov/nceh/radiation/phase2/mleukemi.pdf

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