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Leukemia is a cancer of the blood cells. There are several broad categories of blood cells, including red blood cells (RBCs), white blood cells (WBCs), and platelets. Generally, leukemia refers to cancers of the WBCs.
WBCs are a vital part of your immune system. They protect your body from invasion by bacteria, viruses, and fungi, as well as from abnormal cells and other foreign substances. In leukemia, the WBCs don’t function like normal WBCs. They can also divide too quickly and eventually crowd out normal cells.
WBCs are mostly produced in the bone marrow, but certain types of WBCs are also made in the lymph nodes, spleen, and thymus gland. Once formed, WBCs circulate throughout your body in your blood and lymph (fluid that circulates through the lymphatic system), concentrating in the lymph nodes and spleen.
The causes of leukemia aren’t known. However, several factors have been identified which may increase your risk. These include:
The onset of leukemia can be acute (sudden onset) or chronic (slow onset). In acute leukemia, cancer cells multiply quickly. In chronic leukemia, the disease progresses slowly and early symptoms may be very mild.
Leukemia is also classified according to the type of cell. Leukemia involving myeloid cells is called myelogenous leukemia. Myeloid cells are immature blood cells that’d normally become granulocytes or monocytes. Leukemia involving lymphocytes is called lymphocytic leukemia. There are four main types of leukemia:
Acute myelogenous leukemia (AML) can occur in children and adults. According to the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute (NCI), about 21,000 new cases of AML are diagnosed annually in the United States. This is the most common form of leukemia. The five-year survival rate for AML is 26.9 percent.
Chronic lymphocytic leukemia (CLL) is most likely to affect people over the age of 55. It’s very rarely seen in children. According to the NCI, about 20,000 new cases of CLL are diagnosed annually. The five-year survival rate for CLL is 83.2 percent.
Hairy cell leukemia is a very rare subtype of CLL. Its name comes from the appearance of the cancerous lymphocytes under a microscope.
The symptoms of leukemia include:
Leukemia can also cause symptoms in organs that have been infiltrated or affected by the cancer cells. For example, if the cancer spreads to the central nervous system, it can cause headaches, nausea and vomiting, confusion, loss of muscle control, and seizures.
Leukemia can also spread to other parts of your body, including:
Leukemia may be suspected if you have certain risk factors or concerning symptoms. Your doctor will begin with a complete history and physical examination, but leukemia can’t be fully diagnosed by a physical exam. Instead, doctors will use blood tests, biopsies, and imaging tests to make a diagnosis.
There are a number of different tests that can be used to diagnose leukemia. A complete blood count determines the numbers of RBCs, WBCs, and platelets in the blood. Looking at your blood under a microscope can also determine if the cells have an abnormal appearance.
Tissue biopsies can be taken from the bone marrow or lymph nodes to look for evidence of leukemia. These small samples can identify the type of leukemia and its growth rate. Biopsies of other organs such as the liver and spleen can show if the cancer has spread.
Once leukemia is diagnosed, it’ll be staged. Staging helps your doctor determine your outlook.
AML and ALL are staged based on how cancer cells look under the microscope and the type of cell involved. ALL and CLL are staged based on the WBC count at the time of diagnosis. The presence of immature white blood cells, or myeloblasts, in the blood and bone marrow is also used to stage AML and CML.
A number of other tests can be used to assess the progression of the disease:
Leukemia is usually treated by a hematologist-oncologist. These are doctors who specialize in blood disorders and cancer. The treatment depends on the type and stage of the cancer. Some forms of leukemia grow slowly and don’t need immediate treatment. However, treatment for leukemia usually involves one or more of the following:
The long-term outlook for people who have leukemia depends on the type of cancer they have and their stage at diagnosis. The sooner leukemia is diagnosed and the faster it’s treated, the better the chance of recovery. Some factors, like older age, past history of blood disorders, and chromosome mutations, can negatively affect the outlook.
According to the NCI, the number of leukemia deaths has been falling on average 1 percent each year from 2005 to 2014. From 2007 to 2013, the five-year survival rate (or percent surviving over five years after receiving a diagnosis) was 60.6 percent.
However, it’s important to note that this figure includes people of all ages and with all forms of leukemia. It’s not predictive of the outcome for any one person. Work with your medical team to treat leukemia. Remember that each person’s situation is different.
Written by: Verneda Lights, Lauren Reed-Guy, and Elizabeth Boskey, PhDon: Aug 25, 2017
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