In the United States, more than more than 61,000 and approximately 22,000 people will die from the disease this year, according to the American Cancer Society. The survival rate, however, has tripled in the past 45 years to nearly 51 percent.
Leukemia, cancer of the bone marrow and blood, is characterized by the uncontrolled accumulation of blood cells, and is divided into four categories named for the type of cell involved and whether it is acute or chronic. The four categories are:
- Acute Lymphocytic Leukemia (ALL)
- Chronic Lymphocytic Leukemia (CLL)
- Acute Myelogenous Leukemia (AML)
- Chronic Myelogenous Leukemia (CML)
Acute means the leukemia progresses rapidly resulting in the accumulation of immature, functionless cells in the marrow and blood. The marrow often can no longer produce enough normal red blood cells, white blood cells and platelets. Anemia, a deficiency of red cells, develops in virtually all leukemia patients, and the lack of normal white cells impairs the body’s ability to fight infections. A shortage of platelets results in bruising and easy bleeding.
Chronic leukemia progresses more slowly and allows greater numbers of more mature, functional cells to be made.
Leukemia Risk Factors
The cause and risk factors of the four main types of leukemia continue to be studied, but in most cases, the cause of the disease is not evident. However, the list below has been linked to an increased risk of developing leukemia.
- Exposure – high doses of irradiation, benzene and chemotherapy drugs, such as alkylating agents and topoisosomerase inhibitors, can be associated with a higher risk.
- Genetic Abnormalities – cancers can be caused by DNA mutations (gene defects) when cells enter the growth and division processes.
- Race/Ethnicity – ALL is more common in whites than in African Americans, although the reasons for this are not clear. CLL is more common in North America and Europe than in Asia.
- Gender – ALL, AML, CLL and CML are slightly more common in males than in females. The reason for this is unknown.
- Smoking – Smoking is a proven risk factor for AML. Although many people know that smoking causes lung cancer, few realize that it can affect cells that do not come into direct contact with smoke. Cancer-causing substances in tobacco smoke get into the bloodstream and spread to many parts of the body. As many as 1 in 5 cases of AML are caused by smoking.
- Family History – First-degree relatives (parents, siblings, or children) of CLL patients have an increased risk for this cancer.
Leukemia Signs and Symptoms
Early signs of leukemia include:
- Tiring more easily
- Feeling short of breath when physically active
- Weight loss
- Dizzy or lightheaded
- Blurred vision
- Night Sweats
- Frequent infections of the skin, lungs, kidneys or other sites
- Swollen lymph nodes
- Swollen belly
- Pale complexion from anemia
- Bruising easily
- Small red dots under the skin, called petechia
- Bleeding (frequent nosebleeds or bleeding and swelling of the gums)
- Slow healing of cuts
- Discomfort in bones or joints
Anyone who experiences any of these symptoms should consult their healthcare provider.
To diagnose leukemia, a physician will need a complete medical history, physical examination and the blood and marrow cells must be examined. In addition, the physician will need complete blood counts. The blood and/or marrow cells are also used for studies of the number and shape of chromosomes (cytogenetic examination), immunophenotyping, and other special studies, if required. These samples are used to diagnose and classify the disease and to determine the approach to treatment and the intensity of the drug combinations to be used.
Treatment approaches for blood cancers may include chemotherapy, radiation therapy, stem cell or marrow transplantation, or immunotherapy. These treatments are often given as standard care or in a clinical trial.
- Radiation Therapy – Radiotherapy, which is the use of high-energy rays to kill cancer cells in treated areas, is sometimes useful to treat central nervous system lymphoblastic leukemia.
- Chemotherapy – Chemotherapy is the use of drugs to kill cancers. It is the most common form of treatment for blood cancers because the drugs enter the bloodstream and travel throughout the body.
- Stem Cell Transplant – Transplanting stems cells collected from the patient while in remission, or from a donor, is a common form of treatment for patients with blood cancer.
- Immunotherapy – Immune treatments using antibodies directed against leukemia or lymphoma cells have been approved for use by the U.S. Food and Drug Administration.
At Comprehensive Cancer Centers, research and the participation in clinical research trials is a vital part of our mission. Our physicians are dedicated to finding new ways to treat this disease. We are able to offer our patients access to groundbreaking clinical research close to home. Many of the advancements being made in cancer treatment are the result of in-depth clinical research. For more information about our research efforts, click here.