Leukemia is a cancer of the bone marrow, lymphatic system, blood cells, and other blood-producing tissues. There are four major types of leukemia - acute lymphoblastic leukemia. sometimes called acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphoblastic leukemia (CLL), and chronic myeloid leukemia, sometimes called chronic myelogenous leukemia (CML) - and many other less common types.
Acute leukemia has a rapid onset and usually progresses aggressively, while chronic leukemia may develop silently in the body for months or even years before a person develops symptoms. Lymphocytic leukemias attack the lymphoid cells, also known as white blood cells, while myelogenous leukemia attacks myeloid cells in the bone marrow and other structures in the body that produce red blood cells.
Over 60,000 people were newly diagnosed with leukemia in 2021, and nearly 400,000 people in the United States are in remission from or living with leukemia.
Leukemia has no single known cause. Like many other cancers, leukemia develops when normal blood cells mutate, causing them to reproduce and spread out of control. The mutated red blood cells or immune blast cells can eventually interfere with the production of healthy blood cells, which causes leukemia symptoms.
Scientists believe that many factors contribute to the development of leukemia. Some risk factors are lifestyle choices within a person’s control, while others, such as genetic disorders and environmental exposure, are not.
Part of the reason that leukemia is such a tough disease to fight is that symptoms are often either not detected right away or mistaken for a milder disease such as the flu.
The typical symptoms of leukemia include:
- Weight loss and loss of appetite
- Fever and chills
- Night sweats or excessive sweating in general
- Frequent or severe infections
- Frequent nosebleeds or bruising
- Swollen lymph nodes
- Red spotting on the skin known as petechiae
As leukemia cells (the excess of immature white blood cells) build up in the bloodstream, severe symptoms arise, such as:
- Bone and joint pain
- Blood clotting
- Swelling in the liver or spleen
- Lumps, spots, or rashes on the skin (known as chloroma or sarcoma)
Leukostasis is a severe condition in which leukemia cells stop oxygen flow through the bloodstream. It causes stroke-like symptoms such as head pain, weakness in one side of the body, slurred speech, disorientation or confusion, and drowsiness. Immediate medical intervention is required.
Who Gets It
Anyone can get leukemia, and there is no typical leukemia patient. Children and adults can develop leukemia, though some types are more common in children than adults or vice versa.
While it’s impossible to predict who will get leukemia, doctors and researchers have identified certain risk factors that make a person more likely to develop it. These risk factors include:
- Family history
- Genetic disorders
- Chemical exposure
- Prior chemotherapy or radiation therapy
However, it’s important to note that most people with these risk factors never develop leukemia, and many people diagnosed with leukemia have none of these risk factors. If you have symptoms that may signal leukemia, talk to your healthcare provider, even if none of these risk factors apply to you.
How to Prevent
What Research Says
While you can reduce your risk of developing leukemia by limiting your exposure to dangerous chemicals and not smoking, it is no guarantee that you will not develop leukemia.
Scientists at the National Cancer Institute, the American Cancer Society, the Leukemia and Lymphoma Society, and other research centers are working every day to develop new treatments for leukemia.
After a stem cell transplant, healthy blood cells and lymphoid stem cells can be overwhelmed by the residual cancer cells in the body, causing relapse. Researchers believe it may be possible to reduce the likelihood of relapse after a stem cell transplant using ordinary baking soda, which boosts lymphocytes’ cancer-fighting abilities.
Cranial radiotherapy is commonly used in children with leukemia to reduce the risk of relapse. However, recent studies suggest that radiation may not actually reduce their relapse risk at all.
One form of immunotherapy, called chimera antigen receptor T (CAR-T) cell therapy, has shown promising results in clinical trials, but its side effects seriously limit its use. Researchers are working on modifying CAR-T cells with on-switches, suicide genes, and other inhibitory features to make this highly effective therapy more widely usable.
Tests & Diagnosis
How is it given?
If you have these symptoms and they’re not explained by any other illness, your doctor will likely perform a series of tests to determine whether they’re caused by leukemia. Because leukemia is a blood cell cancer, it’s generally easy to detect in laboratory tests. Diagnostic tests for leukemia include:
- Physical examination. During a routine physical exam, your doctor can often detect signs of leukemia such as anemia, lymph node swelling, and enlarged organs.
- Laboratory tests. Certain indicators in blood tests can signal the presence of cancer in the body. Some forms of leukemia cause cancer cells to circulate in the blood, making them easy to detect, but that’s not always the case.
- Bone marrow biopsy. If your doctor suspects leukemia, but there are no leukemia cells in your blood, they will likely order a bone marrow biopsy. Some forms of leukemia never release cancer cells in the blood and can only be detected in the bone marrow.