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Leukemia

OVERVIEW

Leukemia is a broad term for cancers of the blood cells. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15. Explore the links on this page to learn more about the types of leukemia plus treatment, statistics, research, and clinical trials.

Leukemia usually involves the white blood cells. Your white blood cells are potent infection fighters — they normally grow and divide in an orderly way, as your body needs them. But in people with leukemia, the bone marrow produces an excessive amount of abnormal white blood cells, which don't function properly.

Treatment for leukemia can be complex — depending on the type of leukemia and other factors. But there are strategies and resources that can help make your treatment successful.

Symptoms


Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include:

  • Fever or chills
  • Persistent fatigue, weakness
  • Frequent or severe infections
  • Losing weight without trying
  • Swollen lymph nodes, enlarged liver or spleen
  • Easy bleeding or bruising
  • Recurrent nosebleeds
  • Tiny red spots in your skin (petechiae)
  • Excessive sweating, especially at night
  • Bone pain or tenderness

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.

Leukemia symptoms are often vague and not specific. You may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses.

Sometimes leukemia is discovered during blood tests for some other condition.

What causes leukemia?

Leukemia starts when the DNA of a single cell in the bone marrow changes (mutates) and can’t develop and function normally. (DNA is the “instruction code” for the cell’s growth and function. Segments of DNA make up genes, which are arranged on larger structures called chromosomes.) All cells that arise from that initial mutated cell also have the mutated DNA.

What causes the damage to the DNA in the first place is still not known in all cases. Scientists have been able to locate changes in certain chromosomes of patients diagnosed with different types of leukemia.

Who gets leukemia? Are certain people at higher risk for developing leukemia?

Although the exact cause of the DNA mutation that leads to leukemia is not fully known, scientists have discovered certain risk factors that may increase your risk of developing leukemia. These risk factors include:

Previous cancer treatment with radiation or chemotherapy.

History of smoking or working with industrial chemicals. Benzene and formaldehyde are known cancer-causing chemicals found in tobacco smoke and building materials and household chemicals. Benzene is used in the making of plastics, rubbers, dyes, pesticides, drugs and detergents. Formaldehyde is found in building materials and many household products such as soaps, shampoos and cleaning products.

Having a genetic disorder, such as neurofibromatosis, Klinefelter syndrome, Schwachman-Diamond syndrome or Down Syndrome.

Leukemia can happen to anyone. You may get leukemia and have none of these risk factors. Other people have one or more of these risk factors and never get leukemia.

You cannot “catch” leukemia from someone else. It is not “transmitted” from one person to another.

Does leukemia run in families? Can leukemia be inherited?

Yes, however this is uncommon. Genetic disorders such as Down syndrome can increase the risk of leukemia. Scientists have also found other genetic mutations that can increase the risk. How much the risk is increased is not exactly known. Having a relative in your family with leukemia does not mean you or your family members will also develop leukemia. In fact, in most cases, there’s no family history of leukemia. However, if you or a family member has a genetic condition, tell your doctor. Your doctor may recommend genetic testing or counseling.

What are the symptoms of leukemia?

Your symptoms depend, in part, on what type of leukemia you have. However, common signs and symptoms include:

  • Tire easily, little energy, weakness.
  • Pale skin tone.
  • Fever.
  • Easy bruising and bleeding. Nosebleeds and bleeding gums. Tiny red spots in skin (called petechiae). Purplish patches in the skin.
  • Bone or joint pain and/or tenderness.
  • Swollen lymph nodes in the neck, underarm, groin or stomach; enlarged spleen or liver.
  • Frequent infections.
  • Unplanned weight loss.
  • Night sweats.
  • Shortness of breath.
  • Pain or full feeling under the ribs on the left side.
  • Keep in mind that if you have a chronic form of leukemia, you may not have any noticeable symptoms in the early stages of this cancer.

Leukemia Diagnosis

Your doctor will need to check for signs of leukemia in your blood or bone marrow. They might do tests including:

Blood tests. A complete blood count (CBC) looks at the number and maturity of different types of blood cells. A blood smear looks for unusual or immature cells.

Bone marrow biopsy. This test involves marrow taken from your pelvic bone with a long needle. It can tell your doctor what kind of leukemia you have and how severe it is.

Spinal tap. This involves fluid from your spinal cord. It can tell your doctor whether the leukemia has spread.

Imaging tests. Things like CT, MRI, and PET scans can spot signs of leukemia.

Leukemia Treatments

The treatment you get depends on the type of leukemia you have, how far it’s spread, and how healthy you are. The main options are:

  • Chemotherapy
  • Radiation
  • Biologic therapy
  • Targeted therapy
  • Stem cell transplant
  • Surgery

Chemotherapy uses drugs to kill cancer cells in your blood and bone marrow. You can get the medicine:

  • Through a shot into a vein or muscle
  • As a pill
  • Into the fluid around your spinal cord

Radiation uses high-energy X-rays to kill leukemia cells or keep them from growing. You can get it all over or in only one part of your body where there are a lot of cancer cells.

Biologic therapy also called immunotherapy, helps your immune system find and attack cancer cells. Drugs like interleukins and interferon can help boost your body's natural defenses against leukemia.

Targeted therapy uses drugs to block specific genes or proteins that cancer cells need to grow. This treatment can stop the signals that leukemia cells use to grow and divide, cut off their blood supply, or kill them directly.

A stem cell transplant replaces the leukemia cells in your bone marrow with new ones that make blood. Your doctor can get the new stem cells from your own body or from a donor. First, you'll have high doses of chemotherapy to destroy the cancer cells in your bone marrow. Then, you'll get the new stem cells through an infusion into one of your veins. They will grow into new, healthy blood cells.

Surgery. Your doctor can remove your spleen if it’s filled with cancer cells and is pressing on nearby organs. This procedure is called a splenectomy

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