Leukemia

Leukemia is the abnormal growth of white blood cells known as leukemia cells in the bone marrow that over time can swarm out the normal blood cells leading to major complications like anaemia, bleeding and infections.

Leukemia is generally classified on its rate of increase and which type of white blood cells it impinges upon. Acute leukemia deteriorates rapidly making the person experience instant sickness while chronic leukemia exacerbates at a slow pace being asymptomatic for years.

The four key kinds of leukemia include:

• Acute lymphoblastic leukemia (ALL) is the commonest type of leukemia affecting children and adults.
• Acute myelogenous leukemia (AML) affecting children and adults.
• Chronic lymphocytic leukemia (CLL) is a commonly occurring form of leukemia detected in elderly individual over 55, with children rarely contracting it.
• Chronic myelogenous leukemia (CML) is observed to affect mostly adults.

Leukemia Causes:

Though the causes of leukemia are still not clear, it has been noted that most cases that had the risk factors didn’t contract leukemia while contrarily those who got leukemia were not even faced with the risk factors. One would be more prone to leukemia if:

• There has been exposure to massive amounts of radiation.
• Work related exposure to chemicals like benzene.
• Having undergone some form of chemotherapy treatment for another form of cancer.
• Those with Down’s syndrome or other genetic abnormalities.
• Smoking.

Leukemia Symptoms:

Though the symptoms vary with the type of leukemia the person has, the general symptoms are:

• Fever accompanied by profuse night sweating.
• Experience frequent headaches.
• Easily prone to contusion or blood loss.
• Having bone or joint ache.
• A distended or hurting belly due to an increased spleen.
• Engorgement of the lymph nodes in the underarms, neck or groin area.
• Repeated infections.
• Experiencing a sense of fatigue or weakness.
• Weight loss and decreased or no craving for food.

Exams & Tests:

• If leukemia is suspected, then during medical examination the doctor would take into account the medical history, palpate for swollen lymph nodes in the armpits, groin or neck and examine the liver or spleen for enlargement.
• A battery of blood tests are then ordered by the doctor that include blood profiling and a complete blood count or CBC that will provide vital clues to the presence of chronic lymphocytic leukemia (CLL).
• An aspiration of the bone marrow and biopsy are adept means to diagnose majority of leukemias.
• Presence of abnormal cells, chromosomes or proteins on the cells can point to leukemia types that could be ALL, AML or ACL or could even be a subtype. It is crucial to detect the presence of a subtype, as varied subtypes respond favourably to miscellaneous treatment forms.
• Additional tests might also be suggested that comprise of a Chest X-ray if there is recurrent cough or accompanied by blood, chest pain or breathing distress.
• A CT scan of the head, chest and abdomen is needed to check the spread of the disease.
• A lumbar puncture to spot leukemia cells in the cerebrospinal fluid or CSF.
• An MRI of the brain when symptoms include vision difficulty, vertigo, headache, lack of sensation, paralysis or perplexity that signifies its extent of spread to the brain.

Leukemia Treatment:

The objective of treatment is destruction of the leukemia cells and encouraging normal cell growth in the bone marrow, the assessment for which is done taking into consideration the type or subtype one has contracted, the extent of its spread, the age and basic health condition of the person concerned.

• Chemotherapy involves the administration of drugs to combat cancer that are given in three stages such as Induction stage – using potent high doses of drugs to destroy the leukemia cells, Consolidation stage – to clear out any remnant cells with the same drugs but in altered dosage and schedule and Maintenance stage – to avert re-growth of the malicious cells by giving lower drug doses spanning 2-3 years. Though, maintenance stage is used solely for treatment of ALL type. A stem cell transplant might be included if the leukemia type has a high probability of comeback.
• If acute leukemia has reached the brain and spinal cord, the regular form of chemotherapy is incapable to reaching those areas as the body develops unique barricades to safeguard them. In such cases, intrathecal chemotherapy is undertaken wherein the drugs are directly injected into the spinal canal to combat the leukemia cells. Radiation is also implemented in such cases.
• Allogenic stem cell transplant is regularly used as the first line of treatment for those with high-risk acute leukemia with the aim to kill all cells in the bone marrow inclusive of the leukemia cells and replacement with fresh and normal cells.
• Clinical trials are proposed by many doctors for those patients whose conditions worsen or recur despite treatment.
• Biological therapy comprises the usage of unique drugs like monoclonal antibody that bolsters the body’s innate defence capacity.
• The preliminary line of treatment for CML includes administration of the medicine known as Gleevec or imatinib that could be given in combination other drugs. A novel drug known as Sprycel is presently available for CML treatment in those cases where imatinib does not help.
• Palliative care seems the last option if matters get worse. This form of treatment lays emphasis on the improvement of the quality of life, by assisting in coping with symptoms, side effects and the feelings relating to living alongside a long bearing illness.

Possible Complications:

There could be regular bleeding from the nose, gums, rectum, more common bruising or quite heavy menses. There could be frequent night sweating, fever, unexplained constant fatigue, drastic loss of appetite or current loss in weight. There might a sudden crop up of a lump in the neck, armpit or groin, distension and pain on the left part of the abdomen.

Prevention:

There is no recognized means to avert majority of the leukemia types though some types can be averted by evading high dosages of radiation, contact with benzene, smoking or other sources of tobacco or certain forms of chemotherapy that are utilised to cure other forms of cancer.

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