Leukemia

Leukemia is a type of cancer that primarily affects the blood and bone marrow, where blood cells are produced. It involves the rapid production of abnormal white blood cells, which can interfere with the normal production of red blood cells, white blood cells, and platelets. As a result, individuals with leukemia often experience symptoms like fatigue, increased susceptibility to infections, and easy bruising.

Leukemia is one of the most common types of cancer in both children and adults, though its prevalence varies based on the type and age group. The condition is classified based on the speed of progression and the type of blood cell it affects. While leukemia is a serious condition, advancements in medical treatments have significantly improved the survival rates for many types of leukemia.

Leukemia is a cancer of the blood and bone marrow, which are responsible for the production of blood cells. The disease starts in the bone marrow, where blood cells are made, and leads to the overproduction of abnormal white blood cells. These abnormal cells crowd out normal cells, impairing the body’s ability to fight infections, control bleeding, and deliver oxygen throughout the body.

There are different types of leukemia, which can be broadly divided into two categories based on how quickly they progress: acute and chronic leukemia. Acute leukemia develops rapidly and requires immediate treatment, whereas chronic leukemia progresses more slowly and may not show symptoms for several years.

Leukemia is one of the most common forms of cancer globally. According to the World Health Organization (WHO), over 350,000 new cases of leukemia are diagnosed each year worldwide. The incidence of leukemia varies by type and region, with some types being more common in specific geographical locations.

In India, leukemia is one of the leading cancers among both children and adults. The National Cancer Registry Programme (NCRP) reports that leukemia ranks among the top 10 cancers in India, with varying rates across states. The prevalence of leukemia has been steadily increasing in India due to better diagnostic capabilities and increasing awareness.

Globally, countries with higher incidences of leukemia include the United States, the United Kingdom, and other developed nations, where access to better diagnostic methods has led to higher reported rates.

Leukemia is classified into four main types based on the speed of progression and the type of white blood cells affected. These are:

1. Acute Lymphoblastic Leukemia (ALL)

• Description: ALL affects the lymphoid cells and progresses rapidly. It is more common in children but can also occur in adults. ALL causes the body to produce large numbers of immature lymphocytes, which impair the immune system’s ability to function.
• Symptoms: Symptoms include fever, pale skin, frequent infections, easy bruising, and swollen lymph nodes.

2. Acute Myeloid Leukemia (AML)

• Description: AML affects the myeloid cells and also progresses rapidly. This form of leukemia is more common in adults and older individuals. AML is characterised by the production of abnormal myeloblasts, which are precursors to normal white blood cells.
• Symptoms: Symptoms may include fatigue, fever, bleeding, bruising, and weight loss.

3. Chronic Lymphocytic Leukemia (CLL)

• Description: CLL is a slower-progressing form of leukemia that primarily affects older adults. It involves the gradual accumulation of abnormal lymphocytes, which can impair immune function.
• Symptoms: CLL often has mild symptoms at first, but it can cause fatigue, swollen lymph nodes, fever, and weight loss as it progresses.

4. Chronic Myeloid Leukemia (CML)

• Description: CML is characterised by the overproduction of myeloid cells. It progresses more slowly than acute forms and is typically diagnosed in adults.
• Symptoms: The symptoms of CML include fatigue, night sweats, weight loss, and an enlarged spleen or liver.
   

While the exact cause of leukemia is not always known, several factors have been identified as potential risk factors that increase the likelihood of developing the disease. These include:

• Genetic mutations: Certain genetic changes, such as the Philadelphia chromosome, can increase the risk of developing leukemia.
• Family history: Having a family member with leukemia may increase the risk, though it is not always the case.
• Environmental factors: Prolonged exposure to certain chemicals, such as benzene, and radiation may contribute to the development of leukemia.
• Age: Leukemia is more common in older adults, particularly in chronic forms. However, certain types, such as ALL, are more common in children.
• Weakened immune system: Individuals with a weakened immune system, such as those with HIV/AIDS or those who have undergone organ transplants, are more susceptible to leukemia.
   

The symptoms of leukemia can vary based on the type and stage of the disease. Common symptoms include:

• Fatigue and weakness: A lack of healthy blood cells results in reduced energy levels.
• Frequent infections: Due to low white blood cell count, the immune system cannot effectively fight infections.
• Easy bruising or bleeding: A reduced number of platelets can lead to unexplained bruising, bleeding gums, or nosebleeds.
• Pain or tenderness in bones or joints: Some individuals with leukemia experience pain due to the abnormal accumulation of cells in the bone marrow.
• Swollen lymph nodes or spleen: These may be palpable under the skin, particularly in cases of CLL or ALL.
• Unexplained weight loss or fever: Common in both acute and chronic forms of leukemia.

The diagnosis of leukemia typically involves several steps, including a physical examination and a variety of tests to confirm the presence of abnormal cells in the blood or bone marrow. These tests may include:

• Blood tests: A complete blood count (CBC) is used to check for abnormal numbers of blood cells, which can indicate leukemia.
• Bone marrow biopsy: A small sample of bone marrow is taken from the hip bone to examine under a microscope for the presence of cancerous cells.
• Imaging tests: X-rays, CT scans, and ultrasounds may be used to look for swelling of organs or lymph nodes.
• Cytogenetic analysis: This test examines the chromosomes of the cancer cells to identify specific genetic changes, such as the Philadelphia chromosome.
   

The treatment of leukemia varies based on the type of leukemia, the patient’s age, and overall health. The primary treatment options include:

1. Chemotherapy

The most common treatment for leukemia, chemotherapy uses drugs to kill rapidly dividing cancer cells. It can be administered orally or intravenously. Some reputed brands for the chemotherapy, such as Bucelon 60 mg injection and Bufatas 60 mg IV injection are also an option of leukemia treatment.

2. Stem Cell Transplant (Bone Marrow Transplant)

Stem cell transplants replace damaged bone marrow with healthy stem cells, often from a donor, to help restore normal blood cell production.

3. Radiation Therapy

Radiation therapy may be used to target leukemia cells in specific areas, particularly in cases of CLL or to prepare for a stem cell transplant.

4. Targeted Therapy

Targeted drugs work by interfering with specific molecules involved in cancer cell growth and survival, offering a more focused approach to treatment.

5. Immunotherapy

Immunotherapy boosts the body’s immune system to fight cancer. It can be effective for certain types of leukemia, such as CLL.
 

Some individuals with leukemia explore complementary or alternative therapies, such as herbal treatments, acupuncture, and nutritional supplements. However, these should never replace standard treatments. Always consult with a healthcare provider before considering any alternative therapies.

The risk factors for leukemia include:

• Age: Leukemia is more common in older adults, though some types are more common in children.
• Genetics: Certain inherited genetic mutations or a family history of leukemia can increase the risk.
• Exposure to chemicals: Prolonged exposure to substances like benzene, found in some industrial settings, can raise the risk.
• Radiation exposure: High levels of radiation, such as from nuclear accidents or radiation therapy for other cancers, can increase the risk of leukemia.

If left untreated, leukemia can lead to several serious complications:

• Infections: A weakened immune system can make it harder to fight infections, leading to life-threatening conditions.
• Anaemia: The lack of healthy red blood cells can lead to fatigue and shortness of breath.
• Bleeding: A lack of platelets increases the risk of excessive bleeding.
• Relapse: Even after successful treatment, leukemia may return, especially in cases of acute leukemia.

Living with leukemia can be challenging, but support, proper treatment, and lifestyle adjustments can improve quality of life. Here are some tips:

• Follow-up care: Regular check-ups and blood tests are crucial to monitor remission and detect relapse early.
• Emotional support: Joining a support group or talking to a counsellor can help manage the psychological impact of living with leukemia.
• Adhering to treatment: Stick to the prescribed treatment plan and report any side effects to your healthcare provider.
   

• Leukemia only affects children: While childhood leukemia is common, leukemia also affects adults, particularly older adults.
• Chemotherapy is always ineffective: Chemotherapy remains a cornerstone of leukemia treatment and can be highly effective
   

If you experience any of the common symptoms of leukemia, such as unexplained bruising, fatigue, or swollen lymph nodes, it’s important to see a doctor. Early diagnosis increases the chances of effective treatment.

• What type of leukemia do I have?
• What treatment options are available for my condition?
• What are the potential side effects of the treatment?
• How can I manage side effects and improve my quality of life?
   

Supporting a loved one with leukemia involves understanding their physical and emotional needs. Provide emotional support, assist with daily tasks, and help them stick to their treatment plan.

Leukemia is a serious but treatable disease that affects the blood and bone marrow. Early detection and advancements in treatment options have greatly improved the prognosis for many individuals with leukemia. While the exact cause remains unclear, understanding the risk factors and symptoms can aid in early diagnosis and better management of the disease.