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Blood and immune system-related cancer

Leukemia

Leukemia is a cancer found in early blood-forming cells and is most often a cancer of the white blood cells. Leukemia is often classified as either chronic (progresses slowly) or acute (progresses quickly).

Four main types of leukemia exist. Different types have different prognoses and treatments.

Acute myeloid leukemia (AML) – Begins in the bone marrow, and often moves quickly to the blood.

Chronic myeloid leukemia (CML) – Begins in the blood-forming cells. Accounts for only 10% of leukemia.

Acute lymphocytic leukemia (ALL) – Begins in the bone marrow from cells that become lymphocytes. More common in children than adults.

Chronic lymphocytic leukemia (CLL) - Begins in the bone marrow from cells that become lymphocytes. Usually progresses more slowly than other types of leukemia.   

Common causes and risk factors

  • Radiation exposure
  • Exposure to certain chemicals such as benzene
  • Smoking
  • Cancer treatment

Symptoms

These symptoms may also be caused by other, less serious conditions, so it is important to talk to your doctor if you experience any of them:

  • Fatigue
  • Persistent fever
  • Night sweats
  • Weakness
  • Weight loss
  • Pain or fullness in lower abdomen
  • Frequent or excessive bruising and bleeding
  • Enlarged lymph nodes

Diagnosis

Acute myeloid leukemia (AML) – A doctor will conduct a physical exam if the patient is experiencing symptoms that suggest AML. During the exam, the doctor will look for areas of bruising, bleeding or infection and focus on the mouth, eyes, liver, spleen and lymph nodes. The doctor may then order blood tests.

Chronic myeloid leukemia (CML) – People with CML usually do not display symptoms when diagnosed. CML is often found if your doctor orders a blood test for a routine checkup or different health problem.

Chronic lymphocytic leukemia (CLL) – People with CLL usually do not display symptoms when diagnosed. CLL is often found if your doctor orders a blood test for a routine checkup or different health problem.

Acute lymphocytic leukemia (ALL) – The doctor will conduct a physical exam if you display AML symptoms. The doctor will focus on lymph nodes, areas of bleeding or bruising and the abdomen. The exam may be followed up with blood tests. Tests include:

  • Blood tests
  • Bone marrow tests
  • Image testing
  • Lumbar puncture (spinal tap)
  • Lymph node biopsy

Treatment

Your cancer care team will discuss your treatment options with you to determine the best treatment plan. Treatment plans depend on the type of leukemia and stage of the cancer.

Acute myeloid leukemia (AML) – Treatment options for AML patients depend on prognostic features and lab tests of the leukemia cells. The most common type of treatment for people with AML is chemotherapy, while radiation therapy and surgery may be used in certain cases. 

Chronic myeloid leukemia (CML) – Treatment options for CML patients most commonly involve targeted therapy drugs. However, some patients may have other treatment options such as surgery, radiation therapy, chemotherapy and interferon.

Chronic lymphocytic leukemia (CLL) – Although treatment is often not needed immediately after diagnosis, some patients will need treatment. The main treatments include chemotherapy and monoclonal antibodies.

Acute lymphocytic leukemia (ALL) – Treatment plans vary depending on leukemia subtype and prognostic features. The main types of treatment include chemotherapy and targeted therapy. Chemotherapy usually occurs over two years and is given in three phases.

Chemotherapy uses medicines to destroy cancer cells. You may receive it by mouth or through your veins.

Interferon is often used to slow the growth of cancer cells. It is injected as a shot under the skin.

Radiation therapy uses high-dose X-rays to destroy cancerous cells.

Targeted therapy uses substances that target or block the biological process involved in a particular kind of cancer.

Monoclonal antibodies are manufactured versions of antibodies that attach to and destroy cancer cells.

Prevention

For most people who have ALL, AML, CML and CLL, no known causes exist for why they developed the disease. Therefore, there is currently no way to prevent leukemia from developing.