Acute leukemia is a blood or bone marrow cancer that is identified by an unusually high count of blood cells – mostly white blood cells, known as leukocytes. This disease is a member of a broad type of blood diseases known as hematological neoplasms.
Leukemia causes damage to the bone marrow which in turn causes a decreased number of platelets used for clotting. Leukemia patients are prone to unusual bleeding, bruising and a rash known as petechiae. Petechiae are actually pin prick bleeds on the skin.
The bone marrow damage also causes a severe decrease in white blood cells, which are part of the body’s immune system. This causes an increased risk of infections for the patients.
Red blood cells levels are also decreased by leukemia, causing anemia.
Common symptoms for leukemia can be associated with other diseases, sometimes making diagnosis difficult. The common symptoms are fatigue, weakness, fever, chills and aches like the flu; loss of weight or appetite, headache, swollen liver and/or spleen and swollen, bleeding gums.
Diagnosis is made by blood tests, biopsy, genetic studies, lumbar puncture (spinal tap), chest x-ray, imaging and lymphectomy.
Blood tests will determine if the counts of blood cells – white, red and platelets; check liver functioning, kidney functioning and for the presence of luekemic cells.
A biopsy is performed to exactly diagnose leukemia. This procedure is done with mild sedation and involves the aspiration of bone marrow. A pathologist will examine the marrow for leukemic cells.
Genetic studies of cells’ chromosomes will detect abnormalities and irregularities in order to classify the type of leukemia.
A lumbar puncture is also known as a spinal tap. The spinal fluid is withdrawn from the patient in order to check for leukemic cells.
A lymphectomy is sometimes performed to remove a swollen lymph node to check for the presence of leukemia.
Typing is important in order to determine the best treatment. There are four major types of leukemia. Leukemia is classified by the numbers of abnormal cells in the blood count and the type of blood cells in the blood count.
Acute and Chronic classification characterizes the type of abnormal cells found in the blood and bone marrow. Acute Leukemia describes the rapid growth of immature blood cells. Immediate treatment is required for acute leukemia because of the rapid growth and build up of leukemic cells in the bone marrow quickly infuse the blood stream. Chronic leukemia describes higher levels of mature, yet abnormal cells. This type of leukemia takes months or years to progress. Chronic leukemia occurs mostly in older patients. Chronic leukemia may be monitored for some time before pursuing treatment.
The next two classifications are based on the types of cells that develop abnormally in the bone marrow. The two types of cells are lymphoid cells and myeloid cells. Lumphocytic leukemia is an abnormal growth of lymphoid cells. Myelogenous leukemia is an abnormal growth of myeloid cells. Lymphoid cells are lymphocytes (white blood cells) and plasma). Myeloid cells are eosinophils, neutrophils and basophils.
These two types of classifying leukemia result in four main categories of leukemia – acute lymphocytic leukemia (ALL), acute myelogenous leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML).
ALL is the most common leukemia in young children and sometimes patients 65 and older are diagnosed. AML occurs mostly in adults and was previously known as non-lymphocytic leukemia. CLL patients are usually over fifty five. Young children are almost never diagnosed with CLL. CML affects mainly adults, but a small number of children can be diagnosed.
Leukemia treatment depends on the health and age of the patient and on the type of leukemia that is diagnosed. Treatment is divided into induction phase, consolidation phase and maintenance phase. The goal of treatment depends on the type of leukemia. Induction phase is directed toward killing off all leukemic cells and placing the patient in remission. Consolidation treatment is targeted at killing off any leukemia cells that may be ‘hiding’ in the body. Maintenance treatment is used to prevent the recurrence of leukemia once a patient has reached remission. Sometimes the leukemia progresses so slowly that the patient is monitored instead of immediately starting treatment.
Treatment can include a combination or single therapy of the following: chemotherapy, biologic therapy, radiation therapy and bone marrow transplant. A bone marrow transplant is an aggressive treatment that involves a few stages. The first stage is to kill all bone marrow in the patient. The second stage is to transplant healthy bone marrow back into the patient. This is performed intravenously.
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