Blood Cancer-Leukemia

 

BLOOD CANCER ( LEUKEMIA)

(i) Acute Myeloid Leukemia 

Overview

Acute myeloid leukemia is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated. It is the most common type of acute leukemia in adults.

Normally the bone marrow produces stem cells (immature cells) that develop into mature cells. There are three types of mature blood cells.

• Red blood cells that carry oxygen and other materials to all tissues of the body.
• White blood cells that fight infection and disease.
• Platelets that help prevent bleeding by causing blood clots to form.

In AML, the stem cells usually develop into a type of immature white blood cell called myeloblasts. The myeloblasts in AML are abnormal and do not mature into healthy white blood cells. Occasionally in AML, too many stem cells develop into abnormal red blood cells or platelets. These abnormal white blood cells, red blood cells, or platelets are also called leukemia cells or blasts. Leukemia cells are unable to do their usual work and can build up in the bone marrow and blood so there is less room for healthy white blood cells, red blood cells, and platelets. When this happens, infection, anemia, or easy bleeding may occur. The leukemia cells can spread outside the blood to other parts of the body, including the central nervous system, skin, and gums.

Risk of developing AML

         Being male

         Smoking especially after age 60

         Having had treatment for ALL in the past

         Being exposed to atomic bomb radiation or the chemical benzene. 

Symptom

May include fever, feeling tired, and easy bruising or bleeding. 

Diagnosis

• Physical exam and history
• Complete blood count
• Peripheral blood smear
• Bone marrow aspiration and biopsy
• Cytogenetic analysis

(II) Acute Lymphoblastic leukemia 

Overview

It is also called acute lymphocytic leukemia. Cancer of the blood and the bone marrow. This type of cancer usually gets worse quickly if it is not treated.

Normally the bone marrow produces stem cells (immature cells) that develop into mature blood cells. In ALL, too many stem cells develop into a type of white blood cells called lymphocytes. These lymphocytes may also be called lymphoblasts or leukemia cells. There are three types of lymphocytes.

• B lymphocytes that make antibodies to help fight infection.
• T lymphocytes that help B lymphocytes make the antibodies that help fight infection.
• Natural killer cells that attack viruses.

In ALL, the lymphocytes are not able to fight infection very well. Also the number of lymphocytes increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. The cancer can also spread to the central nervous system. 

Risk factors

• Being older than 70
• Being male
• Past treatment with chemotherapy or radiation therapy.
• Exposure to nuclear radiation.
• Having a certain disorder such as down’s syndrome.

Symptoms

·         

• Weakness and fever
• Easy bruising and bleeding
• Under the skin bleeding
• Shortness of breath.
• Weight loss or loss of appetite
• Pain in the bones or stomach
• Pain or feeling of fullness below the ribs
• Painless lump in the neck, underarm, stomach, or groin.

Diagnosis

• Physical exam and history
• Complete blood count
• Peripheral blood smear
• Bone marrow aspiration and biopsy
• Cytogenic analysis
• Immunophenotyping

(III) Chronic Lymphocytic Leukemia 

Overview

Chronic Lymphocytic Leukemia (CLL) is a blood and bone marrow disease that usually gets worse slowly. Cll often occurs during or after middle age, it rarely occurs in children.

In CLL too many stem cells develop into a type of white blood cell called lymphocytes. There are 3 types of lymphocytes.

• B lymphocytes that make antibodies to help fight infection
• T lymphocytes that make antibodies to help fight infection
• Natural killer cells that attack viruses

The lymphocytes in CLL are not able to fight infection very well. Also, as the amount of lymphocytes increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells and platelets. 

Risk factors

• Being middle aged or elder
• A family history of CLL or cancer of the lymph system

Symptoms

• Painless swelling of the lymphnodes in the neck, underarm, stomach or groin.
• Feeling very tired
• Pain or fullness below the ribs
• Fever and infection
• Weight loss for no known reason

Diagnosis

• Physical exam and history
• Complete blood count
• Cytogenic analysis
• Immunophenotyping
• Bone marrow aspiration and biopsy

(IV) Chronic Myelogenous Leukemia 

Overview

Chronic myelogenous leukemia (CML) is a slowly progessing blood and bone marrow disease that usually occurs during or after middle age, and rarely occurs in children.

In CML, the body produces too many bone marrow stem cells to develop into a type of white blood cell called granulocytes. Some of these bone marrow stem cells never become mature white blood cells. These are called blasts. Over time, the granulocytes and blasts crowd out the red blood cells and platelets in the bone marrow. 

Symptoms

• Tiredness that does not go away
• Lack of energy
• Weight loss
• Night sweats
• Fever
• Pain or fullness below the ribs on the left side

Risk factors

A major risk factor is a genetic disorder called Philadelphia syndrome, where the DNA produces an enzyme which makes too many white cells from stem cells. 

Diagnosis

• Physical exam and history
• Complete blood count
• Blood chemistry studies
• Cytogenic analysis
• Bone marrow aspiration and biopsy

(V) Hairy cell Leukemia 

Overview

Hairy Cell Leukemia is a cancer of the blood and bone marrow. This rare type of leukemia gets worse slowly or not at all. The disease is called hairy cell leukemia because the leukemia cells look hairy when viewed under a microscope.

In hairy cell leukemia, too many stem cells develop into a type of white blood cell called lymphocytes. There are 3 types of lymphocytes.

In hairy cell leukemia, the B type lymphocytes do not work normally. Also, as the number of lymphocytes increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells and platelets. This may cause infection, anemia, and easy bleeding. Some of the leukemia cells may collect in the spleen and cause it to swell. 

Risk factor

Old age is considered to be a major risk factor 

Symptoms

         Weakness of feeling tired

         Fever or frequent infections

         Easy bruising or bleeding

         Shortness of breath

         Weight loss for no known reason

         Painfull lumps in the neck, underarm stomach or groin 

Diagnosis

• Physical exam and history
• Complete blood count
• Peripheral blood smear
• Bone marrow biopsy
• Immunophenotyping
• CT SCAN