Know the Basics of Leukemia

How a spinal tap is done (photo from http://www.patientedlibrary.com/generateexhibit.php?ID=10472)

Cancer is a very treacherous diseases and I learned that the hard way. Years ago, my mother was diagnosed with leukemia, a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells. She was diagnosed in the month of July, had her first chemotherapy by December and died May of the next year.

You never really get over the death of  loved one, you just have to live with it, accept it  and at least learn from it. My mother was a hardworking grade-school teacher and a devoted mother, wife, sister and daughter. Sometimes, I think that it was all the dedication and tremendous effort she put into work and to other people that caused her sickness. She never really had time to take care of herself. When my mom got sick, three or four trips to  the hospital in a month is an understatement. I started to hate the white walls, the rush during daytime when patients, doctors and visitors come and go during the daytime, the quiet evenings  when the patients are asleep  and only the nurses are awake. To this day, I know which floor the nursey, the ICU, the blood bank, and the chapel was of certain hospitals.

No one in my mom’s family had ever been diagnosed with the disease before and it had always been a puzzle to us, especially her kids. When she died, I  made it a point that my sisters and I were tested and checked from time to time. You might say it’s over the top, but losing another loved one is not an option. I know that early detection will work wonders, unlike how it was when my mom was diagnosed at a stage that the chances of a five year survical is 40%.

Leukemia is subdivided into a variety of large groups depending on the progression and accumulation of the malignant cells, which kind of blood cells are affected.

The first division is between its acute and chronic forms:

  • Acute leukemia is characterized by a rapid increase in      the number of immature blood cells. Immediate treatment is required in      acute leukemia due to the rapid progression and accumulation of the malignant cells, which then spill over into the bloodstream and spread to other      organs of the body. This type of leukemia is comon in children, but can      also happen to adults.
  • Chronic leukemia is characterized by the excessive build  up of relatively mature, but still abnormal, white blood cells. Though, it takes months or years to progress, with chronic leukemia, the cells are  produced at a much higher rate than normal, resulting in many abnormal white blood cells. Unlike acute leukemia that has to be treated  immediately, the progression of chronic leukemia can sometimes be monitored  before any treatment is done to ensure maximum that the therapy done will  be effective. Chronic leukemia mostly occurs in older people, but can theoretically occur in any age group.

Let’s not go into details regarding the sub types of leukemia. It takes a lot of understanding to fully understand these other types. What each of us must know is  how we can be afflicted of such condition. Leukemia, like other cancers, results is a result of the mutations in the body’s DNA. Certain mutations can trigger leukemia by activating oncogenes or deactivating genes that suppress tumors. No one knows the exact causes of DNA mutations and doctors seldom know why one person gets leukemia and another doesn’t. However, research shows that there are certain conditions that may increase the chance of a person acquiring this disease. The following are known to be risk factors for leukemia:

  • People exposed to very high levels of radiation are much more likely than others to acute leukemia. Exposure to radiation happens in atomic bomb explosions (God forbid.), medical treatment  for cancer and other conditions (this can happen to health workers and those who frequent hospitals and medical facilities). Researchers are studying whether having many x-rays (dental x-rays, chest x-rays, etc) and CT scans may increase the risk of leukemia.
  • Smoking cigarettes increases the risk of acute myeloid leukemia.
  • Exposure to benzene, widely used in the chemical industry and  also found in cigarette smoke and gasoline,  can cause several types of leukemia.
  • Cancer patients treated with certain types of cancer-fighting drugs and those who have gone thru chemotherapy sometimes later get acute myeloid leukemia or acute lymphocytic leukemia.
  • Down syndrome and certain other inherited diseases increase the risk of developing acute leukemia.
  • People with certain blood disorders are at increased risk of acute leukemia.
  • People with HTLV-I infection are at increased risk of a rare type of leukemia known as adult T-cell leukemia
  • It’s rare for more than one person in a family to have leukemia, but if someone in the family had been diagnosed before, one’s chances of having leukemia also increases.

Having one or more risk factors does not mean that a person will get leukemia. Most people who have risk factors never develop the disease.

What are the early signs of leukemia?

Unfortunately, like all blood cells, leukemia cells travel through the body. The symptoms of leukemia depend on the number of leukemia cells and where these cells collect in the body. Those with chronic leukemia may not have symptoms at all, and may only be discovered during a routine blood test. Those with acute leukemia will usually feel sick, with various symptoms as leukemia cells travel to other body parts.

Common symptoms of chronic or acute leukemia may include:

  • Swollen lymph nodes in the neck, groin or armpit that usually don’t hurt
  • Fevers or night sweats
  • Frequent infections due to weak immune system
  • Feeling weak or tired
  • Bleeding and bruising easily (bleeding gums, purplish patches in the skin, or tiny red spots under the skin) due to poor blood clotting
  • Swelling or discomfort in the abdomen (from a swollen spleen or liver)
  • Weight loss with unknown causes
  • Pain in the bones or joints
  • Loss of appetite
  • Early stage of anemia

Anyone with these symptoms should tell the doctor so that problems can be diagnosed and treated as early as possible. As all these symptoms could be due to other illnesses. A diagnosis of leukemia can only be confirmed after medical tests are carried out. Depending on the type of leukemia, several tests are done some of the test includes:

  • Physical exam where the doctor checks for swollen lymph nodes, spleen, or liver.
  • A complete blood count to check the number of white blood cells, red blood cells, and platelets. Leukemia causes a very high level of white blood cells. It may also cause low levels of platelets and hemoglobin, which is found inside red blood cells.
  • An x-ray can show swollen lymph nodes or other signs of disease in your chest.
  • The doctor will gather tissue samples to look for cancer cells. A biopsy is the only sure way to know whether leukemia cells are in your bone marrow. Samples of bone marrow (bone marrow aspiration) or a small piece of bone (bone marrow biopsy) can be taken from your hipbone or another large bone. A pathologist will then examine the tissue under microscope to check the tissue for leukemia cells.
  • The lab looks at the chromosomes of cells from samples of blood, bone marrow, or lymph nodes (cytogenetics). If abnormal chromosomes are found, the test can show what type of leukemia you have.
  • The doctor may do a spinal tap wherein cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord) will be removed using a long, thin needle to remove fluid from the lower spine. The lab checks the fluid for leukemia cells or other signs of problems.

    How a spinal tap is done (photo from http://www.patientedlibrary.com/generateexhibit.php?ID=10472)

As with any disease, early detection is always your best tool.

Web References:

http://en.wikipedia.org/wiki/Leukemia

http://www.medicinenet.com/leukemia/article.htm

http://www.webmd.com/cancer/tc/leukemia-topic-overview

http://www.medicalnewstoday.com/articles/142595.php