Leukemia (blood cancer) Types, Signs and Symptoms, Treatment options

 Leukemia is commonly referred to as a type of blood cancer. In which blood-forming cells, bone marrow cells, or the cells of the lymphatic system start growing abnormally. Types of leukemia depend upon the kind of cells involved. Some cancers are specific to children, and some occur in adults.

TYPES OF LEUKEMIA:

The following are the types of leukemia.

1. Acute lymphoblastic/Lymphocytic leukemia (ALL): This type involves abnormal production of lymphocytes. This type of cancer occurs mostly in younger children. This is the most aggressive form of blood cancer, which is suddenly diagnosed within a few days after symptoms.

This type is further divided into the following subtypes:

• B-Cell ALL: Cancer of the B-lymphocyte is called B-cell ALL. (B-cells are responsible for the production of antibodies).
  • T-Cell ALL: Cancer of T Cells is called T-cell ALL (T-cells directly engulf pathogens and regulate the immune system.
• Chronic lymphoblastic/Lymphocytic leukemia (CLL): This type also involves lymphocytes, but slowly over time. It takes months or years to show symptoms.
• Acute Myeloid Leukemia (AML): This type of blood cancer grows aggressively and fast. Moreover, acute means growing fast, and myeloid means occurring in myeloid cells in the bone marrow. It usually develops in older people. However, some evidence exists in children as well. AML involves myoblasts, which are responsible for the production of red blood cells and platelets.

• Chronic myeloid leukemia (CML): This involves specific myeloid cells called monocytes, which are present in the bone marrow. The abnormal production of these cells is called chronic myeloid leukemia. This is chronic because it grows slowly in the bone marrow and comes to the bloodstream slowly over time. It can convert into a fast-growing cancer in later stages. Some cells can deposit in other parts of the body, like the spleen.

Signs and symptoms of leukemia.

The following are the common signs and symptoms of leukemia.

• Fatigue
• Fever (a sign of infection)
•   An unexplained Weight loss
• Bleeding (easily bruising and discoloration)
• Decrease the number of hemoglobin, platelets, and white blood cells
• Sore throat
• Sweating and chills
• Gum bleed
• Flu-like symptoms
• Abdominal distention or a hard abdomen
• Black stools (a sign of internal bleeding)

However, in case of the above symptoms, do not delay consulting with your healthcare provider. Your consultant will do supportive management along with the treatment of cancer. The supportive management includes red blood cell and platelets transfussion and medication for fever and bleeding.

Diagnostic tests to diagnose leukemia

The following are the tests to diagnose leukemia.

• Complete blood count: This test gives an idea of blood cancer. However, in total blood count following results give a general picture, i.e., markedly increased in white blood cells. In a regular CBC report, white count is 4000-11000, but in a patient with leukemia, white blood cells range from 100000 -400000, decreased platelet counts, and a decrease in hemoglobin level.
• Peripheral Smear: Peripheral smear contains blast cells, shown in %.eg 90%, 80%, etc.
• Bone Marrow Biopsy: Furthermore, this test is carried out to rule out the type of leukemia. Moreover, a biopsy reveals the exact type of cells involved, and based on the type of cancer, your oncologist suggests/decides the kind of treatment. Bone marrow biopsy is the standard gold test to diagnose leukemia.

Causes and Risk Factors of Leukemia:

The exact cause of leukemia /blood cancer is unknown, but some risk factors could be the leading cause of blood cancer.

• Genetic cause. Some types of blood cancer run in families, called familial cancer, which means transferred from parents to children.
•  Exposure to Radiation: Moreover, unnecessary exposure to radiation can cause blood cancer
• Exposure to cytotoxic medications: Medications like chemotherapy can cause blood cancer. Mishandling of chemotherapeutic drugs by healthcare providers could be a causative factor that could lead to cancer.
• Exposure to or contact with nuclear materials and pesticides.

Treatment of leukemia:

As soon as leukemia is confirmed. Do not delay getting treatment.

Chemotherapy for  Leukemia

However, chemotherapeutic drugs are the first treatment of choice for it. Moreover, treatment regimens vary for each type. Chemotherapy drugs kill cancer cells. The stages of treatment are induction, consolidation, and maintenance therapy, depending upon the patient’s response to cancer.

Radiation therapy in  Leukemia

However, in some cancer treatments, along with chemotherapy regimens, radiation therapy is also administered for better results and remission. Such as in an allogenic stem cell transplant specilally in a half-matched stem cell transplant.

Moreover, this combination is done for a better outcome in a stem cell transplant; this combination prevents graft versus host disease. The radiation therapy depletes the T-cells, which are the main cause of graft versus host disease after stem cell infusion.

How to know if the leukemia is under control or is in remission?

There are many methods to know about leukemia in remission. For example, the physical health of the patient will indicate that the cancer is no longer present. This may include the following

the energy level of the patients

normal skin colour/ no paler

normal weight reduction

no bleeding

without fever or decreased appetite

a complete blood count test with normal results

Besides all of the above, the authentic test is a bone marrow biopsy, which is done by taking a marrow sample with the help of a needle. SO, Leukemia is usually monitored through bone marrow biopsy and complete blood count testing.

Bone Marrow Transplant and Leukemia

Moreover, the second choice of treatment is a stem cell orbone marrow transplant, which could be fully matched allogeneic from a matched sibling or matched unrelated donor or haploidentical.

Moreover, before transplant, cancer cells or leukemic cells are killed by high-dose chemotherapy or radiation therapy, and then new bone marrow is infused to establish a leukemia-free bone marrow to regenerate new healthy cells.

CAR-T.  (Chimeric antigen receptor T cell therapy):

CAR-T is a new form of treatment for leukemia. The T cells (the infection-fighting cells) are separated from the blood, engineered, and reinfused into the patient’s body to fight cancer.CAR-T is the latest treatment for it. However, highly expensive and not available in many developing countries.