Explanation

Leukemia or blood cancer has an unknown cause. Risk factors have been identified as exposure to radiation and benzene. It is grouped by how quickly the disease develops, breaking it into acute or chronic. As well as grouping how fast it develops, it is also grouped by what type of blood cells are affected. The four main types of leukemia are acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelocytic leukemia (AML), and chronic myelocytic leukemia (CML). People with leukemia have a significantly increased risk for developing infections, anemia, and bleeding. The diagnosis of leukemia is supported by results of the examination and medical history, and examining bone marrow and blood samples under a microscope. The diagnosis of leukemia depends upon the patient’s age, type of leukemia and the extent of the spread of the cancer.

Leukemia was not officially diagnosed until 1845, by John Hughes Benett. Other European physicians in the 19th century witnessed that their patients had abnormally high levels of white blood cells, and they called the disease “weisses blut,” meaning “white blood.” The term “leukemia” that is used now comes from the Greek words “leukos” and “heima,” also meaning “white blood.” In 1970, it was first confirmed that some patients could be cured of leukemia. By the 1980s and 1990s the cure rates for leukemia were around 70 percent.

Signs & Symptoms

The symptoms for leukemia are fever, chills, fatigue, and weakness. A person may also have a loss of appetite or weight loss, night sweats, bone and joint pains. They could have abdominal discomforts, headaches, shortness of breath, frequent infections, easy bruising or bleeding and petechiae (small red spots under the skin).

Consequences

First and foremost, the patient can die of leukemia. Chemotherapy can affect concentration, memory, and a person's ability to multitask. The patient can experience post-traumatic stress disorder and depression. Physical fatigue is combined with the possibility of heart, lung, thyroid, infertility, hearing loss, eye, other cancers, nerve, brain, and bone problems.

Treatment

For each type of leukemia there is a different treatment plan. For ALL there is induction therapy, consolidation therapy, and maintenance therapy. During induction therapy, the doctors use chemotherapy and corticosteroids to kill leukemia cells in the blood and bone marrow. Induction usually lasts four weeks and is done in a hospital. In the next step, the patient goes through more chemotherapy which may include stem cell transplants. This step is called consolidation therapy, which continues to kill the leukemia cells that may still be present even though they do not show up in the tests and could still regrow, causing the patient to relapse. The last stage of treatment is called maintenance therapy. It helps to prevent any remaining leukemia cells from growing. This can be done by using lower dosages of chemotherapy than the ones used in the previous stages. Chemo will be given as pills or once-a-month intravenous (IV) treatments. It is often continued for up to three years. During that time, most people are able to go back to being as active as they were before beginning treatment.

AML usually has two steps which include induction on remission and post-remission therapy. Induction of remission is used to kill leukemia cells in the blood and bone marrow to induce remission. Chemotherapy is given by IV treatments. It normally lasts four weeks - a week of chemotherapy, then three weeks for bone marrow recovery during which the patient will be in a hospital. Post-remission therapy is used to kill any leukemia cells that are still present, even if they did not show up in tests. This involves getting additional chemotherapy or stem cell transplants or even a clinical trial recommended by the patient's doctor. Chemotherapy may be given to you in the hospital for several days each month for three to four months.

CLL is not always treated right away. The two treatments set for this type are radiation therapy and chemotherapy. Radiation therapy uses X-rays or similar forms of radiation.

CML is normally treated right away. The two choices that the patient has are targeted therapy and stem cell transplants. Targeted therapy is usually treated with a tyrosine kinase inhibitor, which is the first treatment used for CML. Before the stem cell transplants can be done, chemotherapy or radiation need to be used to destroy the bone marrow activity.

Health Careers

When given the diagnosis of leukemia, four doctors help: the patient's family physician, a hematologist, radiologist, and oncologist. The patient's family physician will be their home base for gentoms. Next is the hematologist, who will do all of the lab work and help find the information the patient will need. The radiologist will be the one with the patient when they go for x-rays and electro cardiograph. Lastly the oncologist will be the one who gives the patient chemo and helps them with T cell transplants and experimental drugs.

Support Services

There are so many support systems for leukemia and cancer patients - it is absolutely amazing. First, on the national level, there is the Bone Marrow Foundation. It helps support patients, their families and caregivers every part of the way. The Eastern Pennsylvania chapter of the leukemia and lymphoma society helps people learn and support those with leukemia. Lastly, Pinnacle Health operates on the local level. They set up support groups to help the patient talk to others who also have leukemia.