What Leukemia Is, How It’s Treated, and How to Cope

Leukemia is a group of different blood cancers that cause white blood cells in the body and bone marrow to reproduce in an uncontrolled and disorganized manner. These white blood cells replace and damage the normal, healthy blood components in the body. There are four main types of leukemia that affect people and they are: chronic leukemia, acute leukemia, myelogenous leukemia and lymphocytic leukemia.

Chronic and acute leukemia affects the blood-forming cells of the bone marrow and can also spread to distant parts of the body like lymph nodes, liver, spleen, skin, or brain. Leukemia can also be spread to the bone marrow from tumors in the lungs, colon, or breast but cancer that starts in any other part of the body and then spreads to bone marrow tissue is not considered leukemia.

How Does Our Bone Marrow Work?

Bone marrow is contained in bones like the skull, shoulder blades, ribs, pelvis and spine and is the soft inner portion within the bone itself. Contained in the bone marrow are blood forming cells called hematopoietic cells as well as fat cells and growth supporting tissue. In the bone marrow, stem cells are busy reproducing new cells all the time and some of these cells change into lymphoid cells or hematopoietic stem cells. The latter are also able to divide and form new ones or grow into red and white blood cells or platelets.

These blood components are important to help the body fight infection, gain access to oxygen and keep the body healthy.

The Different Types of Leukemia

There are four main kinds of leukemia and these can be further broken down into sub-types which help to understand a patient’s outlook and gives doctors some guidance on how best it can be treated.

When leukemia is said to be ‘acute’ it means that the bone marrow cells can’t become mature. These new cells keep reproducing and collect in the bone marrow. If no treatment is given to a person with acute leukemia their life span is very limited. There are leukemias in this group that can be successfully treated and cured while others cannot.

‘Chronic’ leukemia differs from the acute type in that the cells can and do become mature but they are abnormal cells that can’t fight infection in the normal way that healthy white blood cells do. Cells don’t overproduce like in acute leukemia but rather live for too long, longer than a white blood cell normally would. This causes a build up of mature granulocytes or lymphocytes (the cells that protect the body from infection and cancerous changes).

Lymphocytic leukemia starts in the bone marrow lymphocytes while myelogenous leukemia has its origin in the bone marrow itself.

By considering the above differences you will see that leukemia can be divided into four distinct groups:

• Acute myelogenous leukemia (AML)

• Chronic myelogenous leukemia (CML)

• Acute lymphocytic leukemia (ALL)

• Chronic lymphocytic leukemia (CLL)

There are also several sub-types of leukemia like hairy cell leukemia (HCL), which is a slowly advancing lymphocyte cancer and is treated differently from other types of leukemia.

Prolymphocytic leukemia and T-cell chronic lymphocytic leukemia are two rare types of CLL. These sub-types of leukemia are quite aggressive and often don’t respond well to treatment.

There are no known risk factors for developing leukemia so it is not (at present) possible to avoid or prevent the onset of the disease.

What are the Symptoms of Leukemia?

Depending on whether a person has acute or chronic your symptoms will vary. People who have acute leukemia will feel flu-like symptoms, an abnormal tiredness, sore throat, bleeding gums and skin, and loss of appetite and weight.

The lymph nodes in the neck, armpits and groin may become enlarged and if a blood test is done there will be a very severe anemia and large numbers of very immature white cells.

People with chronic leukemia will experience symptoms that are very slow to develop and will feel tired, unable to carry out their normal activities and may have a dragging weight in the upper left side of the abdomen. Loss of weight is gradual and there may be aching in the bones, nosebleeds and men may have unwanted and prolonged erections. Patients with chronic leukemia may not be able to take hot weather and may sweat excessively.

What Are the Treatments for Leukemia?

Chemotherapy

Leukemia is usually treated by means of chemotherapy and several different types of drugs are given to the person over some time. The drugs used for the treatment of CLL are usually chlorambucil (Leukeran) and fludarabine (Fludara).

In the case of chronic leukemia these drugs could sustain life for years. Because leukemia spreads throughout the body, chemotherapy drugs may be given by mouth or injected into a vein or muscle allowing them to go directly into the bloodstream where they attack and destroy the dividing cancer cells.

What are the Side Effects of Chemotherapy Treatment?

Normal bone marrow tissue may also be destroyed during treatment such as those in the mouth, intestines, hair follicles so people may experience side effects like hair loss, mouth sores, lowered resistance to infection, bleeding or bruising, tiredness, loss of appetite and weight, nausea and vomiting. The good news is that these side effects usually vanish after treatment is stopped.

If you are undergoing chemotherapy treatments for leukemia and find that the side effects are very unpleasant and disruptive tell your doctor and he can provide medication to lessen their impact on your body.

These drugs can include those given with your chemotherapy treatment to control nausea and vomiting or growth factors like G-CSF and GM-CSF to increase your white blood cells levels after treatment so your infection risk is lowered. You may also be given a course of antibiotics to avoid infection or at the first signs of illness.

Your doctor may decide to give you a blood platelet transfusion to protect you against bleeding or if you lack red blood cells and become tired and breathless you may be given a transfusion or medicine to keep you healthy. (Click Here to read more about Chemotherapy)

Radiation Treatment

In certain cases, such as if your internal organs are enlarged and causing other symptoms or pain and loss of appetite, you may also be prescribed radiotherapy or ‘radiation’ treatments to treat your leukemia. This is a kind of therapy that involves using high energy rays or particles to destroy the cancer cells in your body.

You may be given radiation therapy if chemotherapy treatments are not working effectively. It also helps with pain due to bone damage which can be caused by the growing leukemia cells in the bone marrow.

What are the Side Effects of Radiation Treatment?

Side effects of radiotherapy may include a sunburn-like reddening of the skin, severe tiredness and a lowered infection resistance.(Click Here to read more about Radiation Treatment )

Monoclonal Antibody Treatment

Monoclonal antibodies are produced naturally by our immune systems as a way to fight off infection but these antibodies can also be produced in a laboratory to destroy cancer cells. This kind of therapy aims to help the patient’s own immune system to react to and destroy the abnormal cancer cells.

Alemtuzumab (Campath) is a monoclonal antibody that has been approved to treat chronic lymphocytic leukemia and can be sued when patients are not responding to standard chemotherapy programs. Treatment is by intravenous (IV) injection on a daily schedule or several times a week.

Rituximab (Rituxan) is approved for use against certain kinds of non-Hodgkin’s lymphoma but it has been helpful in chronic lymphocytic leukemia also.

What are the Side Effects of Monoclonal Antibody Treatment?

You may experience fever and chills during treatment and the use of Campath can raise your risk of infection because it acts against both healthy and damaged lymphocytes.

Looking After Yourself During Treatment

During chemotherapy or radiation treatments you can take added safety precautions to avoid infection by:

• Following careful hand washing procedures.

• Not eating fresh, uncooked fruits and vegetables or any food that might carry bacteria.

• Staying away from fresh flowers and plants due to the mold spores that they carry.

• Asking others to wash their hands when they are near you or handling your food.

• Staying away from crowds and ill people or wearing a surgical mask to avoid infection.

To conclude, leukemia can be a highly treatable disease especially in the case of chronic leukemia. In acute leukemia, as many as fifty to sixty percent of patients undergo a remission with chemotherapy treatment.

Talk to your treatment professionals about your disease and find out as much information as you can about what is going on inside your body, what your treatment goals are and how to cope with any possible side effects you may experience.

Keeping a positive and optimistic outlook during your treatment program will help you to stay in a good frame of mind and boost your chances of successful therapy. Make sure to talk over any issues that are causing you stress with a supportive person or group.

Constant study is being carried out on improving treatment options for patients with leukemia and there is every hope that in time all forms of this disease may be completely treatable.