Introduction

Leukemia is a type of cancer that starts in the blood cells, usually the bone marrow (the spongy tissue found inside the bones). Leukemia is the overproduction of abnormal white blood cells i.e. the part of the blood cells of the immune system which helps to defend the body against infection.

Symptoms of Leukemia

Typical signs and symptoms of leukemia may include the following:

• Weakness or Fatigue: This is an overall feeling of being tired and lack of energy. During this time, the body seems to lack any form of motivation or energy to do anything.
• Poor Blood Clotting: This causes easy bruising or bleeding which heals slowly; and can over time develop into petechiae, which are small red and purple spots on the body. Petechiae develops when white blood cells in the body are immature, crowding out the platelets that are essential for blood clotting.
• Fever or Chills: At this stage, the body temperatures begin to rise above the normal body temperature (98 – 100^OF / 36 – 37^OC).
• Weight Loss: This is the unintentional or unexplainable loss of the human body mass. Weight loss may also occur even without an enlarged liver or spleen.
• Frequent Infections: The white blood cells are an important part of the blood system that helps in fighting any form of infection. But the moment there is an abnormal functioning of the white blood cells, the body may develop frequent infections due to consistent attacks by the body’s cells.
• Anemia: Once the red blood cells in the body become fewer, an individual may become anemic i.e. not having enough hemoglobin in the blood cells. Hemoglobin helps to transport iron around the body, and once there is a shortage of iron in the body, it could lead to difficulties in breathing or pale skin.
• Night Sweats: Although without diagnosis, the presence of leukemia can’t be ascertained by excessive sweating, yet excessive sweating especially at night could be a symptom of leukemia presence in the body.
• Swollen Lymph Nodes: The body experiences painless and swollen lymph nodes, especially around the neck and the armpits during leukemia.
• Enlarged Liver or Spleen: Once the liver or spleen becomes swollen, a person may feel full and eat less, resulting in weight loss.
• Joint or Bone Pains and Tenderness
• Recurrent Nosebleeds
• Flu-like Symptoms

Once leukemia cells infiltrate the central nervous system such as the brain, symptoms such as headaches, seizures, loss of muscle control and vomiting may also occur. However, all these can be symptoms of other illnesses. Consultation and testing are necessary to confirm a diagnosis of leukemia.

What Causes Leukemia?

Unlike other types of cancer, a clear cause of leukemia is relatively unknown making it to be unpreventable, but some factors can trigger it. People who have it have certain unusual chromosomes, yet ironically the chromosomes do not cause leukemia. However, some risk factors have been identified that could increase an individual’s risk of having it, and they include:

Age: Although leukemia can be downstreamed to different ages, it is more common among children and young adults with an average age of 15 years.

Certain Blood Disorders: Some blood disorders such as polycythemia vera, idiopathic myelofibrosis, and essential thrombocytopenia can increase the risk of developing leukemia especially acute myelogenous leukemia (AML).

Family History of Leukemia: According to past research on leukemia, it has been shown that leukemia does not necessarily have any family trait. But that does not debunk that when certain close family members such as one’s nuclear family, aunt, and/or uncle are diagnosed with leukemia, an individual may have an increased risk of having leukemia.

Gender: Men are more likely than women to develop leukemia. Although this fact remains rather unexplainable, it could be a result of a sex-determined link to the ABO blood groups.

Genetic Disorders: Genetic disorders or congenital syndromes including Down syndrome, Fanconi anemia, Bloom syndrome, ataxia-telangiectasia, and Blackfan-Diamond syndrome seem to create a dysfunctional part in the body system that could lead to leukemia.

Smoking: Although the effect of smoking is not a direct cause of leukemia, it can increase the risk of developing acute myelogenous leukemia (AML)

Radiation: People who are exposed to or live around low-energy radiation from electromagnetic fields such as power lines are at an increased risk of developing leukemia especially Acute lymphocytic leukemia (ALL) than others who don’t. Also, exposure to high-energy radiation such as atomic bomb can cause a reaction in the body system.

Exposure to Certain Chemicals: Long-term exposure to certain pesticides or industrial chemicals like benzene is considered a risk for leukemia.

Previous Cancer Treatment: People who have undergone some type of cancer treatment plan such as radiation therapy and chemotherapy need to get themselves screened for leukemia possibility.

Diagnosis of Leukemia

Getting tested or checked through routine blood tests could help detect any form of leukemia in the body system, most especially chronic leukemia. Once an individual body starts showing signs or symptoms that suggest leukemia, it is important to undergo one of the following diagnostic tests.

• Physical Examination: Here, the doctor asks about the various symptoms the patient might be experiencing, and also checks for any physical signs that include; lymph nodes swelling; enlargement of the liver and spleen; and also, pale skin.
• Complete Blood Count: This has the details of the red blood cells, white blood cells, and platelets. Once the count is lower than the normal counts of red blood cells and platelets, and there is an abnormal number of white blood cells; then leukemia is present in the body system.
• Blood Cell Examination: This test would help to detect any shape of blood cells detected in the body, and also various forms of substances that had been released into the body system.
• Bone Marrow Biopsy: For this type of test to be carried out, the hematologist will take a certain sample of the bone marrow for examination under a microscope.
• Cytogenetic Testing:Cytogenetic testing involves identifying the genetic makeup of the cancerous cells.
• Imaging and Other Tests:Imaging tests such as chest X-ray, CT scan, or magnetic resonance imaging (MRI) scans might be recommended if there are symptoms that indicate a complication of leukemia. A lumbar puncture (also called a spinal tap) may be used to see if the cancer has spread to the spinal fluid surrounding the brain and spinal cord.

Treatment of Leukemia

Treatments for leukemia include chemotherapy, biological (immunotherapy) therapy, radiation therapy, targeted therapy, and stem cell transplant. Although chronic leukemia is unlikely to be cured with treatment, treatments are often able to control the cancer and manage symptoms. Some people with chronic leukemia may be candidates for stem cell transplantation, which does offer a chance for cure.

Also treating leukemia can be carried out in three stages:

• Induction: The initial stage of treatment aims to kill the leukemia cells in the bone marrow, restore blood for proper working order, and resolve any symptoms
• Consolidation: The aim is to kill any remaining leukemia cells that may be present in the central nervous system.
• Maintenance: The final stage involves taking regular doses of chemotherapy tablets to prevent the leukemia from returning.

Treatment Options for Leukemia

• Chemotherapy: Chemotherapy is the most used form of treatment for leukemia. It is the administration of drugs to help kill leukemia or stop the cells from dividing. Depending on the type of leukemia an individual might have, a single drug or a combination of drugs may be used. These drugs are usually injected into the body system through the vein but also might be available in pill form. The side effects of chemotherapy depend on the particular drugs taken and the dosage or regimen. Some side effects from chemotherapy drugs include hair loss, nausea, vomiting, mouth sores, loss of appetite, tiredness, easy bruising or bleeding, and an increased chance of infection due to the destruction of white blood cells.
• Biological Therapy (Immunotherapy): Biological therapy is the use of certain treatments (certain drugs) that help boost the immune system to recognize and attack leukemia cells. Its side effects include rashes or swelling in injected areas, headaches, muscular pains, fever, or tiredness.
• Radiation Therapy: This is using X-rays and/or strong beams of energy to kill leukemia cells or stop them from growing. It can also be used to treat leukemia that has spread to the brain or a targeted area where leukemia cells are found. Its side effects are dependent on the location of the body where the radiation has taken place. For example, radiation to the abdomen can cause nausea, vomiting, and diarrhea.
• Targeted Therapy: This is the use of specific drugs to attack some specific weakness within the cancer cells. It helps to block the ability of leukemia cells to multiply and divide, cutting off the blood supply needed for the cells to live, or killing the cells directly. Its side effects can include swelling, bloating, and sudden weight gain. Other side effects can include nausea, vomiting, diarrhea, muscle cramps, or rash.
• Stem Cell Transplant: This is replacing the affected bone marrow of an individual with a healthy bone marrow. It is usually carried out after the person has gone through chemotherapy or radiation therapy to kill the leukemia cells in the bone marrow.

Other Treatment Plans

• Chimeric Antigen Receptor (CAR) T-Cell Treatment: Chimeric antigen receptor (CAR) T-cell treatment is a new form of treatment in which a patient's normal T lymphocytes are re-engineered in a laboratory to attack the leukemia cells and are then reintroduced into the patient's bloodstream.
• Supportive Treatments: This treatment method is used to help prevent any form of complications that might arise after other treatment plans. This is because many of the treatments for leukemia deplete normal blood cells, increasing the risk of bleeding and infection. These supportive treatments include vaccination against flu or pneumonia; blood or platelet transfusions; antibiotics or antibiotics; and immunoglobulin injections to fight infections.

Prevention of Leukemia

People who mostly develop leukemia do not have any known risk factors, therefore making it generally impossible to prevent leukemia. Though certain risk factors, such as exposure to radiation or benzene, may be minimized, this does not guarantee prevention of leukemia.

Prognosis

The prognosis of leukemia depends upon the type of leukemia present in the blood system, also the age and health status of the person involved. The death rates for leukemia over the years have shown to be higher in elderly persons than in younger adults and children, yet there have been certain improvements in results from recent and new treatment plans used.

Presently, leukemia is manageable or cured with various treatment plans available.