Leukemia (Blood Cancer): What is it, what are its symptoms, diagnosis and treatment methods?

Leukemia, colloquially referred to as blood cancer, is one of the most common types of cancer. It originates from the bone marrow and lymphatic system. Although some types are mostly seen in children, there are also different types seen in adults. Early diagnosis is important in leukemia, as in all other types of cancer. Although leukemia involves a complex treatment process, it is getting better day by day thanks to the methods and strategies developed.

What is Leukemia?

Leukemia is a type of cancer. Cancer literally means the uncontrolled growth and proliferation of cells. The cause of leukemia is usually related to white blood cells or bone marrow. White blood cells, which are important for the immune system in our body, follow a certain cycle like other cells in a healthy person. They grow and divide regularly. They fight invasive microorganisms such as bacteria, viruses and fungi in our body. However, in the case of leukemia, the healthy cycle for these cells is disrupted and the cells that multiply uncontrollably begin to harm the body. This is because the bone marrow, which produces white blood cells, is not working properly.

What are the symptoms of leukemia?

Symptoms of leukemia may vary depending on the type of leukemia. However, common symptoms are:

• Unexplained weight loss,
• Fatigue, weakness that does not go away with rest,
• Frequently recurring infection,
• fever and chills,
• Skin sensitivity such as easy bruising, swelling, bleeding,
• Persistent bone pain and bone tenderness,
• night sweats,
• Lymph nodes that do not cause pain (especially in the neck and armpit)

It should not be forgotten that the symptoms of leukemia may vary according to different age groups. In addition, leukemia that has spread to different parts of the body may cause symptoms depending on the region it spreads to. For example, in leukemia that has spread to the nervous system, symptoms such as headache, muscle pain, and confusion may also be observed in addition to these symptoms.

What are the Causes and Risk Factors of Leukemia?

As with many types of cancer, leukemia cannot be explained by a single cause. A more accurate approach is to consider genetic and environmental factors together. The underlying mechanism of the main cause of cancer can be explained by DNA damage. The DNA in our cells cannot manage the cell properly as a result of the damage it receives or the mutations it undergoes. Cells that do not receive the correct command to divide begin to divide uncontrollably.

Although the causes of leukemia are not fully known, risk factors may include:

• cancer history,
• exposure to radiation,
• Some congenital genetic diseases,
• Long-term exposure to chemicals known to cause cancer
• Family history of cancer,
• Having a history of chemotherapy.
• Having had radiotherapy
• To smoke
• Having Myelodysplastic Syndromes and some genetically transmitted diseases.

What are the Types of Leukemia?

Differences in leukemia types are related to the rate of progression of cancer and the cell group it affects.

Leukemia is basically divided into two: acute and chronic leukemia. Acute leukemia is a type of leukemia in which cells multiply rapidly and symptoms appear in a shorter time. Chronic leukemia has a more severe course. Symptoms may not appear for years.

Another reason for the difference in leukemia types is the difference in the cell group it affects. While lymphocytic leukemia affects lymphocytes (lymphoid cells), myeloid leukemia affects blood cells. Blood cells consist of red blood cells, white blood cells and platelets.

Acute Lymphocytic Leukemia (ALL): It is a type of leukemia that usually occurs in children, affects immunity and shows rapid symptoms.

Acute Myeloid Leukemia (AML): It is the most common type of acute leukemia. It affects both children and adults.

Chronic Lymphocytic Leukemia (CLL): Usually occurs in adults. Sometimes it may not show symptoms for years. It is the most common type of chronic leukemia among adults.

Chronic Myeloid Leukemia (AML): It is mostly seen in adults.

How is Leukemia Diagnosed?

Acute Leukemia and chronic leukemia are also differentiated from each other in diagnosis. Since leukemia with a chronic course does not cause symptoms in the short term, it may be revealed in a blood test performed for a different reason.

Physicians may need some tests to fully diagnose leukemia.

• Physical examination and history: Physicians may first ask the patient some questions to find out whether the patient has symptoms of leukemia. Afterwards, they can apply for a general physical examination.
• Blood Test: Blood levels of cells affected by leukemia, such as red and white blood cells and platelets, can provide information about leukemia. Complete blood count is checked. However, blood tests alone may not always be sufficient to diagnose leukemia. More detailed tests are needed.
• Peripheral Smear: The blood cells of a patient with suspected leukemia are examined under a microscope, the structure of the cells is examined, the sample taken with different dyes is stained and examined for the diagnosis of the disease and its subtype.
• Biopsy Tests: Performed to take tissue samples and examine them. To diagnose leukemia, tissue samples are usually taken from lymph nodes or bone marrow. The sample taken is sent to the laboratory. Necessary examinations are performed in the laboratory and the results are often decisive for the treatment of leukemia.

How is Leukemia Treated?

Leukemia treatment varies depending on the individual’s age, gender, physiological state, type of leukemia and how advanced the disease is. After performing the necessary examinations and tests, physicians plan the treatment by looking at the general health condition of the individual. The methods generally used in the treatment of leukemia are:

• Chemotherapy: It is a treatment method that uses chemicals to kill cells that damage the body. It can also be administered to the patient via intravenous injection. A single drug can be used, or sometimes more than one drug can be used in combination.
• Radiotherapy: Radiotherapy is a form of treatment that uses high-energy rays to damage cells that grow abnormally and cause cancer. It can be applied only to certain areas of the body or sometimes to the whole body. This treatment may also be used to prepare the patient for bone marrow transplantation.
• Bone Marrow Transplantation: Also known as stem cell transplantation. The cancerous bone marrow that causes leukemia is cleared with high-dose chemotherapy and radiotherapy. Then, the stem cell taken from a healthy bone marrow is placed here and a healthy, cancer-free bone marrow is formed. Stem cells can be taken from the person himself or from a donor.
• Immunotherapy: Although cancer involves a system that harms the body, our immune cells may not attack cancerous cells. This is because cancer cells have a shield against immune cells. Immunotherapy tries to eliminate this shield and enable our immune system to come into play. Thus, immune cells recognize cancer cells and can attack them.

Physicians may also use some techniques to evaluate the course of leukemia treatment. Tests performed to understand the condition of organs, such as liver function tests, may be performed to find out whether leukemia has spread to the organs. Blood tests may be ordered at regular intervals to monitor how interventions are changing the level of blood cells in the blood. Imaging techniques such as ultrasound or tomography can be used to learn about the damage caused by leukemia to the body.

Leukemia treatment, like many other types of cancer, may require a long treatment process. The important thing is early diagnosis and treatment. The earlier leukemia, that is, blood cancer, is diagnosed, the chance of recovery will increase proportionally. The chances of success in cancer treatments are increasing day by day and promising developments continue to occur. Cancer cases are increasing both in our country and around the world. It is extremely important not to neglect health checks and to be examined if there are suspicious symptoms. Remember, early diagnosis saves lives.