Leukemia

Blood, Cancer and Neoplasms

Leukemia is a type of blood cancer that forms in the white blood cells that are made in the bone marrow. When you have leukemia, some of the blood cells that form are cancerous and take over the space that healthy blood cells occupy. Most cases of leukemia are found in adults over the age of 55, but it is also common in kids less than 15 years old. The statistics for blood cancers (including leukemia) are startling. Every 3 minutes one person in the United States will be diagnosed with a blood cancer. Over 310,000 people in the United States have leukemia and it is the number one cause of death due to cancer in children. Hispanic children and teenagers are the most common group to suffer from leukemia. Despite these sobering statistics, many leukemia cases are treatable with aggressive cancer treatments and some cases are cured completely.

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Symptoms

The symptoms of leukemia result from low blood cell counts. They include:

  • Easy bruising
  • Fatigue
  • Weakness
  • Dizziness
  • Shortness of breath
  • Unexplained fevers
  • Infections
  • Frequent nosebleeds
  • Bleeding gums
  • Weight loss
  • Night sweats
  • Loss of appetite
  • Abdominal swelling (from leukemia cells in the spleen and liver)
  • Enlarged lymph nodes
  • Bone pain
  • Joint pain
  • Headaches
  • Seizures
  • Vomiting
  • Feeling off balance

Because of the wide range of symptoms, leukemia can often go undiagnosed, misdiagnosed or the symptoms could have causes other than leukemia.

Types

Leukemia has different types:

 Acute lymphocytic leukemia. Creates “immature” lymphocytes (white blood cells) that are cancerous and most common in children. These cancerous cells replace normal cells and reproduce exponentially. Progresses rapidly.

Acute myeloid leukemia. Affects myeloid blood cells and is rapidly progressive. Common in both children and adults. Myeloid cells produce special white blood cells (neutrophils, basophils, eosinophils, and monocytes).

Chronic lymphocytic leukemia. Affects white blood cells known as “lymphocytes.” Slow growing and common in adults.

Chronic myeloid leukemia. Slow growing with little to no symptoms and affects mostly adults.

Risk Factors

Certain risk factors increase the chances of getting leukemia. These are:

Family history. If you have a family history of leukemia, you are at higher risk for getting it.

Smoking. Smokers have a higher risk for leukemia.

History of treated cancer. Chemotherapy and radiation treatments for cancer increase the risk of leukemia.

Genetic conditions. Certain genetic conditions increase the risk of leukemia.

Diagnosis

If you or someone close to you has any of the above symptoms, see a doctor as soon as possible. The doctor will take a medical history that includes a thorough discussion of symptoms and how long you have had them. You may be asked if you have any of the above risk factors. Before going to the doctor, gather as much family history as possible.

You will most likely have a very thorough exam to check lymph nodes and check for signs of bruising and bleeding. The doctor will also check your liver and spleen. Then, the following blood tests will be ordered:

Complete blood count. This checks for counts of all the red and white blood cells. They will also look at the blood under a microscope to look for abnormal cells. Too many immature white blood cells are often a clue to diagnosing leukemia.

Blood chemistry. The doctor will check your liver and kidneys that are affected by leukemia.

Coagulation studies. Problems with blood clotting can indicate leukemia.

DNA testing. They can check for DNA abnormalities in the cells and look for the changes that cause leukemia.

If any of the blood studies suggest leukemia, the doctor will move forward with more testing to confirm the diagnosis. These tests include:

Bone marrow biopsy. The doctor will insert a needle into the bone and take a sample of the marrow. They use a local anesthetic and pass a very thin needle into a hip or pelvic bone. There is a brief pain during aspiration. The doctor will then take a small “punch” out of the bone to send off to the lab with the marrow. A pathologist and hematologist will look at the sample to check the shape and size of the cells. They can diagnose and tell what type of leukemia at that time.

Imaging tests. These include computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans. A CT scan, MRI, PET, and bone scans may only be performed if the doctor thinks cancer has spread to the organs. Since leukemia is a type of blood cancer, imaging studies are of little use in the initial diagnosis.

Treatments

Before treatment, the doctor will determine the type of leukemia you have and how advanced your case is. Depending on these things, treatment will include:

Chemotherapy. The first line of treatment for leukemia is chemotherapy. Chemotherapy is either medicine given intravenously in an infusion center or as an oral (by mouth) medication. Sometimes only one drug is given and sometimes multiple drugs are used.

Radiation. This is high-dose x-rays that stop the growth of leukemia cells. This is also done before stem cell transplants and in conjunction with chemotherapy.

Biological therapy or immunotherapy. Biological medications boost your immune system to fight off the cancer cells in the blood.

Targeted therapy. These drugs go straight to the cancer cells and attack them so they cannot divide and grow.

Stem cell transplant. This procedure transplants healthy bone marrow into the disease bone marrow. This is done after chemotherapy and radiation to get rid of as much unhealthy bone marrow as possible. Then stem cells are introduced from a relative or matched donor. These grow into healthy cells and replace the cancer cells.

Alternative Treatments and Home Remedies

Alternative medicine is not a known cure for any type of cancer including, leukemia. However, alternative medicine can complement cancer treatment with your doctor’s okay. Some helpful things you can try are:

Reduce allergens. This helps keep the immune system in balance.

Exercise as tolerated. Try not to fatigue yourself with exercise but do enough to keep yourself healthy.

Include antioxidants in your diet. Eat cherries, blueberries, kale, spinach, and bright-colored peppers to detox your system.

Eat organic. Avoid refined and processed foods and chemical pesticides.

Reduce intake of alcohol and caffeine.

Take omega-3 fatty acids 1 to 2 fish oil capsules can lower inflammation that may promote the growth of cancer cells.

Use probiotics. If you are under chemo or radiation, probiotics can help put back healthy bacteria in your system. This can help boost immunity.

Drink green tea. The EGCG (epigallocatechin gallate) in green tea has been shown to kill off leukemia cells in studies. ECGC is a plant chemical that may reduce inflammation and is an antioxidant.

Alternative Treatments and Home Remedies

Alternative medicine is not a known cure for any type of cancer including, leukemia. However, alternative medicine can complement cancer treatment with your doctor’s okay. Some helpful things you can try are:

Reduce allergens. This helps keep the immune system in balance.

Exercise as tolerated. Try not to fatigue yourself with exercise but do enough to keep yourself healthy.

Include antioxidants in your diet. Eat cherries, blueberries, kale, spinach, and bright-colored peppers to detox your system.

Eat organic. Avoid refined and processed foods and chemical pesticides.

Reduce intake of alcohol and caffeine.

Take omega-3 fatty acids. 1 to 2 fish oil capsules can lower inflammation that may promote the growth of cancer cells.

Use probiotics. If you are under chemo or radiation, probiotics can help put back healthy bacteria in your system. This can help boost immunity.

Drink green tea. The EGCG (epigallocatechin gallate) in green tea has been shown to kill off leukemia cells in studies. ECGC is a plant chemical that may reduce inflammation and is an antioxidant.

Lifestyle Changes

Avoid infection. Leukemia can increase the risk of infections. Chemotherapy can also increase this risk. Stay away from people who are sick, eat healthily, and get plenty of rest. Practice good handwashing and get your flu shot.

Avoid triggers. If your cancer goes into remission, avoid anything that puts you at risk for relapse or other cancer. Do not smoke, eat healthily, and use sunscreen.

Keep in touch with your doctor. Make all your lab appointments, don’t miss any treatments, and go to all follow-up appointments. Early detection is key in keeping leukemia in check.

References

American Cancer Society Medical and Editorial Content Team. (2021). Acute myeloid leukemia early detection, diagnosis, and types. Retrieved from American Cancer Society: https://www.cancer.org/content/dam/CRC/PDF/Public/8676.00.pdf

Emadi, A. & Law, J. L. (2020, May). Overview of leukemia. Retrieved from Merck Manual: https://www.merckmanuals.com/home/blood-disorders/leukemias/overview-of-leukemia

Hill, A. H. (2019, April 26). EGCG (epigallocatechin gallate): Benefits, dosage, and safety. Retrieved from Healthline: https://www.healthline.com/nutrition/egcg-epigallocatechin-gallate

Leukemia & Lymphoma Society. (2020).  Blood and marrow stem cell transplantation guide.  Retrieved from Leukemia and Lymphoma Society: https://www.lls.org/sites/default/files/National/USA/Pdf/Publications/PS95_Blood_and_Marrow_Guide_2019.pdf

Leukemia & Lymphoma Society. (2020).  Facts and statistics. Retrieved from Leukemia and Lymphoma Society: https://www.lls.org/facts-and-statistics/facts-and-statistics-overview/facts-and-statistics

Mayo Clinic Staff. (2021, January 13). Leukemia. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/leukemia/diagnosis-treatment/drc-20374378

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