The term “leukemia” describes a group of cancers of the blood-forming tissues, such as the bone marrow and lymphatic system. The bone marrow is home to the progenitor cells able to divide and differentiate into all of the cells which make up the blood. The lymphatic system is responsible for the resorption of fluids into the circulation and immune defense against foreign invaders, such as bacteria, which might otherwise cause infection. Leukemias predominantly involve the blood and bone marrow as opposed to the lymphatic system, as is the case for lymphomas.

As leukemia progresses from a single cell to a population of cells, it can crowd out, and thereby disrupt, the development of healthy blood cells that normally occurs in the bone marrow. There are four main types of leukemia, and they are classified by whether they are acute (fast-growing) or chronic (slow-growing), and myeloid or lymphocytic—terms which indicate cell lineage:

AcuteChronic

LymphocyticAcute Lymphocytic LeukemiaChronic Lymphocytic Leukemia

MyeloidAcute Myeloid LeukemiaChronic Myeloid Leukemia

Acute Lymphocytic Leukemia (abbreviated as “ALL” and also known as either “Acute Lymphoblastic Leukemia” or “Acute Lymphoid Leukemia”)

Acute Myeloid Leukemia (abbreviated as “AML” and also known as “Acute Myelogenous Leukemia”)

Chronic Lymphocytic Leukemia (abbreviated as “CLL” and also known as either “Chronic Lymphoblastic Leukemia” or “Chronic Lymphoid Leukemia”)

Chronic Myeloid Leukemia (abbreviated as “CML” and also known as “Chronic Myelogenous Leukemia”)

Still, there are subtypes of the above leukemias and other forms of leukemia, such as “hairy cell leukemia,” which may not fit nicely into the above classifications. For this reason, it is best to speak with your doctor to address the specific questions you may have and to determine together how to best address your care needs.

Leukemias develop as a result of changes to the genetic material within cells of the blood-forming tissues. These changes result in the pattern of cell growth and division characteristic of leukemia. Although the increased likelihood of developing leukemia is associated with the following factors, in most cases, physicians and scientists are still trying to determine what causes leukemia to develop:

• Aging
• Being a male
• Smoking
• Family history of leukemia
• Genetic disorders
• Exposure to carcinogens
• Exposure to high levels of radiation
• Previous cancer treatment

Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing, and review radiological studies to approach patient care in the most comprehensive and personalized manner.

Your doctor may find evidence of leukemia in the results of a routine blood test or physical examination before you begin to experience any symptoms. Your physician might notice you have pale skin as a result of anemia (a condition characterized by a low number of red blood cells), swollen lymph nodes, and/or an enlarged liver or spleen. Your physician might also notice abnormal levels of specific blood cell types indicative of leukemia.

If leukemia is suspected, your doctor may choose to perform a bone marrow biopsy to best determine a diagnosis. This involves the removal of a small sample of bone marrow for laboratory analysis. Alternatively, a physician may suspect a patient’s lymph nodes to be swollen due to a simple infection. In this case, he or she may prescribe antibiotics to rule out this possibility if swelling of the lymph node (or nodes) resolves.

Since many leukemias, especially chronic (slow-growing) ones, do not show obvious symptoms in the early stages of their development, leukemia may be detected incidentally as a result of routine blood testing or physical examination. The following may be indicative of leukemia but may also be indicative of other illnesses:

• Enlarged lymph nodes
• Enlarged liver or spleen
• Pale appearance
• Persistent fatigue and/or weakness
• Fever and/or chills
• Easy bleeding and/or bruising
• Persistent and/or severe infections
• Abnormal weight loss
• Small pinpoint rash (tiny red spots) of skin

It is important you tell your doctor if you have any of these signs and symptoms, so he or she may determine their cause and plan treatment, if necessary.

“Staging” occurs when a physician uses to test and scan results to determine which parts of the body are involved by cancer. Staging is important because different stages of leukemia are better addressed with treatments that may differ in amount, combination, or type. Although most cancers are staged based on the size and spread of tumors because leukemia arises from developing blood cells within the bone marrow, staging for leukemia considers blood cell counts and leukemia involvement in organs such as the liver and spleen. Leukemia stages vary based on leukemia type. Factors affecting leukemia staging and prognosis (the likely course of the disease) are listed below:

• Age
• Bone abnormalities or damage
• Chromosomal abnormalities
• Enlarged liver (hepatomegaly) or spleen (splenomegaly)
• Personal history of previous blood disorders
• White blood cell or platelet count

Treatment of leukemia, depending on the stage and type, may include chemotherapy, immunotherapy, stem cell transplant, and/or radiation therapy. These treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on the leukemia treatment plan include

• Your age, health, and lifestyle.
• The stage of your cancer.
• Any other serious health conditions you have.
• Your feelings about the need to treat cancer right away.
• Your doctor’s opinion about if you need to treat cancer right away.
• The likelihood that treatment will help fight or cure your cancer.
• Possible side effects of each treatment method.

You may feel the need to make a quick decision, but it is very important to ask questions if there is anything about which you’re not entirely sure. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible adverse effects in order to ultimately determine which treatment option is best for you.