About Leukemia
What is leukemia?
Leukemia is a type of cancer that originates in the blood-forming tissues of the body, including the bone marrow and the lymphatic system. It is characterized by the rapid production of abnormal white blood cells, which are not fully developed and hence, are unable to perform their usual functions.
There are several types of leukemia, each classified by the speed of progression and the type of cells involved. The main types are Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Chronic Lymphocytic Leukemia (CLL), and Chronic Myeloid Leukemia (CML). Acute leukemia is a rapidly progressing disease that results in the accumulation of immature blood cells, while chronic leukemia progresses more slowly and allows for the growth of greater numbers of more developed cells.
Leukemia can affect individuals of any age, but certain types are more common in children, while others occur mostly in adults. The exact cause of leukemia is unknown, but it’s believed to involve a combination of genetic and environmental factors.
Symptoms of leukemia can vary widely, depending on the type. Common symptoms may include fatigue, frequent infections, fever, easy bruising or bleeding, weight loss, swollen lymph nodes, and bone pain or tenderness. However, many types of leukemia often don’t cause any symptoms in the early stages.
Diagnosis of leukemia typically involves blood tests to look for abnormal levels of white blood cells or platelets, and bone marrow tests to look for cancerous cells. Once diagnosed, treatment options for leukemia include chemotherapy, radiation therapy, targeted therapy, biological therapy, and stem cell transplant. The choice of treatment depends on the type and stage of leukemia, as well as the patient’s overall health and preferences.
While leukemia is a serious disease, advances in treatment have significantly improved the prognosis for many types of leukemia. Early detection and prompt treatment can increase the chances of a successful outcome.
How does leukemia develop?
Leukemia is a type of cancer that begins in the blood-forming cells of the bone marrow, the soft inner part of certain bones. It involves the production of abnormal white blood cells, the cells responsible for fighting infection in our bodies.
The development of leukemia is a multi-step process that begins with a mutation, or change, in the DNA of a single cell in the bone marrow. This mutation causes the cell to produce white blood cells that are not fully mature and cannot function properly. These immature cells, known as blasts, continue to reproduce and accumulate, eventually crowding out healthy cells in the bone marrow and spilling over into the bloodstream.
There are several types of leukemia, each classified by the type of blood cell that becomes cancerous and the rate at which the disease progresses. Acute leukemia is characterized by a rapid increase in the number of immature blood cells, while chronic leukemia progresses more slowly and allows for the growth of greater numbers of more developed cells.
The exact cause of the initial mutation that leads to leukemia is not known, but it’s believed to involve a combination of genetic and environmental factors. Certain genetic disorders, such as Down syndrome, are associated with an increased risk of leukemia. Exposure to high levels of radiation, certain chemicals, and some chemotherapy drugs can also increase the risk.
It’s important to note that while anyone can develop leukemia, certain factors can increase the risk. These include having a family history of leukemia, having certain genetic disorders, having had previous chemotherapy or radiation therapy, and being a smoker.
Once leukemia develops, it can cause a variety of symptoms, including fatigue, frequent infections, fever, easy bruising or bleeding, weight loss, and bone pain. However, many people with leukemia have no symptoms, particularly in the early stages of the disease.
Leukemia Symptoms
Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include:
Fever or chills
Persistent fatigue, weakness
Frequent or severe infections
Losing weight without trying
Swollen lymph nodes, enlarged liver or spleen
Easy bleeding or bruising
Recurrent nosebleeds
Tiny red spots on your skin (petechiae)
Excessive sweating, especially at night
Bone pain or tenderness
What is the survival rate of leukemia?
Five-year survival rates can give you an idea of how long people with a specific type of leukemia survive after diagnosis. With leukemia, survival rates depend on:
Although this is an estimate, no two people have the same response to treatment. Also, your medical team will recommend lifestyle changes and other ways to increase your chances of successful treatment.
Leukemia Risk Factors
Leukemia is a complex cancer of the blood and bone marrow, and its exact cause is often unknown. However, several risk factors have been identified that can increase the likelihood of developing this disease.
One of the primary risk factors is exposure to high levels of radiation. This includes individuals who have been exposed to radiation from atomic bomb explosions, nuclear reactor accidents, or radiation therapy for other cancers.
Exposure to certain chemicals is another significant risk factor. Long-term exposure to benzene, a chemical found in gasoline and used in the chemical industry, has been linked to an increased risk of leukemia, particularly acute myeloid leukemia (AML). Additionally, smoking is a well-known risk factor, as cigarettes contain numerous cancer-causing substances. Studies estimate that about 20% of AML cases are related to smoking.
A history of previous cancer treatment can also elevate the risk. Patients who have undergone chemotherapy or radiation therapy for other cancers may develop secondary leukemia due to the DNA damage caused by these treatments. For instance, treatments for Hodgkin’s disease, non-Hodgkin lymphoma, and childhood acute lymphocytic leukemia (ALL) have been associated with an increased risk of developing AML later in life.
Genetic predispositions play a crucial role as well. Certain genetic disorders, such as Down syndrome, Fanconi anemia, ataxia-telangiectasia, and Bloom syndrome, are associated with a higher risk of leukemia. These conditions often involve chromosomal abnormalities that can predispose individuals to cancer. Moreover, a family history of leukemia can increase risk, particularly for chronic lymphocytic leukemia (CLL). Individuals with a first-degree relative (parent, sibling, or child) with CLL have a two- to four-fold increased risk of developing the disease.
Other risk factors include myelodysplastic syndromes (MDS), which are disorders caused by poorly formed or dysfunctional blood cells. About one-third of patients with MDS may eventually develop leukemia.
Additionally, age is a significant factor, as the risk of most types of leukemia increases with age, particularly for chronic forms like CLL and CML.
Despite these known risk factors, it is important to note that many people with one or more of these risk factors never develop leukemia, and many who do develop leukemia have no known risk factors.
Leukemia Treatment long-term side effects
- Fertility problems
- Fatigue
- Cough
- Cataracts
- Heart and lung problems
- Thyroid problems
- Diabetes
- Bone density issues like osteoporosis
- Increased infection risks
- Confusion or memory problems
Leukemia Treatment Recovery
Chemotherapy treatment will damage your healthy cells as well as the leukemia cells. Patients should stay in the hospital until they recover from induction treatment, which usually takes about 4 to 6 weeks.
Leukemia in Iran
Equipped hospitals and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who suffer from leukemia aka blood cancer.
Cost of Leukemia Diagnosis in Iran
The cost of leukemia diagnosis in Iran can vary significantly depending on several factors, including the type of leukemia, the diagnostic tests required, and the healthcare facility where the diagnosis is conducted. Generally, the cost encompasses various components such as laboratory tests, imaging studies, consultations, and hospital fees.
Laboratory tests are a crucial part of leukemia diagnosis. These tests include complete blood counts (CBC), blood chemistry tests, and bone marrow biopsies. Imaging studies such as X-rays, CT scans, and MRIs are often required to assess the extent of the disease and to check for any involvement of other organs. Consultations with specialists such as hematologists and oncologists are also a part of the diagnostic process. Hospital fees for inpatient or outpatient services can vary widely. In some cases, patients may need to be hospitalized for a few days for comprehensive diagnostic workups, which can add significantly to the cost. Overall, the total cost of leukemia diagnosis in Iran can range differently, depending on the specific tests and services required.
Leukemia Diagnosis Process
How does leukemia affect my body?
Leukemia is a type of cancer that originates in the blood-forming tissues, primarily the bone marrow. It leads to the overproduction of abnormal white blood cells, which are not fully developed and hence, are unable to perform their usual functions. This overproduction and malfunction of white blood cells can have several effects on the body.
Immune System: White blood cells are a crucial part of the immune system, responsible for fighting off infections. In leukemia, the abnormal white blood cells are not able to effectively fight off infections, making individuals with leukemia more susceptible to frequent infections.
Blood Clotting: Platelets, which help in blood clotting, can be crowded out by the overproduction of white blood cells in the bone marrow. This can lead to easy bruising and bleeding, as the body cannot form clots effectively.
Anemia: Red blood cells, which carry oxygen to all parts of the body, can also be crowded out by the overproduction of white blood cells. This can lead to anemia, a condition characterized by a lack of enough healthy red blood cells. Symptoms of anemia can include fatigue, weakness, and pale skin.
Organ Function: The overproduction of white blood cells can lead to an enlarged spleen or liver, as these organs work to filter out the excess cells. This can result in abdominal discomfort or pain.
General Health: The body’s energy is diverted to the production of these abnormal cells, which can lead to weight loss and general fatigue. Additionally, the body may produce substances called cytokines in response to the disease, which can cause a person to lose their appetite and feel tired.
Bone Health: As leukemia progresses, it can cause bone or joint pain. This is due to the buildup of abnormal cells in these areas.
What are the different types of leukemia?
Leukemia is a complex disease with several types, each with its own unique characteristics and treatment approaches. The four most common types of leukemia are Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Chronic Lymphocytic Leukemia (CLL), and Chronic Myeloid Leukemia (CML).
Acute Lymphoblastic Leukemia (ALL): Is a fast-growing type of leukemia that affects lymphoid cells. It is the most common type of cancer in children, but it can also occur in adults. Symptoms can include fatigue, fever, weight loss, and bleeding or bruising easily.
Acute Myeloid Leukemia (AML): Affects myeloid cells and progresses rapidly without treatment. It is more common in adults than in children. Symptoms can include fatigue, fever, weight loss, and an increased risk of infections due to a low white blood cell count.
Chronic Lymphocytic Leukemia (CLL): Is a slow-growing type of leukemia that affects lymphoid cells. It is the most common type of leukemia in adults. Many people with CLL do not have any symptoms at the time of diagnosis, and it is often discovered during routine blood tests.
Chronic Myeloid Leukemia (CML): Affects myeloid cells and tends to progress slowly at first before transitioning to a phase where it grows more quickly. It is most commonly diagnosed in adults. Symptoms can include fatigue, weight loss, and an enlarged spleen.
There are also fewer common types of leukemia, such as hairy cell leukemia, myelodysplastic syndromes, and myeloproliferative disorders. Each type of leukemia has its own treatment approach, which can include chemotherapy, radiation therapy, targeted therapy, and stem cell transplant.
What causes leukemia?
Leukemia is a type of cancer that begins in the blood-forming cells of the bone marrow. While the exact cause of leukemia is not known, it is believed to occur due to a combination of genetic and environmental factors.
Genetic Factors: Certain genetic abnormalities or mutations can increase the risk of developing leukemia. For instance, specific chromosomal translocations, where parts of chromosomes swap places, have been associated with different types of leukemia. Additionally, inherited genetic disorders such as Down syndrome or Li-Fraumeni syndrome can increase the risk of leukemia.
Environmental Factors: Exposure to certain environmental factors has been linked to an increased risk of leukemia. This includes high levels of radiation, either from a nuclear reactor accident or from radiation therapy for a previous cancer. Exposure to certain chemicals, such as benzene, which is used in the rubber industry, and certain chemotherapy drugs, can also increase the risk of leukemia.
Immune System Disorders: Certain disorders of the immune system, such as Human T-cell leukemia virus-1 (HTLV-1) and Human Immunodeficiency Virus (HIV), can increase the risk of certain types of leukemia.
Lifestyle Factors: Certain lifestyle factors such as smoking and a high intake of processed meats and alcohol have been associated with an increased risk of certain types of leukemia.
It’s important to note that having one or more risk factors does not necessarily mean that a person will develop leukemia. Most people with risk factors never develop the disease, while many people with leukemia have none of these risk factors. Furthermore, leukemia can occur in individuals of all ages, although the risk generally increases with age.
Leukemia Signs & Symptoms
Leukemia, a cancer of the blood and bone marrow, presents with a variety of signs and symptoms that can vary depending on the type and stage of the disease.
One of the most common symptoms is persistent fatigue and weakness, which occurs because leukemia cells crowd out normal blood cells, leading to anemia. Patients often experience frequent or severe infections due to a shortage of healthy white blood cells, which are crucial for fighting off infections.
Fever or chills are also common, as the body responds to infections or the cancer itself. Another notable symptom is unexplained weight loss, which can occur as the body uses more energy to fight the disease. Swollen lymph nodes, as well as an enlarged liver or spleen, can be detected during physical examinations and may cause discomfort or pain in the abdomen.
Easy bleeding or bruising is a hallmark of leukemia, resulting from a deficiency in platelets, which are essential for blood clotting. This can manifest as frequent nosebleeds, bleeding gums, or tiny red spots on the skin known as petechiae. Patients may also notice recurrent nosebleeds and excessive bleeding from minor cuts.
Bone or joint pain is another symptom, particularly in acute forms of leukemia, where the rapid growth of abnormal cells can cause the bone marrow to expand. This pain is often described as a deep, aching sensation and can be severe enough to interfere with daily activities.
In some cases, leukemia can cause shortness of breath due to anemia or the accumulation of leukemia cells in the lungs. Night sweats and frequent infections are also common, as the immune system is compromised. Additionally, patients may experience pale skin due to a lack of red blood cells.
Neurological symptoms such as headaches, dizziness, and seizures can occur if leukemia cells infiltrate the central nervous system. These symptoms are more common in acute forms of leukemia and can be severe.
It is important to note that these symptoms can be caused by conditions other than leukemia. However, if they persist or worsen over time, it is crucial to seek medical attention for a proper diagnosis and timely treatment. Early detection and treatment are key to managing leukemia effectively and improving patient outcomes.
Diagnostic Exams & Tests for Leukemia
Diagnosing leukemia involves a series of comprehensive exams and tests to accurately identify the presence and type of leukemia, as well as to determine the extent of the disease.
The diagnostic process typically begins with a thorough medical history and physical examination. During the physical exam, the doctor will look for signs such as swollen lymph nodes, an enlarged liver or spleen, and any unusual bruising or bleeding.
The next step often involves blood tests, which are crucial in diagnosing leukemia. A complete blood count (CBC) is commonly performed to measure the levels of red blood cells, white blood cells, and platelets in the blood. Abnormal levels of these cells can indicate leukemia. Additionally, a peripheral blood smear may be conducted, where a drop of blood is examined under a microscope to look for abnormal cells.
If the blood tests suggest leukemia, a bone marrow biopsy is usually the next step. This procedure involves extracting a small sample of bone marrow, typically from the hip bone, using a long needle. The sample is then examined under a microscope to look for leukemia cells. A bone marrow aspiration, which involves removing a small amount of liquid bone marrow, may also be performed. These tests help determine the type and extent of leukemia, which is critical for planning treatment.
In some cases, additional tests may be required to further evaluate the disease. Imaging tests such as X-rays, CT scans, or MRIs can help detect any spread of leukemia to other parts of the body. A lumbar puncture, or spinal tap, may be performed to check for leukemia cells in the cerebrospinal fluid, which surrounds the brain and spinal cord. This is particularly important for certain types of leukemia that are more likely to spread to the central nervous system.
Molecular and genetic tests are also increasingly used in the diagnosis of leukemia. These tests analyze the DNA of leukemia cells to identify specific genetic mutations or abnormalities. This information can provide valuable insights into the prognosis and help guide targeted therapies.
Treatment options for Leukemia
Leukemia treatment options are diverse and tailored to the specific type and stage of leukemia, as well as the patient's overall health and preferences. The primary treatments include chemotherapy, radiation therapy, targeted therapy, immunotherapy, and hematopoietic stem cell transplantation.
Chemotherapy: is the most common treatment for leukemia and involves using drugs to kill rapidly dividing cancer cells. These drugs can be administered orally or intravenously and are often given in cycles to allow the body time to recover between treatments. Chemotherapy can be used alone or in combination with other treatments, depending on the type of leukemia.
Radiation therapy: uses high-energy beams, such as X-rays, to destroy cancer cells or inhibit their growth. This treatment is often used to target specific areas of the body where leukemia cells have accumulated, such as the spleen or brain. Radiation therapy can also be used before a stem cell transplant to prepare the body for the new, healthy cells.
Targeted therapy: involves drugs that specifically target abnormalities within cancer cells. For example, tyrosine kinase inhibitors (TKIs) are used to treat chronic myeloid leukemia (CML) by targeting the BCR-ABL protein that promotes cancer cell growth. These therapies are designed to interfere with specific molecules involved in the growth and survival of cancer cells, making them less harmful to normal cells.
Immunotherapy: boosts the body's immune system to help it recognize and attack cancer cells. One form of immunotherapy, called CAR T-cell therapy, involves modifying a patient's T-cells to better identify and destroy leukemia cells. Another approach uses immune checkpoint inhibitors to block proteins that prevent the immune system from attacking cancer cells.
Hematopoietic stem cell transplantation (HSCT): also known as bone marrow transplant, replaces the diseased bone marrow with healthy stem cell. This procedure can be autologous (using the patient's own stem cells) or allogeneic (using stem cells from a donor). HSCT is often used for patients with high-risk or relapsed leukemia and can provide a potential cure.
In addition to these primary treatments, supportive care is crucial for managing symptoms and side effects. This can include blood transfusions, antibiotics to prevent or treat infections, and medications to manage pain and other symptoms. Clinical trials may also be an option for some patients, offering access to new and experimental treatments.
