Overview of Leukemias

What is leukemia?
Leukemia is cancer of the blood cells, usually the white blood cells. Leukemic cells look different than normal cells and do not function properly.

What are the types of leukemia?
There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine if the cancer is:

1. lymphocytic or myelogenous leukemia:
   Cancer can occur in either the lymphoid or myeloid white blood cells
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• When the cancer develops in the lymphocytes (lymphoid cells), it is called
•  lymphocytic leukemia.
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• When the cancer develops in the granulocytes or monocytes (myeloid cells), it is called myelogenous leukemia
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2. acute or chronic leukemia:
   Leukemia is either acute or chronic.

• Acute leukemia
  The new or immature cells, called blasts, remain very immature and cannot perform their functions. The blasts increase in number rapidly, and the disease progresses quickly.

• Chronic leukemia
  There are some blast cells present, but they are more mature and are able to perform some of their functions. The cells grow more slowly, and the number increases less quickly, so the disease progresses gradually.

Based on these findings, the leukemia is then classified into one of the four main types of leukemias.

• acute myelogenous leukemia (AML)
• chronic myelogenous leukemia (CML)
• acute lymphocytic leukemia (ALL)
• chronic lymphocytic leukemia (CLL)

There are other types and subtypes of leukemias.

What are the symptoms of leukemia
The following are the most common symptoms for leukemia, however, each individual may experience symptoms differently:

• more frequent infections and fevers
• anemia and its symptoms: pale skin, fatigue, weakness
• bleeding
• bruising
• fever, chills
• loss of appetite
• loss of weight
• swollen or tender lymph nodes, liver, or spleen
• petechiae (tiny red spots under the skin)
• swollen or bleeding gums
• sweating
• bone or joint pain

In addition, acute leukemia may cause:

• headaches
• vomiting
• confusion
• loss of muscle control
• seizures
• swollen testicles
• sores in the eyes or on the skin

Chronic leukemia may affect the skin, central nervous system, digestive tract, kidneys, and testicles.

The symptoms of acute and chronic leukemias may resemble other blood disorders or medical problems. Consult your physician for a diagnosis.

How are leukemias diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for acute and chronic leukemias may include:

• physician examination for swelling in the:

• liver
• spleen
• lymph nodes under the arms, in the groin, and in the neck

• additional blood tests and other laboratory tests
• blood tests to examine the blast (immature) blood cells
• bone marrow aspiration and biopsy
• lymph node biopsy
• spinal tap
• imaging procedures, such as x-ray, ultrasound, and computed tomography (CT)

Treatment for acute and chronic leukemias:
Specific treatment for acute and chronic leukemias will be determined by your physician(s) based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include (individually or in combination) the following:

• chemotherapy
• radiation therapy
• bone marrow stem cell transplantation
• biological therapy
• platelet transfusion
• red blood cell transfusion
• medications to prevent or treat damage to other systems of the body caused by leukemia treatment