Leukemia is cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system.
Many types of leukemia exist. Some forms of leukemia are more common in children. Other forms of leukemia occur mostly in adults.
Leukemia usually involves the white blood cells. Your white blood cells are potent infection fighters — they normally grow and divide in an orderly way, as your body needs them. But in people with leukemia, the bone marrow produces an excessive amount of abnormal white blood cells, which don't function properly.
Treatment for leukemia can be complex — depending on the type of leukemia and other factors. But there are strategies and resources that can help make your treatment successful.
Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include:
Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.
Leukemia symptoms are often vague and not specific. You may overlook early leukemia symptoms because they may resemble symptoms of the flu and other common illnesses.
Sometimes leukemia is discovered during blood tests for some other condition.
Scientists don't understand the exact causes of leukemia. It seems to develop from a combination of genetic and environmental factors.
In general, leukemia is thought to occur when some blood cells acquire changes (mutations) in their genetic material or DNA. A cell's DNA contains the instructions that tell a cell what to do. Normally, the DNA tells the cell to grow at a set rate and to die at a set time. In leukemia, the mutations tell the blood cells to continue growing and dividing.
When this happens, blood cell production becomes out of control. Over time, these abnormal cells can crowd out healthy blood cells in the bone marrow, leading to fewer healthy white blood cells, red blood cells and platelets, causing the signs and symptoms of leukemia.
Doctors classify leukemia based on its speed of progression and the type of cells involved.
The first type of classification is by how fast the leukemia progresses:
The second type of classification is by type of white blood cell affected:
The major types of leukemia are:
Your body's lymphatic system is part of your immune system, which protects you against infection and disease. The lymphatic system includes your spleen, thymus, lymph nodes and lymph channels, as well as your tonsils and adenoids.
Factors that may increase your risk of developing some types of leukemia include:
However, most people with known risk factors don't get leukemia. And many people with leukemia have none of these risk factors.
Doctors may find chronic leukemia in a routine blood test, before symptoms begin. If this happens, or if you have signs or symptoms that suggest leukemia, you may undergo the following diagnostic exams:
In a bone marrow aspiration, a doctor or nurse uses a thin needle to remove a small amount of liquid bone marrow, usually from a spot in the back of your hipbone (pelvis). A bone marrow biopsy is often done at the same time. This second procedure removes a small piece of bone tissue and the enclosed marrow.
Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system.
Common treatments used to fight leukemia include:
Chemotherapy. Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells.
Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein.
Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body.
You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a bone marrow transplant.
Bone marrow transplant. A bone marrow transplant, also called a stem cell transplant, helps reestablish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will regenerate healthy bone marrow.
Prior to a bone marrow transplant, you receive very high doses of chemotherapy or radiation therapy to destroy your leukemia-producing bone marrow. Then you receive an infusion of blood-forming stem cells that help rebuild your bone marrow.
You may receive stem cells from a donor or you may be able to use your own stem cells.
A diagnosis of leukemia may be devastating — especially for the family of a newly diagnosed child. With time you'll find ways to cope with the distress and uncertainty of cancer. Until then, you may find it helps to:
Learn enough about leukemia to make decisions about your care. Ask your doctor about your leukemia, including your treatment options and, if you like, your prognosis. As you learn more about leukemia, you may become more confident in making treatment decisions.
The term "leukemia" can be confusing because it refers to a group of cancers that aren't all that similar except for the fact that they affect the bone marrow and blood. You can waste a lot of time researching information that doesn't apply to your kind of leukemia. To avoid that, ask your doctor to write down as much information about your specific disease as possible. Then narrow your search for information accordingly.
Find someone to talk with. Find a good listener who is willing to listen to you talk about your hopes and fears. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your doctor about support groups in your area. Or check your phone book, library or a cancer organization, such as the National Cancer Institute, the American Cancer Society or the Leukemia & Lymphoma Society.
Start by seeing your family doctor if you have signs or symptoms that worry you. If your doctor suspects you have leukemia, you may be referred to a doctor who specializes in diseases of the blood and bone marrow (hematologist).
Because appointments can be brief, and because there's often a lot of information to discuss, it's a good idea to be prepared. Here's some information to help you get ready, and know what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For leukemia, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask: