The Scene Behind Leukemia

Last week, between 2-8 November 2021, was the Internation Week for Children with Leukemia and we would like to publish an article in regards to many children suffering from this severe disease at a very little age. Every year nearly 60000 people in the U.S. die from leukemia, the type of cancer that accounts nearly for 5% of all cancer issues. Based on an estimated total of 600000 cancer deaths each year, leukemia is the reason from 10%. While many people, especially children, suffer from leukemia, we do not have accurate knowledge about what leukemia actually is. This article will talk about leukemia from a broad perspective, starting from what actually is leukemia to possible treatments.

In 1827, the surgeon Alfred Velpeau make the initial description of leukemia, which then was improved by Rudolf Virchow in 1845. However, they weren’t successful at determining the origin of the disease. Later in 1856, Franz Neumann found that the bone marrow of a patient with leukemia was greenish while a normal person’s should be red. As a result, Neumann became the first to detect the cause of leukemia. The treatments, on the other hand, were later proposed by Sidney Farber and Emil Freireich. 

As discovered and described by various scientists, leukemia is the type of cancer that arises due to the abnormal growth of cells in the blood and bone marrow. Bone marrow is the soft tissue in the center cavity o fall bones in which blood cells are made and nutrients are supplied for growth. When the growth of the cells, mostly white blood cells, in the bone marrow goes out of control due to a mutation, these cells begin to take over the space inside the bone marrow and fewer normal blood cells are being made and released into the bloodstream than those with mutations. The leukemia cells that are released into the bloodstream do not function properly and as the other cell types are not produced sufficiently the organs and tissues in the body will not get the oxygen they need to work properly. Considering that white blood cells are the main source of leukemia cells and thus inhibit red blood cells and platelets, your body will be weak to fight off infections or clot blood when needed. 

Although you may not know the reason for developing leukemia for certain, previous cancer treatment, earlier interaction with industrial chemicals such as formaldehyde, or having a genetic disorder such as Down Syndrome are found to be risk factors for leukemia as they can cause or arise from mutations. However, it definitely shouldn’t be misunderstood that not having these factors eliminates the risk of getting leukemia. Everyone can develop the disease. 

There are different types of leukemia:

By Speed:

Acute Leukemia: In acute leukemia, the leukemia cells are rapidly dividing and hence the disease spreads through the body very quickly. Symptoms will show themselves within weeks.

Chronic Leukemia: In chronic leukemia, not all cells involved are immature and hence the process progresses slowly. Symptoms may not be noticeable for years. 

By Cell Type:

Acute Lymphocytic Leukemia (ALL): In ALL, the lymphoid cells that make up the immune system divide very quickly. This is commonly seen in children and teens under the age of 20 while it is not impossible to encounter in older adults. Interestingly, it is more common among Hispanic or White people. 

Acute Myelogenous Leukemia (AML): In AML, the myeloid cells in the bone marrow, that produce the blood cells, divide very quickly. This is commonly seen in adults, especially those over 65 years of age while it is also not rare in children. Men are more likely to be diagnosed with AML compared to women.

Chronic Lymphocytic Leukemia (CLL): In CLL, the process progresses more slowly and the lymphoid cells divide more slowly. Hence, no symptoms may be observed for years. This is commonly seen in adults, especially those over 65 years of age. It is more common in men, especially white men, than women.

Chronic Myelogenous Leukemia (CML): In CML, the myeloid cells first divide just a little quicker than usual, and hence no symptoms may be observed for months or years. However, this type becomes more severe as the leukemia cells enter a phase in which they grow more quickly than before. This is commonly seen in adults, especially those over 65 years of age. 

As we have mentioned above, every type of leukemia shows different symptomatic behavior. However, there are some common symptoms that can be observed:

  • Easily getting tired
  • Pale skin tone
  • Fever
  • Nosebleeds
  • Purplish patches or red spots on the skin
  • Bone or joint pain
  • Enlarged spleen or liver
  • Unplanned weight loss
  • Night sweats
  • Shortness of breath
  • Pain under the ribs

If you are suffering from such symptoms, you should immediately see a doctor. The doctor will conduct some tests to determine whether or not you have leukemia cancer. There are several ways for diagnosis:

Physical Exam: This diagnosis way is just a test to observe obvious symptoms. The doctor may check for swollen lymph nodes, bruises, or spots on your skin. However, this test does not give any valid result since most of the symptoms can also be seen in various other illnesses such as flu.

Complete Blood Count (CBC): This blood test gives an idea about the relative proportions of red blood cells, platelets, and white blood cells to each other. If the patient has leukemia, a higher proportion of white blood cells would be expected.

Bone Marrow Biopsy: This is usually the last option that a doctor goes for. If the CBC results turned out to be indicators of leukemia, then the doctor will get a sample of cells from your bone marrow using a long needle. This process is usually applied to an area near the pelvic bone on your hip. By examining your bone marrow cells, the doctor can determine the percentage of abnormality in the bone marrow and decide whether you have leukemia or not.

If you are diagnosed with leukemia, then you will have to start getting treatment as soon as possible. The doctors may recommend specific treatment combinations depending on the type of leukemia, your age, and your overall symptomatic behavior. The most common treatments are five in number:

Chemotherapy: Chemotherapy is the most common treatment for patients that are diagnosed with any type of cancer. Chemicals that are found to work against the leukemia cells are given through an IV into a vein or in pill form to kill those cells and stop them from dividing. These drugs are so heavy on the human body that they are administered several times a week with a few days being breaks. Hence, this treatment can last for months or years.

Radiation Therapy: Radiation therapy uses strong beams of energy to kill leukemia cells or stop them from growing. This therapy is not focused on the whole body, but instead only on the locations where leukemia cells are found as radiation could lead to mutation of genes and can cause further harm.

Immunotherapy: Immunotherapy uses certain drugs to boost your immune system and adapt it to fight leukemia.

Targeted Therapy: Targeted therapies work by blocking the ability of leukemia cells to multiply and divide. They do so by cutting off the blood supply needed for these cells to live or directly killing the cells. 

Bone Marrow Transplant: This procedure replaces the leukemia cells that are previously killed with treatments such as chemotherapy with healthy hematopoietic cells. These cells can be taken either from you prior to the initial treatment or from a donor’s blood and are infused into your blood. 

Especially after starting the treatments, many patients fall into a pool of hopelessness. They are destroying themselves emotionally, which in turn impacts the course of the disease. The first piece of advice you should keep in mind is that it’s difficult to make general predictions on the survival chance of an individual. Certainly, there are various factors that could make everyone think that one may not survive the disease, keep in mind that your body miraculously could win the war against leukemia cells. But still, if you want to examine the survival chance of a loved one, consider these occurrences:

  • Presence of any chromosomal mutations or alterations inside the leukemia cell
  • The age of the patient (the younger the age, the better the outcome)
  • Patient’s general health (the better the overall health, the better the outcome)
  • Response to initial treatment (if leukemia cells have been mostly dealt with at the end of the initial treatment, it is so likely that the patient will survive the disease)

Leukemia is the 10th most common cancer that is diagnosed each year. Although in general knowledge we accept it as a disease of children, it is far more common in adults as it is a disease that increases its likelihood with increasing age. It is a disease that you should always be following, in other words just because you are clean of leukemia cells after a year of treatments doesn’t mean you may not develop again. Follow-up appointments with doctors to get your routine controls are essential, not only for leukemia but also for every other disease out there. These appointments can help manage treatment side effects and check to what extent the treatment has been successful. Take care of your health and always go to your routine controls. Remember, early diagnosis saves lives.

CITATIONS

[1] “Leukemia: Symptoms, Types, Causes & Treatments.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/4365-leukemia. 

[2] “Leukemia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 13 Jan. 2021, https://www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373. 

[3] “Leukemia.” Wikipedia, Wikimedia Foundation, 16 Nov. 2021, https://en.wikipedia.org/wiki/Leukemia. 

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