What is Leukemia?

Leukemia is a type of cancer affecting the blood and bone marrow, characterized by the uncontrolled proliferation of abnormal white blood cells (WBCs). These abnormal cells interfere with the production of healthy blood cells, impairing the body’s ability to fight infections, transport oxygen, and form clots.

Types of Leukemia

Leukemia is classified based on the speed of progression (acute or chronic) and the type of blood cell affected (lymphoid or myeloid).

1. Acute Leukemia (rapid progression):

•Acute Lymphoblastic Leukemia (ALL): Common in children but also affects adults. Affects immature lymphoid cells (lymphoblasts).

•Acute Myeloid Leukemia (AML): More common in adults. Affects immature myeloid cells, leading to rapid accumulation of abnormal cells.

2. Chronic Leukemia (slow progression):

•Chronic Lymphocytic Leukemia (CLL): Common in older adults. Affects mature lymphocytes and progresses gradually.

•Chronic Myeloid Leukemia (CML): Associated with the Philadelphia chromosome mutation (BCR-ABL fusion gene). Progresses through phases: chronic, accelerated, and blast crisis.

3. Other Forms:

• Hairy Cell Leukemia (HCL): A rare, slow-growing form of leukemia affecting B-lymphocytes.
• Mixed Lineage Leukemia (MLL): involves characteristics of both lymphoid and myeloid cells.

Symptoms of Leukemia

Symptoms vary based on the type and stage of leukemia but commonly include:

1.General Symptoms:

• Fatigue and weakness.
• Fever or chills.
• Unexplained weight loss.
• Night sweats.

2.Blood and Bone Marrow Symptoms:

• Frequent infections due to reduced immunity.
• Easy bruising or bleeding (e.g., nosebleeds, gum bleeding).
• Anemia (pale skin, shortness of breath).

3.Other Symptoms:

• Swollen lymph nodes (especially in the neck or armpits).
• Enlarged spleen or liver (causing abdominal discomfort).
• Bone pain or tenderness.

Diagnosis of Leukemia

1.Physical Examination: Checking for swollen lymph nodes, enlarged liver or spleen, and signs of bruising.

2.Blood Tests:

• Complete Blood Count (CBC): Detects abnormal WBC, RBC, or platelet levels.
• Peripheral Blood Smear: Examines blood cells under a microscope for abnormalities.

3.Bone Marrow Biopsy: Extracts bone marrow for examination to confirm leukemia and identify the type.

4.Cytogenetic and Molecular Testing: Detects genetic mutations like the Philadelphia chromosome in CML.

5.Flow Cytometry: Identifies leukemia cell types based on surface markers.

6.Imaging Tests: X-rays, PET-CT, CT scans, or MRI may be done to check for organ involvement.

Treatment of Leukemia: Treatment varies based on the type, age, and health of the patient.

1. Chemotherapy

• The primary treatment for most leukemias.
• Drugs like cytarabine, vincristine, and doxorubicin are commonly used.

2. Targeted Therapy: Focuses on specific genetic abnormalities.

Imatinib (Gleevec): Effective for CML with BCR-ABL mutations.

Other examples: Dasatinib, Venetoclax.

3. Radiation Therapy: Uses high-energy radiation to kill cancer cells or reduce tumor size. Often used in cases of CNS involvement.

4. Bone Marrow Transplant (Stem Cell Transplant): Replaces diseased bone marrow with healthy stem cells from a donor. Typically used in high-risk or relapsed cases.

5. Immunotherapy: Boosts the body’s immune response against cancer cells.

CAR-T Cell Therapy: Modifies T-cells to target leukemia.

6. Supportive Care: Blood transfusions to address anemia or low platelets. Antibiotics to prevent or treat infections.

Prognosis and Follow-Up: Prognosis depends on factors such as the type of leukemia, age, and overall health. Regular follow-ups with blood tests and bone marrow evaluations are essential for monitoring remission and detecting recurrence.

Leukemia is a complex disease, but advancements in molecular medicine, targeted therapies, and immunotherapy have significantly improved survival rates and quality of life for many patients. Early diagnosis and a multidisciplinary approach are key to effective management.