Leukemia is an oncological disease that affects blood and bone marrow cells, especially white blood cells (leukocytes). These bodies are responsible for the functioning of the body's immune system. Leukemia starts in the bone marrow, where blood cells are made. This happens when some cells mutate and begin to multiply out of control. These abnormal cells can travel into the blood and spread to other organs such as the lymph nodes, liver, brain and others.

Leukemia can be chronic or acute. Acute leukemia progresses quickly and requires immediate treatment, while chronic leukemia can progress slowly and does not always require immediate treatment. There are also different types of leukemia, which are classified according to which cells are affected (myeloid or lymphocytic) and how quickly the disease progresses (acute or chronic).

The etiology of leukemia is not entirely clear, but it is known that certain genetic and environmental factors may contribute to its development. These include certain genetic disorders, exposure to chemicals and radiation, use of certain medications and chemotherapy agents, smoking, and some immune system disorders.

Leukemia can affect any age, but some types are more common in children and others in adults. Although rare, leukemia is one of the most common childhood cancers. The success of treatment depends on many factors, including the type of disease, its stage, the patient's age, general health, and the method of treatment.

What are the types of leukemia?

Leukemia is a complex disease that has different types and subtypes. These types are divided according to how the disease develops (acute or chronic) and what type of blood cells are affected (myeloid or lymphocytic). Here are the main types of leukemia:

Acute Myeloid Leukemia (AML):

This disease progresses rapidly and affects the myeloid cells that make red blood cells, some white blood cells, and platelets. AML is most common in adults, especially older people.

Acute Lymphoblastic Leukemia (ALL):

ALL is the most common form of leukemia in children, but it can also occur in adults. It develops rapidly and affects lymphoblasts (lymphocytes), which are a type of white blood cell.

Chronic Myeloid Leukemia (CML):

CML develops slowly and affects myeloid cells. It mostly occurs in adults. CML is associated with a chromosomal abnormality known as the Philadelphia chromosome.

Chronic Lymphocytic Leukemia (CLL):

CLL is the most common adult leukemia in Western countries. It affects lymphocytes and develops slowly. CLL can be asymptomatic and have no symptoms for a long time.

Acute Monocytic Leukemia (AMoL) and other rarer forms:

There are other rarer forms of leukemia, such as AMoL, which affect specific blood cells such as monocytes. These forms can have unique symptoms and require specialized treatment.

These types of leukemia can be further classified based on which specific genes or chromosomal abnormalities are involved, what symptoms are present, how the disease responds to treatment, and other factors. To determine the type of leukemia, doctors perform various laboratory tests and diagnostic procedures, such as bone marrow aspiration and biopsy, blood tests, chromosome analysis, etc. An accurate diagnosis is vital to determining the right treatment plan, as each type of treatment can be different.

Reasons

The causes of leukemia are complex and often unclear. It can be caused by a combination of various genetic and environmental factors. Here are the main causes and risk factors for leukemia:

  • Genetic predisposition. Some people may have a genetic predisposition to leukemia. This can be due to certain inherited conditions such as Down syndrome.

  • The environmental factors. Certain chemicals, such as benzene, which is found in cigarettes and petroleum products, can increase the risk of leukemia.

  • Radiation. High doses of radiation, such as radiation after a nuclear explosion or during radiation therapy, can cause leukemia.

  • Chemotherapy and radiation therapy. Some treatments for other cancers can increase the risk of leukemia later in life.

  • Immune system disorders. People with certain immune system disorders may be more vulnerable to leukemia.

  • Infectious diseases. Some viral infections, such as human T-lymphotropic virus (HTLV-1), can increase the risk of leukemia.

  • Age and gender. Some types of leukemia are more common in certain age groups or among men.

  • Smoking. Cigarette smoking is a known risk factor for leukemia, especially in adults.

  • Genetic mutations. Some forms of leukemia may be associated with genetic mutations that may be congenital or may occur during life.

  • Blood disorders. Certain blood disorders, such as myelodysplastic syndrome, can increase the risk of leukemia.

The effect of many of these factors on leukemia is not fully understood, and in many cases the cause of leukemia is unknown. Each case is unique and may be related to many of these and other factors. Research and scientific analysis are still ongoing to find out the exact causes of leukemia and develop more effective prevention strategies.

Symptoms

Leukemia is a cancer of the blood and bone marrow that causes an abnormal proliferation of white blood cells, or leukocytes. These pathological white blood cells begin to interfere with the normal process of blood cell production, causing a variety of symptoms. Leukemia symptoms can vary depending on the type of leukemia, but there are common signs that can occur:

  • Weakness and fatigue: Due to the reduced number of red blood cells that carry oxygen to the tissues of the body, severe fatigue and weakness may occur.

  • Common: Dysfunction of white blood cells can disrupt the immune system, making the patient more vulnerable to infections.

  • Fever and night sweats: Fever may occur, especially at night.

  • Bone and joint pain: A build-up of leukocytes in the bone marrow can cause pain.

  • Skin rash or redness: Skin rash or redness can be caused by damage to blood vessels.

  • Enlarged lymph nodes: Abnormal production of white blood cells can cause swollen lymph nodes, especially in the neck, armpits, and pelvis.

  • Weight loss: Unexplained weight loss can be one of the symptoms of leukemia.

  • Bleeding and bruising: Decreased production of platelets can cause easy bleeding and bruising from even the smallest injury.

  • Shortness of breath: A low red blood cell count can cause shortness of breath.

  • Altered production of blood cells: A complete blood count may show abnormal production of blood cells, with an increase in white blood cells and a decrease in red blood cells and platelets.

  • Brain and nervous system symptoms: In some cases, leukemia cells can spread to the brain, causing headaches, vomiting, vision problems, or loss of coordination.

It is important to note that many of these symptoms are common and may be related to other conditions or diseases. Therefore, a careful diagnosis should be made with medical professionals who can perform the necessary blood tests and other diagnostic tests in order to establish an accurate diagnosis of leukemia.


Treatment

Leukemia treatment is complex and depends on many factors, including the type of leukemia, its stage, the patient's age, general health, and other individual factors. Here are the main strategies and methods for treating leukemia:

Chemotherapy: This is one of the main treatments for leukemia, which uses drugs to inhibit or kill cancer cells. Chemotherapy can be administered intravenously or orally, depending on the type and stage of the disease.

Radiotherapy: This procedure uses high-energy rays to damage cancer cells and stop their growth. This can be used in conjunction with other treatments, especially in severe cases.

Blood and bone marrow transplant (BMT): BMT may be done if the leukemia recurs or does not respond well to other treatments. The procedure involves injecting healthy bone marrow cells into a patient after intensive chemotherapy or radiotherapy.

Cytotoxic drugs: These drugs specifically affect cancer cells and can be used in combination with chemotherapy.

Immunotherapy: Immunotherapy stimulates the body's immune system to fight leukemia. This can be done using antibodies, vaccines, or other immune system modulators.

Targeted therapy: This is a newer treatment that is used for some types of leukemia. It uses drugs that specifically affect certain molecular points on cancer cells.

Supportive care: Leukemia treatment can cause side effects such as infections, anemia, bleeding, etc. Supportive therapy may include antibiotics, blood transfusions, anti-nausea medications, and other measures to manage these symptoms.

Psychological support and psychotherapy: Leukemia diagnosis and treatment can be very stressful. Psychological support, counseling and psychotherapy can help patients and their families deal with these challenges.

Clinical trials: Some patients may be eligible for new therapies or treatments that are being studied in clinical trials.

The treatment plan for leukemia is highly individualized, and the patient needs to work closely with the oncologist, hematologist, and other specialists. These professionals will consider the patient's needs, wishes and goals to create an optimal, individualized treatment plan. It is important to emphasize that the success of leukemia treatment can vary greatly depending on many factors, so continuous monitoring of the patient and adjustment of the treatment plan are necessary.

Can leukemia be prevented?

Prevention of leukemia is difficult because many factors that can cause this disease are not yet fully understood. However, there are some general principles and strategies that can help reduce the risk of leukemia, or at least contribute to early diagnosis. Here are the main areas of leukemia prevention:

A healthy diet that includes plenty of fruits, vegetables, fish, and less fat and processed foods can boost your immune system. It is also important to maintain a healthy body weight and include regular physical activity.

Smoking is a known risk factor for cancer, including some types of leukemia. Harmful substances released during smoking can enter the blood and affect the bone marrow. It is also important to limit alcohol consumption.

Workers who work with certain chemical compounds, such as gasoline, herbicides, pesticides, may have a higher risk of leukemia. Workplace protection such as ventilation, appropriate clothing and safe work practices can reduce the risk.

A high dose of radiation can increase the risk of leukemia. It is necessary to monitor radiation levels during medical examinations and in professional settings, using appropriate protective equipment.

Individuals with a family history of leukemia or other blood cancers may benefit from genetic counseling. This can help assess individual risk and potentially lead to early diagnostic programs.

Although a direct link between the immune system and leukemia prevention is not yet fully confirmed, a healthy lifestyle, balanced diet, adequate sleep and stress management can help maintain a strong immune system.

Although not preventative, early diagnosis can help detect leukemia in its early stages, when it is more likely to be curable. This may include regular blood tests for those at higher risk.

It should be noted that there is no guaranteed way to prevent leukemia, as some risk factors such as age or genetics are beyond our control. However, adequate information about and management of known risk factors can help reduce the risk of this disease.


Sources of information:

  1. National Cancer Institute. "Leukemia - Patient Version." cancer.gov.

  2. Mayo Clinic. "Leukemia - Symptoms and causes." mayoclinic.org.

  3. American Cancer Society. "Treatment Choices by Type and Stage of Leukemia." cancer.org.


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