Blood is composed of two components, first the plasma and second the cells suspended in plasma. Plasma consists of basically water in which proteins (albumin), hormones, vitamins and electrolytes are all dissolved.
The cells suspended in plasma comprise of red cells, platelets and white cells (the neutrophils, the monocytes, the eosinophils, the basophils and the lymphocytes).
The Red Cells are filled with hemoglobin, and are ensured with the job of carrying & delivering oxygen from the lungs to the body’s tissues, when we inhale. They also pick up carbon dioxide when they return from the body’s cells and deliver it back to the lungs, after which we exhale air.
The Platelets are cells that control and halt the bleeding in the body and help in forming a firm clot at the injury site.
The White Cells battle infection and make up our body’s immunity. They include both granulocytes and lymphocytes.
The Granulocytes are the neutrophils and monocytes. These are “phagocytes” (or the eating cells) which have granules that can ingest and kill infective agents like bacteria or fungi.
The Lymphocytes, a type of white cell found in the lymph nodes, the spleen and the lymphatic channels, as well as blood. There are three chief types of lymphocytes: The T- lymphocytes (T cells), the B-lymphocytes (B cells) and the natural killer (NK) cells. Each of these cells plays their key part in the functioning of the immune system.
Marrow is a spongy, soft tissue of bone where the blood cells develop. It is seen occupying the central hollow cavity of bones. In newborns, all bones enclose active marrow. By the time a person reaches young adulthood, some bones of the hands, feet, arms and legs are no longer functional. In contrast, the spine (vertebrae), hip and shoulder bones, ribs, breastbone and skull contain active marrow that produces blood cells in adults.
The Stem Cells are the parent cells that develop into all the blood cells in the bone marrow through the differentiation process. In normal healthy individuals, there are adequate stem cells to keep making new blood cells continuously.
What are leukemias ?
Leukemia is a group of malignant cancers of the blood and blood-manufacturing tissues in the bone marrow, as well as in the lymphatic system and spleen. What leukemia literally means is “white blood” as it is a neoplastic proliferation of a specific type of blood cell, known as the white blood cell or the leucocyte. Leukemias are regarded as aberrant, abnormal and uncontrolled growth of blood-forming cells.
It is important to differentiate Leukemia from Leukocytosis. Leukocytosis is a typical response to infection, manifested as an increased white blood cell count. However, when leukocytosis becomes increasingly elevated without any apparent cause and for a long time interval, then it may point to a malignancy known as LEUKEMIA.
What are the types of leukemias ?
The different types of leukemias are classified firstly according to the disease’s duration, course and nature, the number of blood cells seen in blood (ie. acute or chronic), and secondly, on the specific type of blood cell involved (ie. myeloid or lymphoid).
The four chief variants of leukemia are the acute myeloid leukemia, the chronic myeloid leukemia, the acute lymphoblastic leukemia and the chronic lymphocytic leukemia.
It is important to know that patients show diverse symptoms and need varied treatment for the different types of leukemia. But the four leukemias have one universal thing– they are all initiated in a bone marrow cell. This cell then undergoes a neoplastic change and becomes a type of leukemia tumour cell.
The marrow has two main jobs, that is, to form myeloid cells (platelets, RBCs and certain WBCs) and to form lymphocytes. Myeloid leukemia can begin in these myeloid cells. The lymphocytic or lymphoblastic leukemia is when the cancerous change takes place in a marrow cell that forms lymphocytes.
ALL ( Acute Lymphoblastic Leukemia ) and AML (Acute Myeloid Leukemia) are each composed of young cells, known as lymphoblasts or myeloblasts. These cells are sometimes called blasts. Acute leukemias progress rapidly and need quick and effective treatment.
CLL ( Chronic Lymphocytic Leukemia ) and CML ( Chronic Myeloid Leukemia ) have few or no blast cells. CLL and CML often progress slowly compared to acute leukemias, even without immediate treatment.
How are leukemias caused ?
Some risk factors for acute myeloid leukemia (AML) are :
- Some chemotherapy regimens.
- Down’s syndrome and some other genetic diseases.
- Chronic exposure to benzene- A lot of the environmental benzene exposure is from petroleum products, however, personal benzene exposure is mostly from cigarettes.
- Exposure to high doses of radiation therapy for cancer is also a risk factor for acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML).
- Familial Predilection for chronic lymphocytic leukemia (CLL).
What are the clinical features of leukemias ?
Regardless of the type of leukemia, the abnormal cells in the bone marrow depress production of other blood cells, resulting in numerous adverse effects like,
- Anemia, manifested as tiredness or no energy, shortness of breath during physical activity and pale skin.
- Risk of infection occurs if neutrophil count decreases, manifesting as mild fever and night sweats.
- Clotting factors decrease, increasing risk of bleeding as bruises and tiny pin-point bleeding spots.
- Risk of fracture increases as periosteum weakens and the bone marrow enlarges.
- Other organs such as the liver, spleen, and lymph glands may be affected because of infiltration of malignant cells.
- Loss of appetite, weight loss, general fatigue, and muscle atrophy also may be noted.
How are leukemias diagnosed ?
- A complete physical examination of the body is mandatory.
- Complete blood count (CBC) – Usually a small, representative amount of blood is collected from the person’s forearm with a needle and syringe. The blood is then put in tubes and sent to a hematology lab. A complete blood count or CBC is a test that is used to diagnose and monitor leukemias as well as other diseases. This blood test may show high or low levels of white cells and also show the presence of leukemia tumour cells in the blood. Platelet counts and red cell counts can also be found to be depressed or low.
- Bone marrow tests (aspiration and biopsy) are often done both to confirm the diagnosis of leukemia and to look for chromosome abnormalities. A sample of cells is taken by needle aspiration from the bone marrow. The cells are then looked at and checked under a microscope. These pathologic tests are done to identify the leukemia cell-type.
How are leukemias staged ?
Grade and Stage describe the tumour, helping to provide guidance for the oncologist in choosing the best treatment option(s). Staging is a careful attempt to find out the exact extent and spread of the cancer. The higher the stage the more the cancer has spread and progressed.
Grade refers to what the cancer cells look like, and how much they resemble their cell of origin or differentiation. The higher the grade, the more aggressive the tumour is.
How are leukemias treated ?
Choose a doctor who is a leukemia specialist and knows about the latest, up-to-date treatments. This type of specialist is usually called a hematologist/oncologist. Or your local cancer specialist can work in-tandem with a leukemia specialist.
- Acute leukemia: Treatment for patients with acute leukemia may include chemotherapy, stem cell transplantation or new approaches under study (clinical trials). Speak to your doctor to find out what treatment is best for you. Patients with an acute leukemia (acute lymphoblastic leukemia-ALL and acute myeloid leukemia-AML) need to start treatment soon after diagnosis. Usually, they begin treatment with chemotherapy, which is often given in the hospital. The first part of treatment is called induction therapy. Later, after even remission of the leukemia, postremission therapy and maintenance therapy may be needed. This part of treatment may be chemotherapy, that may or may not require stem cell transplantation (sometimes called bone marrow transplantation).
- Chronic myeloid leukemia: Patients with CML need treatment soon after diagnosis. Chemotherapy needs to be immediately instituted.
- Chronic lymphocytic leukemia (CLL): Some CLL patients do not need treatment for long periods of time after diagnosis, based on the “watch and wait” policy. Patients who need treatment may receive chemotherapy or monoclonal antibody therapy alone or in combination. Allogeneic stem cell transplantation is also a treatment option for certain patients, but usually not as the first choice of therapy.
What is the care to be taken after the treatment of leukemia ?
All leukemic patients in remission, need to see their doctors regularly and routinely for examination and blood tests. People with leukemia need medical follow-up after they have completed treatment. It is important to see and note if more therapy is needed.
Bone marrow tests may be needed from time to time. The doctor may recommend longer periods of time between follow-up visits if a patient continues to be disease free. Each type of leukemia has to be followed differently. Speak to your doctor to find the best care plan for you.
Patients and caregivers should talk with their doctors about both short-term and long-term effects of cancer treatment. Cancer-related fatigue is one common long-term effect, so it important to be aware of that.
How to find and reach cancer specialists for leukemia treatment ?
Now you can find and reach cancer specialists for leukemia treatment from different cancer hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple cancer specialists, cost estimates for leukemia treatment from different cancer hospitals, compare things and then choose a cancer specialist or a cancer hospital for leukemia treatment.
Find, reach and choose a cancer specialist for leukemia treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
