Leukemia

Leukemia is a cancer which starts in the bone marrow — when white blood cells grow abnormally without a clear cause. The presence of these cells interferes with the creation of other new regular cells within bone marrow, and causes a reduced count of red blood cells, normal white blood cells, and platelets. This can cause the sufferer to become anemic, experience unusual bleeding, experience sped up blood flow, and cause the patient more susceptible to infection. In addition to this, the cancer can spread to other areas of the body, such as the liver, spleen, and lymph nodes.
Leukemia is a particularly aggressive type of cancer, found across all ages but most commonly among the elderly. It is also one of the ten most common cancers found in Thailand.

Types of Leukemia
There are different types of leukemia, but they can be separated into two main categories, based on duration and cancer cell type.
Types of leukemia by duration:

  1. Acute leukemia is a fast-growing leukemia. It progresses rapidly without immediate treatment.
  2. Chronic leukemia is a slow-growing leukemia. 
Leukemia by cell type:
  1. Myelogenous leukemia grows from the myeloid cells.
  2. Lymphocytic leukemia grows from the lymphoid cells.
The most suitable type of treatment will depend on the type of cancer, as each different type has a different progression and prognosis.

Risk Factors for Leukemia
At present, there is no clear evidence to indicate the cause of leukemia, but the following factors can increase the risk of developing it:
  • Contact with high levels of radiation, for example, nuclear radiation
  • Receiving chemotherapy, which while being a cure for some cancers, can increase the risk of leukemia
  • Coming into contact with certain chemicals, for example, benzine and some insecticides
  • Genetic disorders, such as Down’s syndrome
  • Age, as the older you are, the more likely you are to contract leukemia, especially if over 60
  • Suffering from any other bone-marrow conditions such as Myelodysplastic syndrome (MDS)

Symptoms of Leukemia
When the abnormal blood cells affect the production of other various types of blood cells, the following symptoms may occur:
  • Red blood cell levels may lower, which can cause the patient to become anemic; physical symptoms include dizziness and exhaustion
  • White blood cell levels may lower, which makes it easier to contract infections
  • Platelet levels may lower, which can cause easy bleeding or bruising
  • Other symptoms include lack of appetite, weight loss, lumps, and aching bones

Diagnosis of Leukemia
A complete blood count (CBC) blood test may reveal low hemoglobin count, low platelet count, an abnormal amount of white blood cells. The doctor will evaluate the bone-marrow cell count, especially the myeloid, the lymphoid, and chromosomes to predict the likeliness of illness.
The bone marrow evaluation is essential when diagnosing leukemia, which involves a doctor using a needle to take a small piece of bone marrow from the hip bone or the pelvis (not the spinal cord). This process takes between 10 and 15 minutes, and does not require the patient to stay in hospital.

Treating Leukemia
The team of doctors will consider the type of leukemia, the patient’s age, and the patient’s general health before deciding on a treatment. 
Available options include: 
  1. Chemotherapy is the main treatment option for acute leukemia. With this treatment, the growing cancer cells are killed, allowing the bone marrow to begin producing blood cells normally again. There are different types of chemotherapy, including injections into a vein or injections into the spinal cord. Acute leukemia patients often require multiple types of chemotherapy, as determined by their doctor and dependent on the aggressiveness of the patient’s condition. The type of chemotherapy recommended also depends on the strength of the patient, as chemotherapy will affect other cells within the body, particularly cells which grow quickly, such as the lining of the digestive tract or the cells in the bone marrow.
  2. Targeted therapy is when medicine specifically targets cancer cells without damaging any other cells, such as tyrosine kinase inhibitors, which is used to treat chronic myeloid leukemia.
  3. Stem cell transplantation is when a doctor will take healthy cells from the bone marrow of a relative or donor and grow them in the patient during a time that the cancer is dormant, in order to prevent a reoccurrence of the condition.

Follow-up Treatment
After the cancer has been treated and has become dormant, the doctor will arrange an appointment to conduct a blood test every 1-2 months for the first year. Should there be no abnormalities during this period, the doctor will continue these appointments every 3-6 months for the next 5 years, after which it will be considered that the condition has been cured, as the cancer has not returned within this extended period of time.

Self-care for Leukemia Patients
  • Be particularly conscious of your hygiene and cleanliness, especially around the mouth and teeth, to avoid catching an infection
  • Avoid crowds or areas with bad ventilation to prevent catching any respiratory conditions
  • Eat a healthy diet, and ensure your food is ripe, cooked well, all vegetables are washed well, and all fruit is peeled to avoid the transfer of bacteria through food
  • Drink plenty of fresh, clean water, and try to avoid excessive stress

 

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