Leukaemia

Overview

Leukaemia occurs when there is a mutation in a single cell in the bone marrow that leads to the uncontrolled growth of abnormal white blood cells. Gradually, it minimises the body’s ability to function properly, leading to various complications. Hence, people must get diagnosed immediately after noticing the symptoms as early treatment can significantly increase the chances of recovery. This cancer type is somewhat different from the others as there is no formation of tumours.

What is Leukaemia?

Leukaemia is a type of blood cancer, where there is an uncontrolled growth of the WBCs. It occurs due to a mutation in the DNA of the WBCs that originate from the bone marrow. Gradually, the abnormal WBCs take up the majority of the spaces inside the bone marrow, leading to a decrease in the formation of red blood cells, white blood cells, and platelets. Hence, it is essential to go for diagnosis and treatment of leukaemia as early as possible to live a life close to normal, even when suffering from this condition.

Types of Leukaemia

Leukaemia can be classified into two types, based on the following categories:

Based on the Type of Cell

Following are the variants of leukaemia based on the different types of cells:

Myelogenous Leukaemia

It develops from the myeloid cells which ultimately develop into white blood cells, red blood cells, and platelets.

Lymphocytic Leukaemia

This type of leukaemia originates from the lymphocytic cells that develop into white blood cells which form an integral part of the immune system.

Based on the Disease Progression Speed

Listed below are the types of leukaemia based on the disease progression speed:

Acute Leukaemia

This type of leukaemia rapidly spreads all across the body and can be life-threatening if not taken care of at the right time.

Chronic Leukaemia

This type of leukaemia has both mature and immature cells. It worsens slower when compared to acute leukaemia.

Based on these classifications, different types of leukaemia can develop in individuals including:

Acute Lymphocytic Leukaemia (ALL)

This is the most common type of leukaemia that develops in teens, children, and young adults who are above 39 years of age.

Chronic Lymphocytic Leukaemia (CLL)

CLL develops mostly in elderly people who have an age above 65 years. Many times, the symptoms appear at later stages of this disease.

Acute Myelogenous Leukaemia (AML)

This is one of the common types of acute leukaemia that occurs in older adults above 65 years and at times in children as well.

Chronic Myelogenous Leukaemia (CML)

It is more frequent in older adults but can affect people of any age. However, children rarely get affected by this health condition.

Symptoms of Leukaemia

The symptoms of leukaemia vary depending on the part of the body affected and the stage of the leukaemia through which one is suffering. Some of the common signs of leukaemia include:

• fatigue
• night sweats
• fever
• shortness of breath
• vision problems
• headaches
• frequent infections
• pale skin
• unexplained weight loss
• bone or joint pain
• swollen lymph nodes
• enlarged spleen or liver
• pain under the ribs on the left side
• bruising and bleeding easily
• skin rashes

Upon noticing these symptoms, it would be prudent to visit the doctor for prompt diagnosis and treatment immediately.

Causes of Leukaemia

Leukaemia develops due to a genetic mutation in a single cell in the bone marrow because of which the cells keep multiplying. The cells arising from this abnormal cell also contain mutated genetic material, which further increases the count of cells. This uncontrolled growth of cells can ultimately result in the occurrence of leukaemia. Some of the risk factors associated with the development of this health condition include smoking, previous cancer treatment, exposure to industrial chemicals, family history, and certain genetic conditions such as Klinefelter syndrome, Down syndrome, and so on.

Diagnosis of Leukaemia

Based on the symptoms of leukaemia that a patient is showing, the doctor can recommend several diagnostic tests. The commonly prescribed leukaemia diagnosis and tests include:

Complete Blood Count (CBC): This test helps the doctor learn if there are abnormal levels of RBCs, WBCs, and platelets in the patient’s body. If the WBC count is higher, leukaemia can be confirmed.

Physical Exam: The healthcare provider will check for an enlarged spleen, swollen lymph nodes, bleeding gums, and skin rashes which are common symptoms of this disease.

Blood Cell Examination: Here, blood is taken from the patient’s body which is used for conducting peripheral blood smear and flow cytometry to check for markers that indicate the onset of this condition.

Imaging Tests: Doctors often prescribe CT scans, chest X-rays, and magnetic resonance imaging (MRI) scans to check for signs of leukaemia in the organs, bones, or tissues.

Bone Marrow Biopsy: In this test, a long needle is inserted into the bone marrow to take out a small amount of fluid. This fluid sample is then tested in the laboratory to determine the percentage of abnormal cells in the bone marrow.

Lumbar Puncture: Here, a sample fluid from the spinal cord is taken out and tested to check if the disease has spread to the fluid surrounding the brain and spinal cord.

Treatment for Leukaemia

Depending on the results of the diagnostic tests, doctors recommend the following leukaemia treatment and medication options:

Chemotherapy: This is the most common treatment option, where chemicals are used to kill leukaemia cells and stop them from multiplying. Doctors prescribe various chemotherapy drugs that can be taken as a pill or injection, during this treatment procedure.

Targeted Therapy: The healthcare provider prescribes several drugs that are designed to attack specific portions of the leukaemia cells. Doing so cuts off the blood supply for the leukaemia cell which ultimately kills them, preventing their rapid multiplication. Some examples include tyrosine kinase inhibitors and monoclonal antibodies.

Immunotherapy: For this treatment option, doctors prescribe certain drugs that can boost the immunity of the patient. This, in turn, helps the immune system find and destroy the leukaemia cells, treating the condition effectively.

Radiation Therapy: In this treatment type strong energy beams or X-rays are used to effectively kill the leukaemia cells. During this therapy option, a machine directs ratios to the spots where leukaemia cells are located. This prevents the cells from growing and multiplication, ultimately treating this condition.

Chimeric Antigen Receptor (CAR) T-cell Therapy: In this therapy type, the T-cell of the body is extracted, engineered, and infused back into the body so that they can effectively fight the leukaemia cells.

Hematopoietic Cell Transplant: It involves replacing the killed leukaemia cells with new, healthy hematopoietic cells. These can be taken from a donor and infused into the body of the patient. The new cells multiply to form new bone marrow, which in turn, produces RBCs, WBCs, and platelets in the required quantity in the blood.

Preventive Measures for Leukaemia

There are no such direct measures that can prevent the development of leukaemia. However, there are several steps available that one can take to reduce the risk of development of this disease. These steps include quitting smoking, maintaining a healthy body weight, staying physically active, having a balanced diet, avoiding exposure to harmful chemicals, and so on.

Myths and Facts Related to Leukaemia

Listed below are some myths and facts associated with leukaemia:

Myth 1: Leukaemia Only Affects Children
Fact: Leukaemia is a type of disease that can affect people from diverse age groups. In fact, about two-thirds of the population suffering from this condition are above 65 years of age.

Myth 2: The Symptoms Associated with Leukaemia are Specific
Fact: The symptoms associated with Leukaemia are vague and non-specific, implying that the majority of the patients cannot suspect its presence without diagnosis.

Myth 3: Leukaemia is Just One Disease
Fact: Leukaemia can be classified into four different types, based on the speed at which it spreads and the type of cell from which it originates. These include Acute Lymphocytic Leukaemia (ALL), Chronic Lymphocytic Leukaemia (CLL), Acute Myelogenous Leukaemia (AML), and Chronic Myelogenous Leukaemia (CML).

Myth 4: Leukaemia patients Must Avoid Sugar and Meat
Fact: Sugar often acts as a source of glucose for cancerous cells, encouraging them to spread more rapidly. Even, meat is a strong source of protein that can lead to the growth of cells. Thus, doctors often suggest patients with leukaemia avoid the intake of sugar and meat.

Myth 5: All Leukaemia Patients Require Bone Marrow Transplant
Fact: There are various types of treatments available for cancer. Hence, based on the diagnosis report, the doctors will determine the appropriate treatment option, which might not involve a bone marrow transplant.