Leukemia: what it is, types, causes, diagnosis and treatment

Leukemia is a type of cancer that affects white blood cells, also known as leukocytes, which are the body's defense cells. This disease starts in the bone marrow, which the innermost part of the bones, popularly known as 'bone marrow' and spreads through the body through the blood, preventing or hindering the production of red blood cells, platelets and white blood cells, and because of that anemia, infections and hemorrhages arise.

Leukemia is a serious disease that needs treatment, which can be done with chemotherapy, radiation therapy or bone marrow transplantation, for example. The choice of treatment varies according to the type of leukemia that the person has and its severity, which also determines whether the person can be completely cured or not.

Types of Leukemia

There are 2 main types of leukemia, Lymphoid and Myeloid, which can be classified as Acute or Chronic, but there are still 4 other subtypes, as indicated below:

• Acute Myeloid Leukemia: It develops quickly and can also affect adults or children. Treatment can be done through chemotherapy and / or bone marrow transplantation and has an 80% chance of cure. Chronic Myeloid Leukemia: It develops slowly and is more frequent in adults. Treatment can be done with the use of specific medications for life. Acute Lymphoid Leukemia: Advances rapidly and can occur in children or adults. Treatment can be done with radiation and chemotherapy, but bone marrow transplantation is also an option when previous treatments fail to cure the disease. Chronic Lymphoid Leukemia: It develops slowly and affects the elderly more often. Treatment is not always necessary. T or NK granular lymphocytic leukemia: This type of leukemia is slow-growing, but a small number can be more aggressive and difficult to treat. Aggressive NK cell leukemia: It can be caused by the Epstein-Barr virus, affects adolescents and young adults, being aggressive. Treatment is done with chemotherapy. Adult T-cell leukemia: It is caused by the virus (HTLV-1), a retrovirus similar to HIV, and is very serious. Treatment is ineffective but is done with chemotherapy and bone marrow transplantation. Hairy cell leukemia: It is a type of chronic lymphocytic leukemia, which affects cells that appear to have hair, affects men more, not being found in children.

The type of leukemia that the person has is determined through specific tests, being essential to know which treatment is most suitable.

Symptoms of leukemia

The first symptoms of leukemia are high fever followed by chills, night sweat and weight loss without an apparent cause, then other symptoms may appear, such as:

• Inflamed tongue in the neck, armpits and just behind the elbow bone, technically called the elbow fossa, which is one of the characteristics of the disease; Enlarged spleen that causes pain in the upper left region of the abdomen; Anemia that causes symptoms such as tiredness, pallor and drowsiness; Low blood platelet concentration; Infections such as oral candidiasis and stomach (thrush) or atypical pneumonia; Pain in bones and joints; Night sweat; Purple spots on the skin; Pain in bones and joints; Easy bleeding from the nose, gums or heavy menstruation for no apparent reason. Headache, nausea, vomiting, double vision and disorientation occur when the central nervous system is affected.

These symptoms are more common in acute leukemia, because as chronic leukemia progresses slowly, it can be asymptomatic being discovered in a routine examination such as a complete blood count, for example.

Diagnosis of leukemia

The diagnosis is made by the hematologist or oncologist after observing some signs and symptoms and with the results of tests such as blood count, myelogram, computed tomography, magnetic resonance and more specifically, the bone marrow biopsy. In some cases, it may be necessary to have a CSF test, called a lumbar puncture, to assess the fluid that lines the central nervous system.

Treatments for leukemia

Leukemia can be treated with the following options: chemotherapy, immunotherapy, radiotherapy, bone marrow transplantation or the combination of different treatments, depending on the type of leukemia that the person has, and the stage in which the disease is.

In the case of acute leukemia, treatment should be started as soon as possible to combat symptoms and prevent the disease from getting worse. Many cases can be completely cured, with the treatments indicated by the doctor. In the case of chronic leukemia, the disease may have no symptoms, but it can hardly be cured, although the person can undergo 'maintenance' treatment to prevent the onset of symptoms throughout life and to keep this type of cancer under control.

Chemotherapy

Chemotherapy consists of the application of specific cancer drugs, which can be injected directly into the vein during hospitalization. This treatment is usually done in cycles, because they are performed once a week, with only 1 medication, or a combination of 2 or 3. In some cases, sessions can be carried out every few weeks or months.

Immunotherapy

Immunotherapy is a treatment similar to chemotherapy, because it consists of applying drugs directly into the vein, but these drugs work differently, and are monoclonal antibodies, which are substances that bind to cells

carcinogens, allowing the body's defense system to eliminate tumor cells in the blood and bone marrow.

Radiotherapy

It consists in the application of radiation to the spleen, brain or other parts of the body, in some cases it can be directed to the whole body, as it happens before a bone marrow transplant, for example.

Bone marrow transplant

Bone marrow transplantation consists of removing a part of the bone marrow from the hip of a healthy person and compatible with the sick person, and these are frozen until they can be used at the ideal time. The ideal time to place the donated bone marrow is decided by the doctor, and it can happen after finishing the chemo and radiotherapy treatments. The goal is to take the place of malignant cells and return to producing healthy blood cells.

Can leukemia cure?

In some cases, leukemia is curable, especially when it is diagnosed early and treatment is instituted quickly, however there are cases where the individual's body is already so weak that the cure of the disease is hardly achieved. Bone marrow transplantation may represent a cure for leukemia for some, but it has complications and is therefore not always an option indicated by doctors for all affected people.

Currently, some patients with acute leukemia achieve complete remission of the disease and last for many years, and many children with acute lymphocytic leukemia can be cured. The ideal is to talk to the doctor who is monitoring the case to find out what the next treatment steps will be and what can be expected.

What causes leukemia

The causes of leukemia are not fully known but what is known is that some genetic pre-dispositions favor the development of this disease. Leukemia is not hereditary and does not pass from father to son, nor is it contagious and therefore does not pass on to other people. Some factors that can cause leukemia to happen include the effects of irradiation, exposure to drugs, including smoking, immunological factors and certain types of viruses.