Leukaemia - Meaning, Symptoms, Causes, Pictures, Treatment

Leukaemia is a cancer affecting the bone marrow and blood. It originates from the bone marrow, which is where blood cells are made. Leukaemia is characterised by the proliferation of aberrant white blood cells, often known as leukaemia cells, which crowd out normal blood cells.

This results in an imbalance in the blood cell population, which can have several negative effects.

Interestingly, leukaemia is the most common cancer in people under the age of 20. It is also the second most happening cancer in adults older than 55, after lung cancer. 

Leukaemia can be classified into four main types based on the speed of cell growth and the type of cells affected, myeloid (blood-forming cells in bone marrow ) or lymphoid cells (white blood cells that play an essential role in the bone marrow).

1. Acute Lymphoblastic Leukaemia (ALL): A fast-growing form of leukaemia primarily affecting lymphoid cells. 
   1. Most frequently diagnosed in children, but can also occur in adults. 
   2. Prompt treatment is crucial for achieving a favourable outcome.
2. Acute Myeloid Leukaemia (AML): A rapidly progressing leukaemia that affects myeloid cells. 
   1. Occurs in children and adults, with a higher incidence in older individuals. 
   2. Treatment approaches vary depending on various factors, including age and overall health.
3. Chronic Lymphocytic Leukaemia (CLL): An accumulation of mature lymphocytes characterises slow-growing leukaemia. 
   1. Primarily diagnosed in older adults, but can occasionally affect younger individuals. 
   2. Treatment options are influenced by the stage of the disease and the patient's overall health.
4. Chronic Myeloid Leukaemia (CML): leukaemia that typically progresses slowly, initially presenting with chronic phase symptoms.
   1. Involves a specific genetic mutation known as the Philadelphia chromosome. 
   2. Treatment options include targeted therapies and, in some cases, stem cell transplantation.

Leukaemia Stages

Leukemia is staged based on the extent of the disease and the progression of cancer cells. The staging system for leukaemia varies depending on the specific type of leukaemia. Here are the general stages for some common types:

1. Acute Lymphoblastic Leukemia (ALL):
   1. Stage 1: Cancer cells are primarily found in the bone marrow and blood.
   2. Stage 2: Cancer cells have spread to other organs such as the liver, spleen, and lymph nodes.
   3. Stage 3: Cancer cells have spread to the brain and spinal cord, known as central nervous system involvement.
   4. Stage 4: Cancer cells have spread to other body parts beyond the bone marrow and central nervous system.
2. Acute Myeloid Leukemia (AML):
   1. Stage 1: Cancer cells are found mainly in the bone marrow.
   2. Stage 2: Cancer cells have spread to the blood and other organs such as the liver, spleen, and lymph nodes.
   3. Stage 3: Cancer cells have infiltrated the central nervous system or other body parts.
   4. Stage 4: Cancer cells have spread extensively to multiple organs or tissues.
3. Chronic Lymphocytic Leukemia (CLL):
   1. Stage 0: The disease is characterized by abnormal blood cell counts but does not require immediate treatment.
   2. Stage I: Increased lymphocyte count in the blood, enlarged lymph nodes, and enlarged spleen or liver.
   3. Stage II: Increased lymphocyte count, enlarged lymph nodes, and enlarged spleen or liver, along with anaemia.
   4. Stage III: Increased lymphocyte count, enlarged lymph nodes, enlarged spleen or liver, and low platelet count.
   5. Stage IV: Advanced disease with decreased red blood cells, decreased platelets, and significant organ involvement.
4. Chronic Myeloid Leukemia (CML):
   1. Chronic Phase: The disease is stable, and the number of abnormal cells is relatively low.
   2. Accelerated Phase: The disease progresses more rapidly, and the number of abnormal cells increases.
   3. Blast Phase: The disease becomes aggressive, and there is a higher number of immature, abnormal cells.

The leukaemia symptoms differ depending on the type and stage of leukaemia. For example, someone with a chronic form of leukaemia may not have noticeable manifestations in the early stages. Here are some common leukaemia symptoms associated with leukemia:

1. Chills or fever
2. Fatigue, tiring quickly, and weakness that persists
3. Infections that occur frequently or are severe
4. Losing weight without making an effort
5. Lymph node swelling, liver or spleen enlargement
6. Easy bruising or bleeding
7. Repeated nosebleeds
8. Pale skin and shortness of breath
9. Petechiae: little red spots on the skin.
10. Sweating excessively, especially at night bone ache or tenderness
11. The appearance of tiny red spots on the skin 

The exact causes of leukemia are not fully understood, but several factors increase an individual's susceptibility to developing leukaemia. By understanding these factors, we can better assess and mitigate the risks.

Here are some known factors that can increase the risk of developing leukemia:

1. Genetic Factors: Certain genetic abnormalities or inherited conditions can increase the risk of developing leukemia.
   For example, individuals with Down syndrome have a higher risk of developing leukemia compared to the general population.
2. Exposure to Radiation: High levels of ionizing radiation, such as radiation therapy for cancer treatment or exposure to nuclear radiation, can increase the risk of developing leukemia.
3. Chemical Exposure: Certain chemicals, such as benzene and formaldehyde, have been thought to have an increased risk of leukaemia.
4. Environmental Triggers: External factors can also influence the development of leukaemia cancer.
   Exposure to certain substances and environmentally hazardous conditions can contribute to the risk. 
5. Smoking and Tobacco Use: Cigarettes have been known to be one of the potent causes of acute myelogenous leukaemia. 
6. Prior Cancer Treatments: People who have undergone chemotherapy or other forms of radiation to treat prior cancers are at a higher risk of leukaemia.
7. Family History: Those with a family history of leukaemia are at a higher probability of developing the disease. 
8. Myelodysplastic Syndromes: This refers to a bone marrow failure disorder that eventually leads to the development of leukaemia.

It is a bitter truth that nothing can guarantee the prevention of leukaemia cancer. However, to reduce the risk of developing leukaemia, one can involve a combination of the following preventive measures: 

1. Healthy Lifestyle Habits: Eating a healthy and balanced diet, making regular physical activities a part of the everyday routine, getting sufficient sleep, etc., are crucial elements in reducing the risk of leukaemia. 
2. Protect Yourself from Radiation: Minimize exposure to ionizing radiation whenever possible. Follow safety guidelines and precautions if you work in environments where radiation exposure is a concern. Limit unnecessary medical imaging tests that involve radiation, and discuss alternative options with your healthcare provider.
3. Avoid Exposure to Toxins: Certain chemicals and substances such as cigarette smoke, pesticides, and industrial pollutants can increase the risk of leukaemia. 
4. Vaccinations: Immunizations are an essential part of preventive healthcare. Vaccinations can help prevent certain infections, such as hepatitis B and human papillomavirus (HPV), which are associated with a potential risk of leukaemia.
5. Healthy Habits: Adopting healthy habits, such as practicing good hygiene, maintaining a clean environment, and practicing safe sex, can contribute to overall well-being and reduce the risk of leukaemia.
6. Regular Medical Check-Ups: Seeking regular medical check-ups and screenings allows for early detection of any potential health concerns.

In order to determine whether leukaemia is present, a number of examinations and tests must be performed. The typical tests used to identify leukaemia are listed below:

1. Physical Examination: A healthcare professional will perform a comprehensive physical examination to look for any leukemia-related symptoms or signs.
   
   They will look for any abnormalities, such as swollen lymph nodes, liver, or spleen.
2. Blood Tests: Leukaemia must be diagnosed via blood testing. 
   1. To assess the quantity and variety of blood cells, a complete blood count (CBC) will be carried out. 
   2. Unusual numbers of platelets, red blood cells, and white blood cells are frequently seen in leukaemia patients. 
   3. A blood smear can also be studied under a microscope to determine the size, shape, and colour of the blood cells.
3. Bone Marrow Biopsy: In a bone marrow biopsy, a tiny sample of bone marrow is removed from the sternum or hipbone. It is done under local anaesthesia.
   
   The sample is then inspected under a microscope to find any leukaemia cells present and to ascertain the kind and features of those cells.
4. Cytogenetic Analysis: To find any genetic anomalies or chromosomal rearrangements, cytogenetic analysis examines the chromosomes of leukaemia cells.
   
   Determining the particular type of leukaemia with the aid of this information can help with treatment choices.
5. Lumbar Puncture (Spinal Tap): The doctor may test a sample of spinal fluid to see if leukaemia has propagated to the spinal fluid associated with your brain and spinal cord.
6. Imaging Tests: In some cases, imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) may be performed to evaluate the extent of the disease and check for any complications.

How to Prepare for Doctor’s Consultation? 

leukaemia is a serious condition, and immediate examination and treatment are a must to ensure the control and management of the problem.

The first step towards diagnosis is the doctor checking the patient's overall health and the normal functioning of their vital organs.

There are some things that the patient must keep in mind to prepare for the doctor’s consultation appointment. These include:

1. Taking a prior appointment
2. Enlisting symptoms
3. Writing down personal information, including medical history
4. Making a list of questions for the doctor

What to Expect from the Doctor?

The doctor will ask the person some questions that will allow them a proper diagnosis of the problem. Some of the most common questions include : 

1. The duration for which a person has been experiencing the symptoms
2. The frequency and severity of the symptoms 
3. Things that provide relief in the symptoms
4. Things that worsen the symptoms 

Questions the Patient Can Ask?

A person experiencing unexpected symptoms in their body will certainly have a set of doubts or questions. It is only wise for them to speak with their healthcare provider about the same and clear their doubts and confusions.
The questions they must ask include : 

1. What are the possible causes of this condition? 
2. What tests would I need to undergo?
3. Which is the best treatment for my condition?
4. Are there any risks involved in the recommended treatment approach?
5. What is the survival rate of this condition?
6. How successful is this treatment method to treat my condition?
7. What dietary and lifestyle changes should I make to prevent this condition? 
8. Talk about their next follow-up visit and the alternative to prescribed medicines

leukaemia treatment is determined by the type of leukaemia, age, and overall health, and whether or not leukaemia has spread to other organs or tissues.

Treatments are usually a combination of the following:

1. Chemotherapy: Chemotherapy is the most commonly opted for leukaemia treatment. It entails using chemicals to either kill or prevent leukaemia cells from multiplying.
   
   During treatment, the chemicals (medication) may be administered as a pill, an injection into a vein, or a shot under the skin. Typically, the patient will be given a combination of chemotherapy drugs.
2. Targeted Therapy: This treatment relies on drugs that are designed to target specific parts of a leukaemia cell (such as a protein or gene) that are causing it to overtake normal blood cells. 
   1. Targeted therapies may prevent leukaemia cells from multiplying, stop their blood supply, or kill them directly. 
   2. Targeted therapy is less likely to harm healthy cells. Monoclonal antibodies and tyrosine kinase inhibitors (TKI) are two examples of targeted therapy drugs.
3. Biologic Therapy: Immunotherapy is a type of biological therapy. This treatment employs specific drugs to boost the body's defense system to combat leukaemia.
   
   Immunotherapy assists the immune system in recognizing cancer cells and producing more immune cells to fight them.
4. Chimeric Antigen Receptor (CAR) T-cell Therapy: This novel therapy engineers the body's infection-fighting T-cells (T-cell or T-lymphocyte is a type of immune cell) to fight leukaemia cells and reintroduce them into the body.
5. Radiation Treatment: This treatment relies on high-energy beams or X-rays to determine whether it kills or stops the growth of leukaemia cells. 
   1. During treatment, a machine either directs radiation to the exact locations in the body where the cancer cells are located or distributes radiation throughout the entire body. 
   2. Radiation may be administered throughout the body before a hematopoietic cell transplant.
6. Hematopoietic Cell Transplantation: This treatment replaces the cancerous blood-forming cells killed by chemotherapy and/or radiation therapy with new, healthy hematopoietic cells. 
   1. These healthy cells may be extracted from the blood or bone marrow before chemo and radiation or from a donor. 
   2. The healthy new cells multiply, forming new bone marrow and blood cells that become the red blood cells(RBCs), white blood cells (WBCs), and platelets the body requires.

Cost of Leukaemia Treatment

The cost of leukaemia treatment in India ranges from several factors including the type and stage of leukaemia, type of treatment approach, age of the patient, type, and location of the hospital, and expertise of the treating doctor.

The table below shows the cost of different leukaemia treatment options:

Leukemia, like any other serious medical condition, carries certain risks and potential complications.

The specific risks and complications associated with leukemia can vary depending on factors such as the type and stage of the disease, the overall health of the individual, and the treatment approach. 

Here are some common risks and complications associated with leukemia:

1. Complications of Bone Marrow and Blood: leukaemia disrupts the normal production of blood cells, leading to anemia, thrombocytopenia (low platelet count), and compromised immunity.
2. Complications of Lymphatic System: The lymph nodes, spleen, and other components of the lymphatic system may become enlarged due to leukaemia, causing discomfort and potential complications.
3. Complications of Central Nervous System: In some cases, leukaemia cells infiltrate the central nervous system.
   
   This lead to neurological symptoms, such as headaches, seizures, and cognitive changes.
4. Complications of Liver and Kidneys: leukaemia can affect these vital organs, impair function, and potential complications.
5. Complications of Heart and Lungs: Certain types of leukaemia can impact the cardiovascular and respiratory systems, resulting in cardiovascular abnormalities or respiratory difficulties.

Risk of Leukaemia if Left Untreated

Delaying leukaemia can seriously affect health and quality of life. Awareness of the potential hazards and problems associated with untreated leukaemia is vital. Here are some significant complications of leukaemia if left untreated:

1. Disease Growth: Untreated leukaemia will progress swiftly, resulting in the worst symptoms and complications.
   
   Cancerous cells can continue to increase, invading and affecting the function of many organs.
2. Increased Risk of Infections: leukaemia weakens the immune system, making individuals more susceptible to infections which can be severe or life-threatening.
3. Haemorrhage and Bleeding: Untreated leukaemia can lead to severe bleeding and haemorrhage due to low platelet counts and impaired clotting function.
   
   Uncontrolled bleeding can be life-threatening and require immediate medical intervention.
4. Organ Dysfunction: leukaemia if left untreated can affect multiple organs, leading to organ dysfunction.
   
   Compromised organ function can profoundly impact overall health and quality of life.
5. Reduced Treatment Options: Delaying or avoiding treatment can limit the effectiveness of available treatment options.
   
   The disease may progress to an advanced stage, making it more challenging to achieve remission or cure.

When to See a Doctor?

Prioritizing health first and seeking medical help if one experiences any concerning symptoms is essential. leukaemia is a severe medical condition that requires prompt attention from healthcare professionals.

Here are some alarming signs that should prompt one to see a doctor without delay:

1. Unexplained weight loss
2. Bleeding or bruising 
3. Fever or chills
4. Nose bleeding 
5. Fatigue and weakness, etc

Just like any other health condition, the right diet and routine are sure to play a crucial role in improving the overall health of a person. There are certain foods that a person must consume and some foods that a person must not consume.

The ideal diet for a leukaemia patient consists of the following: 

Food Items to Eat

1. Foods rich in protein: soy, milk, eggs, tofu, fish, etc.
2. Foods rich in healthy fats:  seeds, nuts, oils, avocado, olives
3. Foods rich in carbohydrates: oatmeal, millet, barley, rice, sweet potatoes
4. Drink plenty of water and other hydrating fluids

Foods to Avoid

1. Raw bean sprouts
2. Foods with expiry dates
3. Undercooked meat, fish, poultry
4. Unwashed fruits and vegetables 

In conclusion, leukaemia is a complex and serious condition that affects the blood and bone marrow. It is important to understand the stages, symptoms, causes, prevention, diagnosis, and risks associated with leukaemia.

Early detection and prompt medical intervention are crucial for improving outcomes and increasing the chances of successful treatment.

At HexaHealth, we help you not just find the root causes of health problems but also with the diagnosis and treatment of the same. Our medical experts are available round the clock to clear yours.

To learn more about what certain symptoms mean and how they can be treated, and which doctors are best for a particular problem, contact us at HexaHealth today. 

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