Blood cancer medically known as leukemia is a type of cancer, related to the blood and bone marrow. There are several categories of blood cells including red blood cells (RBCs), white blood cells (WBCs), and platelets, leukemia is related to the cancer of WBC and rarely red blood cells and platelets in their premature form. It can affect any age. There are two types of leukemia – acute and chronic leukemia. In acute leukemia, the situation develops and worsens rapidly, while in chronic leukemia, the situation worsens over a period of time. There are different treatment options for leukemia but the treatment modality is decided based on the type of leukemia the patient has.
When the DNA of white blood cells incur damage, leukemia develops. The cancerous cells grow in bone marrow, which is the normal site of blood production after infancy. This results in the poor production of healthy blood cells due to the replacement of the marrow with the cancerous cells. These new cells are not just unhealthy but also abnormal and they live longer than normal cells and have unlimited proliferating ability. These cells build and occupy space in the bone marrow to prevent healthy blood cells from growing and functioning normally. This results in cancerous cells outnumbering the healthy cells in the blood. The exact cause of leukemia is still unknown. Several factors have been identified which can increase the risk of leukemia. These include:
- A family history of leukemia
- Smoking, which increases your risk of developing acute myeloid leukemia (AML)
- Genetic disorders such as Down syndrome, Fanconi’s anaemia
- Blood disorders, such as myelodysplastic syndrome, which is sometimes called “preleukemia”
- Previous treatment for cancer with chemotherapy or radiation therapy
- Exposure to high levels of radiation
- Exposure to chemicals such as benzene
Symptoms arise depending on which blood cell production is affected and the rapid multiplication of cancerous cells.
Platelets play an important function in blood clotting. Due to marrow replacement, platelet production is affected. In some, the function of the platelet is also altered. This results in easy bruises or bleeds. In the form of small red & purple spots on the body called petechae or echymosis.
- Frequent infections
One of the important functions of white blood cells is to protect the body from infections. At times, when the WBCs fail to function properly and are inadequate in number, one can easily get affected by infections. Simple infections in a normal person can become life-threatening in a leukemic patient. They have a fever, chills, rigors, redness in the site of infection, cough, or any other symptom depending on which organ is affected.
Due to the lack of RBCs, a person can become anemic. Low RBCs means that there is a lack of hemoglobin in the blood. As hemoglobin transports iron around the body, any shortage in iron can result in the following symptoms:
- Difficulty in breathing
- Pale skin
Sometimes, there can be a spontaneous breakdown of RBCs in the body leading to jaundice.
All these symptoms can be a result of other illnesses too. Consultation and testing are necessary to confirm whether it is leukemia.
- Bony and joint pains
This is one of the common symptoms that can be mistaken for Rheumatoid Arthritis. Severe pain in bones, joint pain, and swelling are commonly seen. This is due to the rapid multiplication of leukemic cells in the bone marrow.
Due to leukemic cell infiltration, there may be gum swelling, bleeding, painless lymph node swelling, increasing size of liver, spleen, headache, seizures, difficulty in breathing, jaundice, etc.
The treatment for leukemia depends on the person’s age, health and the type of leukemia the person has. The most preferred treatment modality for leukemia is chemotherapy. If administered at an early stage, the chances of a person achieving remission are higher.
Following are the types of treatment for Leukemia:
In chemotherapy, IV medications are administered either by using a drip. In acute leukemia, due to repeated investigations and injections, a central line is placed. These have long term utility and avoid repeated pricks to the patient. Although chemotherapy medications target and kill cancer cells, they also impact other non-cancerous cells leading to severe side effects like hair loss, weight loss and nausea, decrease in blood cell counts. However, these effects are temporary and have complete recovery. There are various chemotherapy regimens depending on the type of leukemia. In children, 90% of acute lymphoblastic leukemia and 70% of acute myeloid leukemia are cured with chemotherapy alone.
- Targeted therapy
In targeted therapies, the doctors administer drugs to target the cancerous cells. These medications only target the cancerous cells without affecting the other cells, thus reducing the possible side effects. Rituximab, Imatinib, Dasatinib, and Nilotinib are some of the medications used under targeted therapy. One study found that people who received treatment with Imatinib had a 5-year survival rate of around 90%.
- Interferon therapy
Interferons are a family of naturally-occurring proteins that are made and secreted by cells of the immune system. Interferons modulate the response of the immune system to viruses, bacteria, cancer, and other foreign substances that invade the body. This therapy acts as a deterrent to the growth of leukemia cells and eventually stops their development. Although helpful in curing leukemia, this therapy has severe side-effects.
This type of treatment is recommended for adults and some children above 3 years who have acute lymphocytic leukemia (ALL).
- Stem cell transplantation
In this procedure, the existing bone marrow is destroyed by either chemotherapy, radiation therapy, or both. This is done so that new stem cells can be infused in the bone marrow to generate non-cancerous cells. Stem cell transplantation is an effective choice of treatment for people with high-risk leukemia and for those whose leukemia recurs early, despite chemotherapy. The latter conditions are fatal if treated with chemotherapy alone.
When a patient is diagnosed with blood cancer, their outlook towards the disease makes a big difference. Having a caring family, friends, and relatives who give emotional, mental, physical, and financial support greatly benefits the patients. With increasing advancements in technology, innovations are being developed that’ll present a ray of hope to all the cancer patients around the world. Advancement in supportive care has made cancer therapy less painful.