Leukemia types, Treatment & Symptoms

There are four main categories of leukemia:

• acute
• chronic
• lymphocytic
• myelogenous

Chronic and acute leukemias

During its lifespan, a white blood cell goes through several stages.

In acute leukemia, developing cells multiply quickly and collect in the marrow and blood. They exit the bone marrow too early and are not functional.

Chronic leukemia progresses more slowly. It allows for the production of more mature, useful cells.

Acute leukemia overcrowds the healthy blood cells more quickly than chronic leukemia.

Lymphocytic and myelogenous leukemias

Doctors classify leukemia according to the type of blood cell they affect.

Lymphocytic leukemia occurs if cancerous changes affect the type of bone marrow that makes lymphocytes. A lymphocyte is a white blood cell that plays a role in the immune system.

Myelogenous leukemia happens when the changes affect bone marrow cells that produce blood cells, rather than the blood cells themselves.

Acute lymphocytic leukemia

Children under 5 years old are at the highest risk of developing acute lymphoblastic leukemia (ALL). However, it can also affect adults, typically over the age of 50 years. Out of every five deaths from ALL, four occur in adults.

Chronic lymphocytic leukemia

This is most common among adults over 55 years, but younger adults can also develop it. About 25% of adults with leukemia have chronic lymphocytic leukemia (CLL). It is more common in men than in women and rarely affects children.

Acute myelogenous leukemia

Acute myelogenous leukemia (AML) is more common in adults than in children, but overall, it is a rare cancer. It develops more often in men than in women.

It develops quickly, and symptoms include fever, difficulty breathing, and pain in the joints. Environmental factors can trigger this type.

Chronic myeloid leukemia

Chronic myelogenous leukemia (CML) mostly develops in adults. About 15% of all leukemia cases in the United States are CML. Children rarely develop this type of leukemia.

Treatment

Treatment options will depend on the type of leukemia a person has, their age, and their overall state of health.

The primary treatment for leukemia is chemotherapy. A cancer care team will tailor this to suit the type of leukemia.

If treatment starts early, the chance of a person achieving remission is higher.

Types of treatment include:

Watchful waiting: A doctor may not actively treat slower growing leukemias, such as chronic lymphocytic leukemia (CLL).

Chemotherapy: A doctor administers medications intravenously (IV), using either a drip or a needle. These target and kill cancer cells. However, they can also damage noncancerous cells and cause severe side effects, including hair loss, weight loss, and nausea.

Chemotherapy is the primary treatment for AML. Sometimes, doctors may recommend a bone marrow transplant.

Targeted therapy: This type of treatment uses tyrosine kinase inhibitors that target cancer cells without affecting other cells, reducing the risk of side effects. Examples include imatinib, dasatinib, and nilotinib.

Many people with CML have a gene mutation that responds to imatinib. One study found that people who received treatment with imatinib had a 5-year survival rate of around 90%.

Interferon therapy: This slows and eventually stops the development and spread of leukemia cells. This drug acts in a similar way to substances that the immune system naturally produces. However, it can cause severe side effects.

Radiation therapy: In people with certain types of leukemia, such as ALL, doctors recommend radiation therapy to destroy bone marrow tissue before a transplant.

Surgery: Surgery often involves removing the spleen, but this depends on the type of leukemia a person has.

Stem cell transplantation: In this procedure, a cancer care team destroys the existing bone marrow with chemotherapy, radiation therapy, or both. Then, they infuse new stem cells into the bone marrow to create noncancerous blood cells.

This procedure can be effective in treating CML. Younger people with leukemia are more likely to undergo a successful transplant than older adults.

Symptoms

Symptoms of leukemia include the following:

Poor blood clotting: This can cause a person to bruise or bleed easily and heal slowly. They may also develop petechiae, which are small red and purple spots on the body. These indicate that blood is not clotting properly.

Petechiae develop when immature white blood cells crowd out platelets, which are crucial for blood clotting.

Frequent infections: The white blood cells are crucial for countering infection. If white blood cells are not working correctly, a person may develop frequent infections. The immune system may attack the body’s own cells.

Anaemia: As fewer effective red blood cells become available, a person may become anemic. This means that they do not have enough hemoglobin in their blood. Hemoglobin transports iron around the body. A shortage of iron can lead to difficult or labored breathing and pale skin.

Other symptoms may include:

• nausea
• fever
• chills
• night sweats
• flu-like symptoms
• weight loss
• bone pain
• tiredness

If the liver or spleen becomes swollen, a person may feel full and eat less, resulting in weight loss.

Weight loss may also occur even without an enlarged liver or spleen. A headache may indicate that cancerous cells have entered the central nervous system (CNS).

However, all these can all be symptoms of other illnesses. Consultation and testing are necessary to confirm a diagnosis of leukemia.