Leukemia: symptoms, causes, and treatment

Definition

What is leukemia?

Leukemia is a disease that occurs when cancer cells are found in the blood and bone marrow. This condition is caused by the production of abnormal or too many white blood cells. Therefore, this disease is also often referred to as white blood cell cancer.

These abnormal cells block the work of white blood cells to fight infection and damage the bone marrow's ability to produce red blood cells and platelets that the body needs. This can cause serious problems in the body, such as anemia, bleeding, and infection.

In fact, leukemia cells can also spread to lymph nodes or other organs, causing swelling or pain in certain areas of the body.

Some leukemia patients still recover. However, in certain conditions, leukemia can be difficult to cure, so the treatment given is only to control the disease and prolong the patient's life expectancy.

How common is leukemia?

Leukemia is one of three common types of blood cancer. There are two other types of blood cancer, namely lymphoma and multiple myeloma.

This white blood cell cancer is most often found in the elderly, namely aged 65-74 years. However, leukemia in children can occur. In fact, this disease is a type of cancer that most often occurs in children.

In Indonesia, leukemia occupies the 9th position with the highest number of cancer cases. Based on 2018 Globocan data, the number of new leukemia cases reached 13,498 with the number of deaths reaching 11,314 cases.

You can still prevent this disease by avoiding various risk factors for it. Ask your doctor to find out more about this disease.

Types

Types of leukemia

Leukemia can develop quickly or slowly. Cancer cells that develop slowly are called chronic leukemia, while those that develop rapidly are called acute leukemia.

Apart from the progression of the disease, this disease is subdivided based on the type of white blood cells affected by cancer. Based on these two things, here are the four main types of leukemia:

• Acute lymphoblastic leukemia: Occurs when the bone marrow produces too many white blood cells, abnormal lymphocytes that are immature (mature) or called lymphoblasts. This type is what often occurs in children.
• Acute myeloid leukemia: Occurs when the bone marrow produces too many abnormal myeloid white blood cells that are not yet mature (mature) or are called myeloblasts.
• Chronic lymphocytic leukemia: Cancer cells involving mature or mature lymphocytes.
• Chronic myeloid leukemia: Cancer cells involving mature myeloid cells.

Apart from the common types, there are also other types that are rare, such as hairy cell leukemia, praleukemia or myelodysplastic syndromes (MDS), or myeloproliferative disorders .

Signs & symptoms

Signs and symptoms of leukemia

Leukemia symptoms can vary, depending on the type you are experiencing. However, in general, the signs or symptoms of this disease are:

• Fever, chills, or excessive sweating at night.
• Fatigue and feeling weak.
• Headache.
• Frequent infections or having severe infections.
• Unexplained drastic weight loss.
• Bleeding or bruising easily.
• Repeated nosebleeds.
• Small red spots on the skin.
• Bone or joint pain.
• Pale skin.
• Swollen lymph nodes in the neck, armpits, groin, or stomach (due to an enlarged spleen or liver).

Symptoms of leukemia in children are generally the same as those in adults mentioned above.

If you have concerns about certain symptoms, do not hesitate to consult a doctor.

When to see a doctor?

The symptoms above do look like a common disease that often occurs, namely the flu. However, you should immediately see a doctor if you feel the symptoms above, especially if the condition continues to occur repeatedly.

If the disease is found early, the chances of a cure will be greater. Always consult a doctor to treat your health condition.

Causes & risk factors

Causes of leukemia

In general, the cause of leukemia is a change or mutation of DNA in blood cells, or other white blood cell disorders. This disorder causes blood cells to grow abnormally and uncontrollably. These abnormal cells will continue to live and develop when normal cells die.

Until now, the cause of this is unknown. However, researchers suspect several factors can increase the risk of developing this disease.

Factors that can increase the risk of leukemia

Several factors are said to increase a person's risk of developing this disease. These factors, namely:

• Have had cancer treatment, such as chemotherapy or radiation therapy.
• Certain genetic disorders, such as down syndrome.
• Being exposed to certain chemicals, such as benzene.
• Smoking habit.
• Family history of leukemia.

Having one or more of the risk factors above does not necessarily mean that you will get this disease. Conversely, someone who has leukemia may have other risk factors that are not mentioned above or are not known.

Diagnosis & staging

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How to diagnose leukemia

The first step in diagnosing leukemia is that the doctor will ask you about your symptoms, how long they have been experiencing, and your overall medical condition.

After that the doctor will perform a physical examination to look for other signs, such as pale skin, swollen lymph nodes, or enlarged liver and spleen.

If you are suspected of having leukemia, you may undergo a series of examinations or tests. Some of the tests you may need to undergo include:

• Blood test

Blood tests that are commonly done, namely complete blood count or complete blood count (CBC). This test shows the condition in detail about the blood cells you have. A person with white blood cell cancer generally has a lower number of red blood cells and platelets and more white blood cells.

• Bone marrow test

A bone marrow aspiration or test or biopsy is done by taking a sample of bone marrow cells from your hip bone, using a long, thin needle. The sample will then be sent to a laboratory to be checked for cancer cells in it.

• Imaging test

The two tests above are the main tests for leukemia. However, your doctor may also ask you to do imaging tests, such as a chest X-ray, CT scan, or MRI, as a supporting examination, especially if you have symptoms related to complications of leukemia.

The type of examination or test that will be performed depends on the condition of each patient. Consult your doctor for the right type of examination.

Determine the stage of leukemia

The stage or stage of leukemia means how far your chronic leukemia has progressed. Your doctor can find out this from the results of tests or diagnosis of leukemia that you are undergoing. Knowing this stage can help your doctor determine the right type of treatment for you.

Reporting from the Moffitt Cancer Center, the stages of chronic leukemia stage can be explained using the Rai system. Here's the explanation:

• Stage 0: the patient has a high level of white blood cells, but has no specific physical symptoms.
• Stage 1: the patient has high levels of white blood cells and enlarged lymph nodes.
• Stage 2: the patient has high levels of white blood cells and develops symptoms of anemia. The patient may also experience swollen lymph nodes.
• Stage 3: the patient has high levels of white blood cells and is anemic. He may also have enlarged lymph nodes and / or an enlarged liver or spleen.
• Stage 4: the patient has low levels of white blood cells and platelets. He may also have anemia, enlarged lymph nodes and liver or spleen.

Treatment

Types of treatment for leukemia

Treatment for leukemia is determined based on your age, overall health condition, type, and the development or spread of cancer cells in your body. However, some common treatments for this disease are:

• Chemotherapy

Using drugs to kill cancer cells that are taken orally or through a vein injection.

• Biological therapy

Medications that help strengthen the immune system to fight cancer cells.

• Target therapy

Using drugs to specifically attack cancer cells.

• Radiation therapy

Uses high levels of radiation to damage and inhibit the growth of cancer cells.

• Transplant stem cells

A procedure to replace diseased bone marrow with healthy bone marrow.

Always consult with your doctor which type of treatment is most appropriate for your condition.

Home care

What are some lifestyle changes or home treatments that can be made to help treat leukemia?

Apart from undergoing medical treatment, you need to make lifestyle changes and home remedies that can help you deal with this disease. Here are home leukemia treatments that you can do:

• Eat a balanced nutritious diet, including eating lots of vegetables and fruits and avoiding high-fat foods.
• Stay active with regular light exercise.
• Maintain ideal body weight.
• Quit smoking and alcoholic beverages.
• Manage stress.
• Seek support from people closest to you.

Prevention

How to prevent leukemia

The cause of this disease is still unclear. However, you can still prevent leukemia by avoiding various risk factors that cause it, such as:

• Avoid exposure to chemicals, such as benzene.
• Avoid unnecessary X-ray radiation.
• Avoid smoking or quit smoking.
• Immediately see a doctor if you feel certain changes or symptoms in the body.
• Maintain ideal body weight.
• Stay active.
• Eat a balanced nutritious diet.

If you have any questions, please consult a doctor to better understand and find the best solution for you.