Leukemia is a blood-related cancer that originates in the bone marrow. It results from an acquired genetic injury to the DNA of a single cell. When leukemia develops, the body produces large numbers of abnormal blood cells, usually white blood cells. These malignant, multiplying cells interfere with the body's production of healthy blood cells and can make the body unable to shield itself against infection. Major forms of leukemia are myelogenous and lymphocytic. Each of these types has an acute and chronic form. Acute leukemia is a rapidly progressing disease that affects mostly immature cells, while chronic leukemia progresses slowly and allows developed cells to grow. Major forms of leukemia are:
- Acute Myelogenous Leukemia (AML) - caused by the uncontrolled, exaggerated growth and accumulation of cells called "leukemic blasts," or "myeloblasts," which do not function as normal blood cells. The occurrence of AML increases dramatically among people over the age of 40.
- Acute Lymphocytic Leukemia (ALL) - caused by too many under-developed infection-fighting white blood cells, called lymphoblasts in the blood and bone marrow. ALL occurs at all ages, but is the most common form of leukemia in children and the most common kind of pediatric cancer.
- Chronic Myelogenous Leukemia (CML) - distinguishable from other leukemias by the presence of a genetic abnormality in blood cells, called the Philadelphia chromosome.
- Chronic Lymphocytic Leukemia (CLL) - also caused by an uncontrolled growth of lymphocytic cells in the marrow; however, these cells do not impede normal blood cell production as profoundly.
- Hairy Cell Leukemia - is a slow-growing malignant disorder that affects white blood cells. It is called hairy cell leukemia because the diseased cells have short, thin protrusions on their surface, which resemble hair when observed under a microscope.
- Myelodysplastic Syndrome (MDS) - is a disease originating, like leukemias, in a single bone marrow cell. The affected cells lose, to various degrees, their ability to produce mature blood cells. In some cases, the disease progresses into acute leukemia within months or years. It is most common after the age of 60.
Facts about leukemia
- Leukemia affects about 27,000 adults and more than 2,000 children in the United States every year.
- About 10,600 new cases of acute myelogenous leukemia are diagnosed each year in the United States.
- About 3,800 new cases of acute lymphocytic leukemia are diagnosed annually in the United States. This type of leukemia is the most common type for people under the age of 15.
- About 4,400 new cases of chronic myelogenous leukemia are diagnosed each year in the United States.
- Nearly 7,000 people in the United States learn they have chronic lymphocytic leukemia annually.
- More than 12,000 new myelodysplastic syndrome cases are diagnosed each year in the U.S. Technologies used in the treatment of leukemia include chemotherapy, radiation therapy, bone marrow transplantation, and biological therapy.
What treatment is available at MD Anderson Cancer Center Orlando?
Each type of leukemia has its own specific course of treatment.
Chemotherapy is the use of medications to kill cancerous cells. It may be administered to a patient through a vein (intravenously), into the muscle (intramuscular) or by mouth. The benefit of chemotherapy is that it is a systemic type of treatment, meaning it can kill cancerous cells that have traveled to other parts of the body but have not been detected.
Chemotherapy also can be placed directly into the fluid around the brain and spinal cord through a tube inserted into the brain or back. This is called intrathecal chemotherapy and is used to reach cancerous cells in the central nervous system. The intensity of chemotherapy and the use of various agents vary greatly depending on the particular disease category.
Radiation therapy uses targeted radiation to kill and shrink cancerous cells. External radiation (using a machine outside the body) is usually used to treat leukemia patients.
Bone marrow transplantation is used to replace a patient's bone marrow with healthy bone marrow. To accomplish this, all bone marrow in the body is destroyed with high doses of chemotherapy, sometimes also using radiation therapy. Healthy marrow is then taken from another person (a donor) whose tissue is the same as or almost the same as the patient.
The donor may be a twin (the best match), brother or sister, or another person not related. The healthy marrow from the donor is given to the patient through a needle in the vein, and the new marrow replaces marrow that was destroyed. A bone marrow transplant using marrow from a relative or person not related to the patient is called an allogeneic bone marrow transplant.
Another type of bone marrow transplant is called autologous. In this type of transplant, a portion of the patient's marrow is removed and treated with medications to kill any cancer cells. This marrow is then frozen while the patient is given high doses of chemotherapy to kill any remaining bone marrow. The frozen marrow is then thawed and given to the patient through a needle in a vein to replace the marrow that was destroyed.
Biotherapy (using the body's immune system to fight cancer) is developed by using either vaccines or antibodies against specific markers on the cancer cells. Generally, it is not associated with the traditional side effects of chemotherapy.
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