Leukemia: Causes, Symptoms, Diagnosis and Treatment

Leukemia or also called blood cancer is a condition in which the body produces more white blood cells than normal so that it interferes with the body’s function in fighting infection. Leukemia becomes dangerous because the excessive amount of white blood cells in the flow makes the production of other blood cells disrupted.

Causes of Leukemia

Until now the cause of leukemia is not known with certainty. The cause of leukemia is from internal and external factors of the body. The causes of leukemia internally are from chromosomal abnormalities, pollution exposure, radiation exposure, and smoking.

In addition, other changes in white blood cells due to gene and environmental factors are also thought to contribute to leukemia or blood cancer. While external factors causing leukemia are including exposure to radiation, pollution, or certain dangerous chemicals.

Leukemia Symptoms

Keep in mind, people with leukemia are susceptible to bruising, bleeding, and infections. Leukemia is a serious disease. Therefore anyone must be aware of leukemia.

Because the buildup of white blood cells occurs in the bloodstream, these abnormal cells can also spread to other organs, such as the liver, lymph, lungs, kidneys, even to the brain and spine.

This disease does not provide typical symptoms at an early stage. The following symptoms of leukemia that can appear, include:

  • Anemia and related symptoms such as fatigue or pale lips.
  • The tendency to bruise or bleed easily, including bleeding from the gums and nose, or blood in the stool or urine can be a symptom.
  • Susceptible to infections such as sore throat or bronchial pneumonia, which can be accompanied by headaches, mild fever, canker sores, or skin rashes.
  • Swollen lymph nodes, usually in the throat, armpits, or groin.
  • Loss of appetite and weight gain is also a sign of leukemia.
  • Discomfort under the lower left rib (caused by a swollen spleen).
  • Very high white blood cell counts can cause vision problems such as retinal bleeding, ringing in the ears (tinnitus), mental disorders, prolonged erection (priapismus), stroke, or seizures due to bleeding in the brain.

Leukemia Diagnosis

Doctors can find chronic leukemia in blood tests done even before symptoms appear. If this happens, or if you have signs or symptoms that indicate leukemia, a number of tests can be performed such as:

1. Physical examination

The doctor will look for physical signs of leukemia, such as pale skin due to anemia, swollen lymph nodes, enlarged liver and spleen.

2. Blood Test

By looking at blood samples, your doctor can determine whether you have abnormal levels of red blood cells or platelets – which may indicate leukemia.

3. Bone Marrow Test

The doctor may recommend this procedure to take bone marrow samples from the hip bones. Bone marrow is taken using a long and thin needle. Samples are sent to the laboratory to look for leukemia cells. Specific tests on leukemia cells can also reveal certain characteristics that are used to determine treatment options.

Leukemia Treatment

The goal of treatment for blood cancer or leukemia is to destroy leukemia cells and allow normal blood cells to be formed in the bone marrow. Leukemia treatment decisions are based on the type of leukemia that is owned, the stage of the disease, age and general health conditions.

Types of Leukemia and Treatment

The type of leukemia itself is seen through microscopic examination of bone marrow, whether lymphoblastic or myeloblastic leukemia. This examination can also determine whether leukemia sufferers fall into the acute or chronic category.

1. Acute lymphoblastic leukemia

How to treat acute lymphoblastic leukemia has 3 steps consisting of induction, consolidation, and maintenance.

  • Leukemia induction therapy is the stage to kill leukemia cells in the blood and bone marrow. Treatment at this stage includes chemotherapy and corticosteroids. Induction usually lasts 4 weeks and is carried out in a hospital. But some patients have leukemia cells with certain gene changes. This gene is called the Philadelphia chromosome. Patients with these genes will be given tyrosine kinase inhibitors.
  • How to treat leukemia is by consolidation therapy to kill leukemia cells that may still be left. If the cells are left, these cells can grow back and can recur. Treatment includes chemotherapy and possibly bone marrow transplantation. Consolidation usually takes several months but does not require hospitalization.
  • Leukemia maintenance therapy is a treatment that prevents the remaining leukemia cells from growing. This can be done using chemotherapy doses lower than those used during induction or consolidation. Chemotherapy is given with oral medication and intravenous injection (IV). Maintenance therapy is carried out for 3 years in a row, but so far, most leukemia patients have a relapse while on maintenance therapy.

2. Acute myeloblastic leukemia

Treatment of acute myeloblastic leukemia (AML) is based on the genetic makeup of normal myeloid cells. The treatment plan usually has 2 steps which include remission induction and post-remission therapy.

  • Remission induction therapy is a common leukemical treatment using chemotherapy, where this therapy is to kill cancer cells in the blood and bone marrow. Chemotherapy is given to patients by means of intravenous (IV) injection treatment. This therapy usually lasts 3 to 5 weeks. Remission induction therapy usually requires hospitalization.
  • Post-remission therapy is done to kill leukemia cells that may be present even if they are not detected. This therapy can be in the form of additional chemotherapy or bone marrow transplantation. Chemotherapy can be given to patients in the hospital for several days each month and the process is usually carried out for 3 to 4 months.

There is a subtype of AML called acute promyelocytic leukemia, so patients or leukemia patients get other drugs, such as arsenic trioxide and all-trans retinoic acid (ATRA) drugs. Stem cell transplantation and chemotherapy are also used when leukemia does not respond to treatment or if AML recurs.

3. Chronic lymphocytic leukemia

The following are choices of chronic lymphocytic leukemia drugs, including:

  • Chemotherapy therapy. By giving special drugs, either by injection or by drinking, where the drugs used to function to kill cancer cells. The drugs given are generally in the form of a single drug, such as chlorambucil or fludarabine, or in the form of a combination drug.
  • Targeted drug therapy. This therapy is the same as chemotherapy, which if using this method is done by giving drugs. However, the drugs given in targeted drug therapy function to inhibit proteins used by cancer cells to survive and develop. Examples of drugs used in this therapy are rituximab.
  • Bone marrow transplantation. This therapy uses the method of replacing damaged bone marrow cells with healthy bone marrow from the donor. Before this method is done, chemotherapy will be done first, 1 or 2 weeks before the transplant.

In addition, patients also need to be alert and check for signs of infection, such as pneumonia (lung infection) or fungal infections. Early treatment will help patients survive longer. Leukemia drugs are adjusted to the severity of the leukemia suffered by the patient.

4. Chronic myeloblastic leukemia

Chronic myelogenous leukemia (CML) needs to be treated immediately. The most common leukemia drug choices for this type of disease include:

  • Targeted drug therapy with ityrosine kinase inhibitors. This is the first treatment used for CML.
  • Bone marrow transplantation. Before a transplant can be done, chemotherapy or radiation is used to destroy bone marrow activity.

For people newly diagnosed in the early stages of CML (chronic phase), tyrosine kinase inhibitors can work for years. If the patient does not show recurrence, the patient does not need to do a bone marrow transplant. But if the patient relapses, the patient should do a bone marrow transplant.

While for people who are diagnosed with CML at a later stage (the acceleration phase or blast crisis phase), treatment may involve chemotherapy or tyrosine kinase inhibitors prior to a bone marrow transplant to increase the likelihood of successful bone marrow transplant surgery.

Leukemia Prevention

Until now, there are no preventive steps that can definitely prevent cancer. If you experience leukemia symptoms consult your doctor immediately. Here are some efforts that can be done to prevent blood cancer, including:

1. Avoid smoking

Smoking is a strong risk factor for acute myeloblastic leukemia. In addition, smoking during pregnancy or even exposure to cigarette smoke during pregnancy can increase the risk of leukemia in children.

Tobacco smoke contains many toxic chemicals, including benzene and formaldehyde. If these chemicals are inhaled into the lungs, these substances can easily enter the bloodstream.

2. Maintain Ideal Body Weight

Numerous studies show that being overweight or obese is associated with an increased risk of acute myelogenous leukemia (AML). If the body mass index shows 30 or more, it risks increasing leukemia compared to normal weight people.

3. Limiting exposure to chemical substances

Sources of exposure around the environment usually come from insecticides, vehicle fumes and plant pesticides. In addition, limiting exposure to radiation originating from X-rays, CT scans, and similar devices also needs to be done.

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