Leukemia — Part 1
What is leukemia?
Leukemia is a type of cancer. Cancer is a group of many related diseases.
All cancers begin in cells, which make up blood and other tissues. Normally,
cells grow and divide to form new cells as the body needs them. When cells
grow old, they die and new cells take their place. Sometimes, this process
dos not work right. New cells form when the body does not need them, and
old cells do not die when they should. Leukemia is cancer that begins
in blood cells.
There are different kinds of childhood leukemia. Leukemia is a disease,
or cancer, of the blood-forming tissues of the bone marrow, spleen and
lymph nodes. It is characterized by an uncontrolled production of abnormal,
immature blood cells. The most common form is acute lymphoblastic leukemia
(also called acute lymphocytic leukemia or ALL). In this disease, too
many underdeveloped infection-fighting white blood cells (lymphocytes)
are present in the blood and bone marrow of a child. ALL is the most common
kind of leukemia in children, and the most common form of cancer in children.
The bone marrow is where lympohcytes and other blood cells are made.
The bone marrow is a spongy tissue which is inside the large bones of
the body. Three different types of blood cells are made in the bone marrow.
It makes red blood cells which carry oxygen and other materials to all
of the tissues throughout the body; white blood cells which fight off
infections in the body; and platelets, which make the blood clot. When
the bone marrow is working properly, it makes cells called blasts, which
mature into one of the three kinds of blood cells that have specific jobs
to do in the body.
When a person has leukemia, the bone marrow does not work properly. The
bone marrow produces abnormal, immature cells that are called leukemia
cells. Then, these immature cancer cells crowd out other blood cells in
the blood and bone marrow. If a child’s bone marrow is not able
to make enough red blood cells to carry oxygen, the child may develop
anemia, and feel very tired. If platelets are not plentiful enough, the
child’s blood will not clot and she may bleed or bruise easily.
When white blood cells are not plentiful enough, the body cannot fight
off germs and the child may develop an infection.
Leukemia can be either acute (fast progressing) or chronic (progressing
more slowly). Most children have acute forms of leukemia.
Incidence and Prevalence
Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood,
representing nearly one third of all pediatric cancers. About 2,000 new
cases of ALL are diagnosed each year in the United States. The peak incidence
of ALL is in children aged 2-5 years. No one knows what causes most cases
of leukemia. ALL occurs more frequently in whites than in blacks. The
annual incidence of ALL in children younger than 15 years in the white
population is 33 per million, compared to 15 per million children younger
than 15 years in the black population. ALL occurs slightly more frequently
in males than in females. This difference is most pronounced for T-cell
ALL.
Symptoms
The first symptoms of leukemia are due to the decrease in the number
of mature, functional red blood cells, white blood cells and platelets.
Symptoms may include:
- fevers or night sweats
- frequent infections
- feeling week or tired
- headache
- bleeding and bruising easily (bleeding gums, purplish patches
in the skin, tine red spots under the skin)
- pain in the bones or joints
- swelling or discomfort in the abdomen (lower tummy)
- swollen lymph nodes, especially in the neck or armpit
- weight loss
These symptoms do not necessarily mean a person has leukemia. They may
also indicate an infection or other problem that could cause the same
symptoms. If some of these symptoms are present, a blood test may show
unusual numbers of blood cells, and further tests will be done to determine
if there is a diagnosis of leukemia or some other cause.
Treatment
A person with leukemia is treated by a doctor who specializes in the
treatment of cancers, call an oncologist or hematologist. The doctor is
the best person to explain treatment, as it will differ depending on the
type of leukemia, the age of the patient and many other factors. However,
most treatment for leukemia consists of chemotherapy, sometimes radiation
therapy, and sometimes a bone marrow or stem cell transplant, or a combination
of treatment types.
People with acute leukemia need to start treatment right away. The goal
of treatment is to bring about a remission when signs and symptoms of
leukemia disappear. Treatment will continue after remission has been achieved
in order to prevent a relapse, or return of the disease. Many children
with acute leukemia can be cured.
Having leukemia is not easy. Therefore, children with leukemia may receive
other type of treatment in addition to anticancer treatments. For example,
they may have treatment to control pain, nausea or other symptoms or treatment
to help with the emotional distress of having leukemia. These types of
treatment may be called symptom management, supportive care or palliative
care.
Part 1 — Introduction, incidence, symptoms, and treatment
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305