Leukemia

LEUKEMIA

Leukemia is a cancer of the blood and bone marrow. This is the most common form of cancer in children and not an uncommon form of disease found in adults. The cause of leukemia is unknown but it has been connected with exposures to radiation, chemicals, and some drugs. Viruses may play a key role in the development of leukemia, although additional evidence for this theory is still being researched. There are several different types of leukemia, with acute lymphocytic leukemia being the most common in children. Chronic lymphocytic leukemia is the most common type of leukemia in adults.

People with leukemia often have less than the normal amount of healthy red blood cells and platelets. As a result, there are not enough red blood cells to carry oxygen through the body. With this condition, called anemia, patients can look pale and feel weak and tired. When there are not enough platelets, patients bleed and bruise easily. Some of the common symptoms of leukemia include flu-like symptoms, fatigue, loss of appetite and/or weight loss and swollen or tender lymph nodes, liver or spleen.

Evaluation of Leukemia includes history and a physical examination. The complete blood count will show an overabundance of white blood cells. Those white blood cells, when viewed under the microscope, will appear abnormal to the trained eye. Bone marrow aspiration and biopsy are necessary for definitive diagnosis. Exact diagnosis will guide the physician to the most effective treatment.

Most patients with leukemia are treated with chemotherapy. Some also may have radiation therapy and/or bone marrow transplantation (BMT) or biological therapy. In some cases, surgery to remove the spleen (an operation called a splenectomy) may be part of the treatment plan.

Chemotherapy is the use of drugs to kill cancer cells. Depending on the type of leukemia, patients may receive a single drug or a combination of drugs. Some anticancer drugs can be taken by mouth. Most are given by IV. Often, patients who need to have many IV treatments receive the drugs through a catheter. One end of this thin, flexible tube is placed in a large vein, often in the upper chest. Drugs are injected into the catheter, rather than directly into a vein, to avoid the discomfort of repeated injections and injury to the skin.

Anticancer drugs given by IV injection or taken by mouth enter the bloodstream and affect leukemia cells in most parts of the body. However, the drugs sometimes do not reach cells in the central nervous system because they are stopped by the blood-brain barrier. This protective barrier is formed by a network of blood vessels that filter blood going to the brain and spinal cord. To reach leukemia cells in the central nervous system, doctors use intrathecal chemotherapy.

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