Leukemia

(i) Description of Leukemia

Leukemia or rather a blood cancer is a type of cancer found in the bone marrow,
blood-forming tissues, and the lymphatic system. This cancer is caused by the rapid
reproduction of abnormal white blood cells. The abnormal white blood cells cannot
function normally: as a result, these white blood cells will impair the immunity of the
body thus affecting the ability of bone marrow to produce red blood cells and
platelets (Yazdian-Robati et al., 2017).
Leukemia can be grouped as either acute or chronic. The difference between the two
is that acute leukemia needs instant treatment while chronic leukemia progresses
slowly as compared to acute leukemia. Leukemia can as well be grouped as
lymphocytic or myelogenous. Lymphocytic leukemia is caused by the abnormal
growth of the cells in the marrow cells that turn into lymphocytes which is a type of
white blood cell that takes part in the immune system of the body (Laosai &
Chamnongthai, 2018). Whereas in myelogenous leukemia, the abnormal cell growth
occurs in the marrow cells that develop into red blood cells, white blood cells, and
platelets. Leukemia can be broadly classified into four categories; acute lymphocytic
leukemia (ALL), acute myelogenous leukemia (AML), chronic lymphocytic leukemia
(CLL), and chronic myelogenous leukemia (CML).
Leukemia occurs both in young ones and adults, however, ALL is common among
children while AML and CLL are the most common among adults.
(ii) Population affected by leukemia.
Around 14 per 100000 men or 61,000 people are diagnosed with leukemia every year
in the United States (Blood Cancer: Leukemia, Lymphoma, Myeloma). Leukemia is the
tenth most popular cancer based on the new cancer cases diagnosed each year.
Statistics show that leukemia accounts for 3.5% of all new cancer cases in the U.S
(Blood Cancer: Leukemia, Lymphoma, Myeloma). Although leukemia is perceived to be a
disease for children, it mostly affects adults. People having the age of 65 to 74 have
frequently been diagnosed with leukemia. Also, leukemia has been diagnosed among
men than in women. Leukemia is as well common among Caucasians as in African-
Americans. Even though leukemia is rare among children, approximately 30% of
children and teens are likely to develop cancer (Miller et al., 2019).
(iii) Causes of Leukemia
Leukemia affects the production and the normal function of blood cells. The
abnormal cells in the bone marrow destroy tampers with the normal production of red
blood cells and platelets. Although scientists are yet to discover the exact cause of
Leukemia, it is believed to develop from a combination of genetic and environmental
factors. It is commonly thought that leukemia occurs when blood cells acquire
changes (mutations) in their DNA or genetic material. Leukemia is also caused by
certain genetic mutations and conditions that are passed along to offspring. Other
hereditary conditions such as Down syndrome, Neurofibromatosis type 1, Ataxia
 telangiectasia, and Noonan syndrome as well increases the risk of cancer
development (Gong et al., 2020).
(iv) Signs and symptoms of Leukemia
Signs and symptoms depicted by leukemia occur according to the type of leukemia.
Chronic leukemia does not show any indicators at its early stages while acute
leukemia may result in severe symptoms (Blackburn et al., 2019). Leukemia’s
symptoms are as a result of the loss of the normal functioning of the blood cells or
due to abnormal cells accumulating in the body. The signs and symptoms associated
with leukemia include:
(a) Fevers
(b) Night sweats
(c) Painless swollen lymph nodes
(d) Having feelings of fatigue and tiredness
(e) Recurring nose bleeds.
(f) Prone to frequent infections
(g) Having a bone or joint pain.
(h) Unintentional loss of weight and loss of appetite.
(i) Enlarged spleen or liver.
(j) Presence of spots on the skin.
In case of leukemia penetrating the brain, headaches, seizures, muscle loss and
vomiting will be depicted as symptoms.
(v) Body parts affected by Leukemia
Leukemia usually affects the blood-forming cells in the bone marrow and lymphatic
system of the body. Cancer can assume several forms and spread at various rates,
however, most types of leukemia disturb the generation of normal white blood cells
whose role include multiplication, fighting infection, and then die off (Rehman et al.,
2018).
Leukemia starts in the bone marrow and then proceeds quickly into the blood.
Components of bone marrow include blood-forming cells, fat cells, and tissues that
help in the growth of blood cells. Being related to the blood, any blood-forming cell
or lymphoid cell can develop into the leukemic cell which then reproduces to create
new cancer cells. The cancer cells will overpower the bone marrow, spill out into the
bloodstream, and spread to other body organs.
(vi) WHAT IS USED TO DIAGNOSE LEUKEMIA
Since leukemia does not show symptoms in the early stages of the disease, it can be
diagnosed coincidentally during physical examination or a routine blood checkup.
The cancer care team can detect the presence of cancer in an individual by the patient
depicting pale skin, swollen lymph nodes, inflamed gums, swollen spleen or liver,
among others. Also, a blood test that depicts an abnormal white cell count can suggest
the diagnosis. In order to confirm the diagnosis and identity of the type of leukemia, a
needle biopsy and aspiration of bone marrow from a pelvic bone is done for testing of
 leukemic cells, DNA markers, and chromosome changes in the bone marrow (Percival
et al., 2017).

(vii) HOW IS DIAGNOSIS OF LEUKEMIA DONE

Leukemia’s diagnosis is done through analysis of the patient’s blood sample through
a complete blood count (CBC) or microscopic evaluation of the blood, or by use of
flow cytometry (Dharani & Hariprasath, 2018). A biopsy can be utilized in the
identification of the type of leukemia, the rate of growth of cancerous cells, and show
if the cancer has spread. Primary procedures of biopsy include:
(a) Bone marrow biopsy helps in the elimination of sample bone marrow.
(b) Lymph node biopsy takes part in the removal of a lymph node either part
of it or the whole of it.
Flow cytometry is a diagnostic test that shows the degree of spread of leukemia in the
body. It as well shows the rate growth of cancer cells and infections present in the body.
Imaging tests show the degree of spread of leukemia in the body, and other infections present in
the body. Imaging tests can be done through X-ray, CT scan, PET/ CT scan, MRI, Ultrasound,
2D echocardiogram, and Pulmonary function (Sneider et al., 2017).
Lumbar puncture tests may be needed to find out the degree of spread of leukemia. Also,
injection of chemotherapy drugs used in the treatment of the disease can be done through a
lumbar puncture.
(viii) TREATMENT FOR LEUKEMIA
Treatment of leukemia depends on the type of leukemia the patient has, their age, and
the general health state of the patient. The main treatment for leukemia is
chemotherapy. Types of treatment for leukemia include:
(a) Watchful waiting: In this form of treatment, the doctor only observes and
does not actively treat gradually growing leukemia such as Chronic
lymphocytic leukemia.
(b) Chemotherapy: In this form of treatment, a doctor administers intravenously
(iv) by use of either a drip or a needle. Acute myelogenous leukemia is
primarily treated by chemotherapy: however, bone marrow transplant may be
recommended sometimes (Lamy et al., 2017).
(c) Targeted therapy: In this type of treatment, tyrosine kinase inhibitors aim at
cancer cells without disturbing other cells which helps reduce the side effects.
Examples of tyrosine kinase inhibitors include imatinib, dasatinib, and
nilotinib.
(d) Interferon therapy: This form of treatment works on the principle of slowing
down and eventually stopping the spread of leukemia cells, though it has
severe side effects.
 (e) Radiation therapy: This type of treatment is recommended to people with
certain types of leukemia such as acute lymphocytic Leukemia.
(f) Surgery: This type of treatment mostly involved the removal of the spleen;
however, it depends on the type of leukemia the patient has.
(g) Stem cell transplantation: Through this procedure of treatment, the existing
bone marrow is destroyed with chemotherapy, radiation therapy, or both by
the cancer care team. Then, new stem cells are infused into the bone marrow
that generates blood cells that are not cancerous. This type of treatment is
effective when treating chronic myelogenous leukemia.
(ix) INTERESTING FACTS: PROGNOSIS
The efficacy of treatment leukemia varies depending on the type of leukemia. The
possibility of recovering from blood cancer depends significantly on the type of
leukemia the patient has. More than 60,000 people are diagnosed with leukemia every
year and around 376,000 Americans are in remissions from leukemia (Staff, 2021).
Leukemia is the sixth-leading cause of cancer deaths among men and women with
approximately 23,000 people deaths each year from leukemia. Nowadays, the average
five-year survival rate or rather the chances of living for at least five years after
diagnosis is 65.8 %. Such a survival rate depicts that in every 100 people with
leukemia 69 are likely to live for at least five years after diagnosis. Survival rates
differ according to the patient’s age, type of leukemia, and the degree of spread of
leukemia after diagnosis (Staff, 2021). A child who is diagnosed with acute leukemia
and survived for at least five years has probably been cured. Research shows that
leukemia is prevalent among Europeans and rare among Asians.

(x) HISTORIC IMPORTANCE OF LEUKEMIA

The history of leukemia dates 200 years back in 1811 when Peter Cullen defined a
case of splenitis acutus with unaccountable milky blood. The first published case of
leukemia was reported by John Hughes Bennett in the “Edinburgh Medical and
Surgical Journal” in October 1845. Thereafter cases of leukemia slowly emerged as a
distinct disease and published case reports become common. The first treatment for
acute leukemia was reported in Sidney Farber in 1948.
Today, much progress has been made against leukemia in terms of survival rates,
however, some types of leukemia still show poor survival threats.