Leukemia

Leukemia is cancer of the blood cells. Most blood cells form in the bone marrow. In leukemia, immature blood cells become cancer. These cells do not work the way they should and they crowd out the healthy blood cells in the bone marrow.

Different types of leukemia depend on the type of blood cell that becomes cancer. For example, lymphoblastic leukemia is a cancer of the lymphoblasts (white blood cells, which fight infection). White blood cells are the most common type of blood cell to become cancer. But red blood cells (cells that carry oxygen from the lungs to the rest of the body) and platelets (cells that clot the blood) may also become cancer.

Leukemia occurs most often in adults older than 55 years, but it is also the most common cancer in children younger than 15 years.

Leukemia can be either acute or chronic. Acute leukemia is a fast-growing cancer that usually gets worse quickly. Chronic leukemia is a slower-growing cancer that gets worse slowly over time. The treatment and prognosis for leukemia depend on the type of blood cell affected and whether the leukemia is acute or chronic.

Adult Acute Lymphoblastic Leukemia

Key points to consider

• Adult acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).
• Leukemia may affect red blood cells, white blood cells, and platelets.
• Previous chemotherapy and exposure to radiation may increase the risk of developing ALL.
• Signs and symptoms of adult ALL include fever, feeling tired, and easy bruising or bleeding.
• Tests that examine the blood and bone marrow are used to detect (find) and diagnose adult ALL.
• Certain factors affect prognosis (chance of recovery) and treatment options.
• Adult acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).

Adult acute lymphoblastic leukemia (ALL; also called acute lymphocytic leukemia) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated.

Normally, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell.

A myeloid stem cell becomes one of three types of mature blood cells:

• Red blood cells that carry oxygen and other substances to all tissues of the body.
• Platelets that form blood clots to stop bleeding.
• Granulocytes (white blood cells) that fight infection and disease.

A lymphoid stem cell becomes a lymphoblast cell and then one of three types of lymphocytes (white blood cells):

• B lymphocytes that make antibodies to help fight infection.
• T lymphocytes that help B lymphocytes make the antibodies that help fight infection.
• Natural killer cells that attack cancer cells and viruses.

Blood cell development; drawing shows the steps a blood stem cell goes through to become a red blood cell, platelet, or white blood cell. A myeloid stem cell becomes a red blood cell, a platelet, or a myeloblast, which then becomes a granulocyte (the types of granulocytes are eosinophils, basophils, and neutrophils). A lymphoid stem cell becomes a lymphoblast and then becomes a B-lymphocyte, T-lymphocyte, or natural killer cell.

In ALL, too many stem cells become lymphoblasts, B lymphocytes, or T lymphocytes. These cells are also called leukemia cells. These leukemia cells are not able to fight infection very well. Also, as the number of leukemia cells increases in the blood and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This may cause infection, anemia, and easy bleeding. The cancer can also spread to the central nervous system (brain and spinal cord).

Possible risk factors for ALL include the following:

• Being male.
• Being white.
• Being older than 70.
• Past treatment with chemotherapy or radiation therapy.
• Being exposed to high levels of radiation in the environment (such as nuclear radiation).
• Having certain genetic disorders, such as Down syndrome.

The early signs and symptoms of ALL may be like the flu or other common diseases:

• Weakness or feeling tired.
• Fever or night sweats.
• Easy bruising or bleeding.
• Petechiae (flat, pinpoint spots under the skin, caused by bleeding).
• Shortness of breath.
• Weight loss or loss of appetite.
• Pain in the bones or stomach.
• Pain or feeling of fullness below the ribs.
• Painless lumps in the neck, underarm, stomach, or groin.
• Having many infections.

This summary is about adult acute lymphoblastic leukemia. There are other types of leukemia:

• Childhood Acute Lymphoblastic Leukemia’
• Adult Acute Myeloid Leukemia.
• Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies.
• Chronic Lymphocytic Leukemia.
• Chronic Myelogenous Leukemia.
• Hairy Cell Leukemia.

Source: National Cancer Institute

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