Leukemia (Blood Cancer): What Is It, What Are Its Symptoms, Diagnosis, and Treatment Methods?

Leukemia, commonly referred to as blood cancer, is one of the most prevalent types of cancer. It originates from the bone marrow and the lymphatic system. While some types are primarily seen in children, there are also various types that occur in adults. Early diagnosis is crucial in leukemia, just as it is for all types of cancer. Although leukemia involves a complex treatment process, advancements in methods and strategies are progressively improving outcomes.

What Is Leukemia?

Leukemia is a type of cancer. The term "cancer" refers to the uncontrolled growth and multiplication of cells. The cause of leukemia is typically related to white blood cells or the bone marrow. In a healthy person, white blood cells, which are vital for the immune system, follow a specific cycle similar to other cells. They grow and divide regularly to combat invading microorganisms such as bacteria, viruses, and fungi. However, in the case of leukemia, this healthy cycle is disrupted, and the uncontrollably multiplying cells begin to harm the body. This disruption is due to the bone marrow, which produces white blood cells, not functioning properly.

What Are the Symptoms of Leukemia?

The symptoms of leukemia can vary depending on the type of leukemia. However, common symptoms include:

• Unexplained weight loss
• Fatigue and weakness that do not improve with rest
• Frequently recurring infections
• Fever and chills
• Skin sensitivity leading to easy bruising, swelling, or bleeding
• Persistent bone pain and sensitivity in the bones
• Night sweats
• Painless swollen lymph nodes (especially in the neck and armpits)

It is important to note that the symptoms of leukemia can vary among different age groups. Additionally, leukemia that has spread to different areas of the body may present symptoms depending on the affected region. For example, in leukemia that has spread to the nervous system, symptoms such as headaches, muscle pain, and confusion may also be observed.

What Are the Causes and Risk Factors of Leukemia?

As with many types of cancer, leukemia cannot be attributed to a single cause. A more accurate approach considers both genetic and environmental factors together. The underlying mechanism of the primary cause of cancer can be explained by DNA damage. The DNA in our cells may fail to manage the cell properly due to damage or mutations. Cells that do not receive the correct signals regarding their division begin to divide uncontrollably.

Although the exact causes of leukemia are not fully understood, the risk factors may include:

• A history of cancer
• Exposure to radiation
• Certain congenital genetic disorders
• Long-term exposure to chemicals known to cause cancer
• Family history of cancer
• History of chemotherapy
• Previous radiotherapy
• Smoking
• Having myelodysplastic syndromes and certain hereditary diseases.

What Are the Types of Leukemia?

The differences in leukemia types relate to the rate of cancer progression and the group of cells affected.

Leukemia is fundamentally divided into acute and chronic leukemia. Acute leukemia is characterized by the rapid multiplication of cells, with symptoms appearing in a shorter time frame. Chronic leukemia, on the other hand, tends to progress more slowly, with symptoms that may not manifest for years.

Another reason for the distinction among types of leukemia is the difference in the groups of cells affected. Lymphocytic leukemia affects lymphocytes (lymphoid cells), while myeloid leukemia affects blood cells. Blood cells consist of red blood cells, white blood cells, and platelets.

• Acute Lymphoblastic Leukemia (ALL): A type of leukemia commonly seen in children that affects the immune system and presents symptoms rapidly.
• Acute Myeloid Leukemia (AML): The most common type of acute leukemia, affecting both children and adults.
• Chronic Lymphocytic Leukemia (CLL): Typically occurs in adults and may sometimes remain asymptomatic for years. It is the most common type of chronic leukemia among adults.
• Chronic Myeloid Leukemia (CML): More commonly observed in adults.

How Is Leukemia Diagnosed?

Acute leukemia and chronic leukemia are diagnosed differently. Chronic leukemia may not show symptoms in the short term, and it can be discovered incidentally during blood tests conducted for other reasons.

To accurately diagnose leukemia, doctors may need to perform several tests.

• Physical Examination and History: Doctors may ask the patient a series of questions to determine whether the symptoms of leukemia are present. They may then proceed to a general physical examination.
• Blood Test: The levels of leukemia-affected cells in the blood, such as red and white blood cells and platelets, can provide information about leukemia. A complete blood count (CBC) is examined. However, a blood test alone may not always be sufficient for a leukemia diagnosis, and more detailed tests may be necessary.
• Peripheral Smear: The blood cells of the patient suspected of having leukemia are examined under a microscope, looking at the structure of the cells. Samples taken are stained with various dyes for diagnostic purposes concerning the disease and its subtype.
• Biopsy Tests: Tissue samples are taken for examination. For leukemia diagnosis, tissue samples are typically taken from lymph nodes or bone marrow. The collected sample is sent to the laboratory, where necessary examinations are performed, and the results often determine the treatment for leukemia.

How Is Leukemia Treated?

The treatment of leukemia varies based on the individual's age, sex, physiological condition, the type of leukemia, and how advanced the disease is. After conducting necessary examinations and tests, doctors will plan the treatment based on the individual's overall health status. Commonly used methods in leukemia treatment include:

• Chemotherapy: This treatment uses chemicals to kill harmful cells in the body. It can be administered through intravenous injection. A single drug may be used, or sometimes multiple drugs may be combined.
• Radiotherapy: This treatment involves the use of high-energy rays to damage abnormally growing cells that cause cancer. It can be applied to specific areas of the body or, in some cases, to the entire body. This treatment can also be used to prepare the patient for bone marrow transplantation.
• Bone Marrow Transplantation: Also known as stem cell transplantation. The cancerous bone marrow causing leukemia is cleared through high doses of chemotherapy and radiotherapy. Healthy stem cells taken from a healthy bone marrow are then placed in the body to allow for the formation of healthy, cancer-free bone marrow. The stem cells can be obtained from the individual or a donor.
• Immunotherapy: Although cancer involves a harmful system in the body, our immune cells may not attack cancer cells. This is due to cancer cells having a shield against immune cells. Immunotherapy aims to eliminate this shield, allowing our immune system to activate. This enables immune cells to recognize and attack cancer cells.

To evaluate the progress of leukemia treatment, doctors may use various techniques. Tests such as liver function tests can help determine the status of organs and whether leukemia has spread to them. Blood tests may be requested regularly to observe how interventions have changed the levels of blood cells. Imaging techniques such as ultrasound or tomography may be used to assess the damage caused by leukemia in the body.

Leukemia treatment, like many other types of cancer treatment, may require a long process. Early diagnosis and treatment are crucial. The earlier leukemia, or blood cancer, is diagnosed, the higher the chances of recovery. The success rate of cancer treatments continues to increase, and promising developments are ongoing. Cancer cases are rising both in our country and worldwide. It is extremely important to maintain health check-ups and seek examination if there are suspected symptoms. Remember, early diagnosis saves lives.