Leukemia is a cancer that usually affects white blood cells, though it can start in other types of blood cells. In patients with leukemia, the bone marrow in the center of the bones produces abnormal blood cells that grow out of control and get into the bloodstream.
- There are several types of leukemia.
- Some types of leukemia grow slowly (“chronic leukemias”) and others grow faster (“acute leukemias”).
- Patients may have a chronic leukemia at first that later develops into fast-growing acute leukemia.
11 Types of Leukemia
Types of leukemia include:
- Acute myeloid leukemia (AML)
- Acute lymphocytic leukemia (ALL)
- Chronic lymphocytic leukemia (CLL)
- Chronic myeloid leukemia (CML)
- Chronic myelomonocytic leukemia (CMML) (uncommon)
- Hairy cell leukemia (HCL)
- Juvenile myelomonocytic leukemia (JMML) (uncommon)
- Large granular lymphocytic (LGL) leukemia
- Background Blastic plasmacytoid dendritic cell neoplasm (BPDCN) [formerly called natural killer (NK) cell leukemia/lymphoma]
- B-cell prolymphocytic leukemia (B-PLL) (very rare)
- T-cell prolymphocytic leukemia (T-PLL) (extremely rare)
Acute myeloid leukemia (AML) is the most common type of acute leukemia, though it is rare, accounting for only about 1% of all cancers overall. AML is also the most fatal type of leukemia.
The five-year survival rate for AML, that is, how many people will be alive 5 years after diagnosis, is 29.5%.
Factors that are linked to a poorer prognosis include:
- Certain chromosome (cytogenetic) abnormalities
- Deletion (loss) of part of chromosome 5 or 7
- Translocation or inversion of chromosome 3
- Translocation between chromosomes 6 and 9
- Translocation between chromosomes 9 and 22
- Abnormalities of chromosome 11 (at the spot q23)
- Loss of a chromosome, so the cell has only 1 copy instead of the normal 2 (called monosomy)
- Complex changes (involves 3 or more chromosomes)
- Mutations in the FLT3, TP53, RUNX1, and ASXL1 genes
- CD34 protein and/or the P-glycoprotein (MDR1 gene product) markers on the leukemia cells
- Age: Death rates are higher among adults age 60 and older
- A high white blood cell count (greater than 100,000/mm3) at the time of diagnosis
- Prior blood disorder leading to AML
- AML that develops after a being treated for another cancer
- A systemic (blood) infection at the time of diagnosis
- Leukemia cells in the central nervous system (the area around the brain and spinal cord) can be hard to treat, since most chemotherapy drugs can’t reach that area
What Are Symptoms of Leukemia?
Leukemia may not cause symptoms, especially at first. When symptoms of leukemia occur, they may include:
- Bleeding more easily than normal
- Getting sick from infections more easily than normal
- Dizziness or lightheadedness
- Shortness of breath
- Pale skin
- Bruises (or small red or purple spots) on the skin
- Bleeding, such as frequent or severe nosebleeds, bleeding gums, or heavy menstrual bleeding in women
- Clotting problems
- Swelling in the abdomen
- Enlarged lymph nodes
- Bone or joint pain
- Feeling cold
Patients with leukemia may also have generalized symptoms such as:
- Weight loss
- Night sweats
- Loss of appetite
What Causes Leukemia?
Acute myeloid leukemia (AML) and other types of leukemia are caused by genetic mutations.
Risk factors for developing acute myeloid leukemia (AML) include:
- Getting older
- Being male
- Exposure to certain chemicals, such as long-term exposure to benzene
- Certain chemotherapy drugs including alkylating agents and topoisomerase II inhibitors
- Exposure to radiation
- Having certain blood disorders including chronic myeloproliferative disorders such as polycythemia vera, essential thrombocythemia, and idiopathic myelofibrosis
- Certain genetic syndromes
- A family history
- Possible other risk factors
- Exposure to electromagnetic fields (such as living near power lines)
- Workplace exposure to diesel, gasoline, and certain other chemicals and solvents
- Exposure to herbicides or pesticides
How Is Leukemia Diagnosed?
Leukemia is diagnosed with tests such as:
- Blood tests
- Bone marrow aspiration and biopsy
- Chromosome tests
- Lumbar puncture (spinal tap)
- Lymph node biopsy
- Imaging tests
What Is the Treatment for Leukemia?
There is technically no cure for leukemia, but treatment can help the cancer go into remission (also called “no evidence of disease”). It is not always possible to tell if any cancer cells remain in the body, which is why doctors often refer to “no evidence of disease” as remission rather than a cure. Whether or not remission occurs depends on the type of leukemia and the stage of the cancer.
Treatment for leukemia, including acute myeloid leukemia (AML), can include one or more of the following:
- Targeted therapy
- Bone marrow transplant (also called "stem cell transplant")
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