What Is Leukemia?

Carrie Madormo, RN, MPH
·7 min read

Leukemia is a type of cancer that affects the blood cells, which begins in your bone marrow or other blood-forming tissue. Your bone marrow produces white blood cells, red blood cells, and platelets. Researchers do not currently understand why your bone marrow starts to make harmful cells, rather than healthy ones. But, they do know that certain risk factors, such as older age, can increase your odds of having leukemia.

Most symptoms of leukemia are caused by a lack of normal blood cells. This occurs when the bone marrow produces a large number of cancer cells, causing symptoms such as fatigue, fever, night sweats, weight loss, and easy bruising or bleeding. If you're experiencing leukemia symptoms, your healthcare provider can use blood tests and physical exams to give you a proper diagnosis and help you figure out the treatment options that are right for you.

Types of Leukemia

There are different types of leukemia—each of which varies based on which blood cell is affected and how quickly cancer cells spread. Leukemia can either affect lymphocytes or myeloid cells. Lymphocytes are a type of white blood cell and myeloid cells are immature blood cells that develop into white blood cells, red blood cells, or platelets. Leukemia is also classified as acute (fast-growing) or chronic (slow-growing).

The types of leukemia include:

  • Acute lymphocytic leukemia (ALL): The most common type in children

  • Acute myeloid leukemia (AML): More common in older adults but may also affect children

  • Chronic lymphocytic leukemia (CLL): The most common type in adults and generally happens in later adulthood

  • Chronic myeloid leukemia (CML): Occurs during adulthood after middle age

  • Chronic myelomonocytic leukemia (CMML): Most cases occur after the age of 60 and are more common in men than in women

The type of leukemia you have will determine which of your blood cells the cancer is targeting and how fast the disease is progressing.

Symptoms

The symptoms of leukemia you experience will largely depend on the exact type of leukemia you have. However, there are some common symptoms that most people with leukemia share. These include:

If your leukemia is making it difficult for you to produce red blood cells, you may also develop a condition called anemia, which limits your body's ability to carry oxygen to your organs. Symptoms of anemia include:

If leukemia is causing you to have low levels of white blood cells, you may have a condition called leukopenia. As a result, you may experience symptoms such as:

  • Frequent infections

  • Fever

  • Night sweats

  • Chills

  • Body aches

  • Cuts or sores on your skin

When leukemia causes a low platelet count, it raises the risk of bleeding. Platelets are blood cells that clot the blood and prevent bleeding. When they are low (thrombocytopenia), it is possible to experience:

  • Easy bruising or bleeding

  • Nosebleeds

  • Bleeding gums

  • Heavy periods

  • Blood in your urine or stool

  • An enlarged spleen

Related:What Is Pancytopenia?

Causes

Leukemia occurs when your bone marrow and blood-forming tissues produce cancer cells. This causes cancer cells to release into your bloodstream, causing changes in your red blood cells, white blood cells, and platelets. While researchers are not certain what causes leukemia, they have found some risk factors that can increase your chances of developing the condition.

Risk Factors

Risk factors for anemia include:

  • Radiation exposure: Being exposed to high levels of radiation raises the risk of acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML).

  • Chemical exposure: Exposure to chemotherapy and other chemicals like benzene increases the risk of leukemia.

  • Viruses: Certain viruses including human T-cell lymphoma/leukemia virus-1 (HTLV-1) and Epstein-Barr virus (EBV) have been linked to a higher likelihood of developing leukemia.

  • Genetics: Having an identical twin with leukemia makes you more likely to experience symptoms yourself. Some genetic syndromes may also raise the risk of ALL, such as include Down syndrome, Klinefelter syndrome, Fanconi anemia, and Ataxia-telangiectasia.

  • Age: Leukemia is more likely to occur after age 50. However, ALL is also more likely to occur in children under the age of 15.

  • Race and ethnicity: Leukemia is more common in white people than in Black people.

  • Sex: Leukemia is more common in people assigned male at birth than those assigned female at birth.

Diagnosis

There are several tests that healthcare providers can use to diagnose leukemia. These include:

  • Physical exam: Leukemia causes physical symptoms, so your provider will perform a thorough physical exam noting any swollen lymph nodes, bruises, or bleeding.

  • Medical history: Your provider will ask several questions about your symptoms, your lifestyle habits or recent changes, your personal medical history, and conditions that run in your family.

  • Blood tests: Because leukemia causes a lack of healthy blood cells, your provider can order a complete blood count (CBC) to determine if there are any low counts of red blood cells, white blood cells, or platelets.

  • Bone marrow tests: A bone marrow aspiration and biopsy can detect the presence of cancer cells in the bone marrow.

  • Genetic tests: Because certain genetic conditions can raise the risk of leukemia, your provider may recommend genetic testing to detect any gene or chromosome changes that may increase your risk of developing the disease.

Related:Surprising Cancer Symptoms Everyone Should Know

Treatment

Fortunately, leukemia is treatable and remission (a period where symptoms go away) is possible. Your prognosis (or, how your condition progresses) depends on the type of leukemia you have and what stage you are in. Your age and overall health also play a factor in which treatment options may be right for you.

Chemotherapy

For most people with leukemia, chemotherapy is the first line of treatment. There are three stages of chemotherapy, which include:

  • Induction: Intense start of treatment for one week for acute lymphocytic leukemia (AML) and one month for acute lymphocytic leukemia (ALL)

  • Consolidation: Intense treatment for months for both acute lymphocytic leukemia (AML) and one month for acute lymphocytic leukemia (ALL)

  • Maintenance: Less intensive treatment for about two years, typically only for acute lymphocytic leukemia (ALL)

Stem Cell Transplant

A stem cell transplant uses high doses of chemotherapy and sometimes radiation to kill leukemia cells. After these treatments, you can receive an infusion of stem cells to help rebuild the bone marrow with healthy cells. Your provider may consider a stem cell transplant when chemotherapy alone has not been effective.

Targeted Therapy

Targeted therapy uses drugs and other substances that target and attack cancer cells. The goal is to treat cancer cells while preventing harm or damage to normal cells.

Radiation Therapy

Radiation therapy is usually not part of the main treatment plan for a person with leukemia. However, your provider might suggest radiation in addition to chemotherapy when preparing for a stem cell transplant.

How to Prevent Leukemia

There is no way to prevent leukemia. This is because you don't have any control over certain risk factors, such as ethnicity, genetics, and age. In addition, many people with leukemia have no known risk factors, so it is difficult to know how to prevent it.

Unfortunately, receiving treatment like chemotherapy and radiation therapy for other types of cancer can raise your risk of leukemia. However, your healthcare provider will not recommend that you dismiss or forego cancer treatment in an attempt to prevent future cancers.

Radiation exposure from imaging studies can also raise your risk of leukemia. If you need frequent X-rays or computed tomography (CT) scans, talk with your healthcare provider about minimizing these tests as much as possible—especially if you're at risk for certain cancers.

Living With Leukemia

Leukemia is a life-changing diagnosis and the treatment can last for months to years. It is normal to experience feelings of overwhelm, sadness, anger, fear, grief, and loneliness—and all of those feelings are OK.

Getting support during your journey is crucial. Work with your healthcare team for support with appointment scheduling and financial aid. Consider asking for a referral to a mental health provider as well. Reach out to your friends and family members for help with daily activities, childcare, food preparation, and other tasks.

Keep in mind: even though you might be experiencing leukemia by yourself, it doesn't mean you have to go through the journey alone.

Related:What Suleika Jaouad Wants You To Know About Living With Leukemia

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