Leukemia
What are the different types of leukemia? Learn about the causes, symptoms, and most effective therapies for this type of blood cancer.
Symptoms and Causes
Leukemia is a type of cancer that affects blood-forming cells. In most cases, it causes an overproduction of white blood cells, which do not function properly. In some cases, this disease can also damage red blood cells, platelets, or bone marrow.
Based on its progression rate, leukemia is divided into two main groups, which are further classified into subtypes depending on the type of affected cells:
- Acute leukemia: Characterized by abnormal cells being blasts (immature cells) that do not function properly. Patients usually deteriorate quickly because cancer cells develop very rapidly.
- Acute lymphoblastic leukemia (ALL): A large number of immature lymphoblasts proliferate rapidly and replace the bone marrow cells responsible for producing blood cells, leading to a decrease in platelets, lymphocytes, and leukocytes. It is more common in children.
- Acute myeloid leukemia (AML): Myeloid cells transform into immature white blood cells (myeloblasts), reducing the number of healthy lymphocytes.
- Chronic leukemia: Usually presents with few symptoms, leading to delayed diagnosis. It can be caused by either excessive or insufficient production of blood cells.
- Chronic lymphocytic leukemia (CLL): An increased number of B lymphocytes accumulate gradually in the bloodstream. Over time, they may spread to other parts of the body. It is the most common type of leukemia among adults.
- Chronic myeloid leukemia (CML): A genetic alteration affects myeloid cells, leading to the development of the BCR-ABL oncogene. The chromosome resulting from this genetic alteration is called the Philadelphia chromosome. Over time, these cells accumulate in the bone marrow, reach the bloodstream, and spread to other organs.
Thanks to advancements in diagnostic techniques and the development of new treatments, the life expectancy of leukemia patients has significantly increased, especially among children. However, the prognosis of the disease depends on the patient’s age, condition, and specific type of leukemia.
Symptoms
Symptoms vary depending on the type of leukemia, but some are common to all:
- Bone pain
- Anemia
- Swollen lymph nodes
- Weakness
- Fatigue
- Petechiae: small, round red spots on the skin
- Unintentional weight loss
- Fever (without an apparent cause)
- Frequent nosebleeds
- Easy bruising
- Frequent infections
Causes
To date, the exact causes of leukemia remain unknown. Scientists believe it results from a combination of genetic predisposition and environmental factors.
Risk Factors
Some factors associated with an increased risk of developing leukemia include:
- Age: Chronic leukemia is more common in people over 65, while acute leukemia is more frequent in childhood.
- Exposure to ionizing radiation
- Handling of chemical substances
- Previous chemotherapy or radiation therapy treatments
- Certain genetic disorders such as Fanconi anemia or Down syndrome
- Family history: The Spanish Association Against Cancer estimates that 10% of leukemia cases are hereditary.
Complications
Leukemia patients are more susceptible to:
- Infections
- Hemorrhages
- Blood thickening
- Superior vena cava syndrome: Characterized by dilation of the veins in the chest and neck, facial swelling, headaches, vision disturbances, or loss of consciousness due to blood flow obstruction.
- Growth retardation
- Cardiopulmonary problems
- Development of other cancers
Prevention
Leukemia is not a type of cancer that can be prevented through lifestyle changes.
What Type of Doctor Treats Leukemia?
Hematologists, medical oncologists, radiation oncologists, and geneticists are among the specialists involved in the diagnosis and treatment of leukemia.
Diagnosis
Leukemia suspicion arises after evaluating the patient’s symptoms and overall health condition. To confirm the diagnosis, the following tests are performed:
- Blood test: Primarily examines white blood cell levels and conducts a complete blood cell count.
- Bone marrow analysis: Determines the existing number of blood-producing cells.
- Flow cytometry: Identifies tumor markers and provides information about blood cells (quantity, size, and shape).
- Cytogenetic study: Analyzes the structure of cellular chromosomes to observe their behavior during mitosis (cell division).
- Imaging tests: Ultrasounds, X-rays, or CT scans allow the assessment of lymph nodes and potentially affected organs.
Treatment
As with other types of cancer, leukemia treatment must be tailored to both the patient’s characteristics and the disease itself. The most effective treatments today include:
- Chemotherapy: Commonly used for acute cases, it involves the intravenous administration of a combination of chemical drugs that destroy cancer cells.
- Bone marrow transplant: Can come from the patient or a donor. It replaces malignant cells with healthy ones that function properly.
- Radiation therapy: Uses high-energy radiation to stop the growth of cancer cells.
- Immunotherapy: Strengthens the body's natural defenses to help fight the disease.
- Targeted therapy: Uses drugs designed to attack specific abnormalities in malignant cells.
