What is leukemia
Leukemia is a form of malignancy affecting the blood cells or blood forming tissues. An example of a blood forming tissue is the bone marrow.
Leukemia can also be associated with leucocytosis,which is the uncontrolled growth of leucocytes(white blood cells). On normal basis,leucocytes are produced from the bone marrow to defend the body against invaders/pathogens. But in the case of leucocytosis ,they remain in the body and thereby leading to leukemia.
When the increase in the formation of leukemic cells becomes too much for the bone marrow,it then enters the bloodstream and eventually invade other parts of the body such as the lymph nodes,spleen,liver,central and peripheral nervous systems.
One may wonder!.But leukemia is a cancer of the blood,Why now mentioning Spleen,Lymph nodes etc??.
Yes!!.The pathogenesis of leukemia is quite different from other cancers because it usually starts occuring in major organs like liver,spleen etc. Before it finally spreads to the bone marrow.
Classification of leukemia
There are several types of leukemia. But they can be grouped into two major class:
1. Acute leukemia.
2.Chronic leukemia.
"Blasts" are new or immature cells and in the case if acute leukemia,the cells remain immature and cannot perform normal functions. Acute leukemia is fast-growing and can invade the whole body in about few weeks to months.
But in the case of Chronic leukemia,some blast cells are present,but they are more matured and can perform normal functions but still cannot perform well. Chronic leukemia us a progressive n slow leukemia.
Under this two groups are also four types,which are:
1. Acute lymphoblastic leukemia.
2. Acute myeloid leukemia.
3. Chronic lymphocytic leukemia.
4. Chronic myeloid leukemia.
1.Acute lymphoblastic leukemia :
This type of leukemia is caused by the accumulation and over production of immature white blood cells (lymphoblasts). Acute lymphoblastic leukemia is the most common malignancy in childhood and it occurs highest at the ages of 3-7years with about 75% occurence at the ages of 6. There could be two classes of Acute lymphoblastic leukemia : B cell and T cell.
Clinical features.
There are various features associated with Acute lymphoblastic leukemia, of which may include:
*** Bone marrow failure:** Failure of the bone marrow results in the ability to produce blood cells( Red blood cells,White blood cells,Platelets etc.). Therefore leading to anaemia,thrombocytopenia,neutropenia etc.
*** Organ infiltration:** Infiltration of organs may lead to enlargement of those organs such as Splenomegaly(enlargement of the spleen) ,hepatomegaly(enlargement of the liver) etc.
2.Acute myeloid leukemia.
Acute myeloid leukemia is also known as Acute non-lymphocytic leukemia and it is characterised by failure differentiate and proliferate accumulated myeloblasts.
Acute myeloid leukemia is the most common form of acute leukemia in the adults and its very common with ages of 65 years and above.
Clinical features.
The clinical features is mainly characterised by bone marrow failure. Infections also can occur as a result of poor functioning of the white blood cells. Anaemia is possible also because of decrease in red bood cell production. Thrombocytopenia are often profound.
3.Chronic lymphocytic leukemia.
In chronic lymphocytic leukemia,there is a production and accumulation of abnormal lymphocyte in the blood. Chronic lymphocytic leukemia is the most common of the chronic lymphoid leukemia and it occurs between ages 60 to 80years.
Clinical features.
There is enlargement of cervical,axillary/inguinal lymph nodes. Enlargement of the throat is also a feature. Immune response of the body becomes suppressed and aneamia could also b a feature.
4.Chronic myeloid leukemia.
It is a myeloproliferative,a clonal disorder of a primitive pluripotent stem cell. It can occur at any age. The diagnosis of chronic myeloid leukemia is rarely difficult.
Abnormality of philadelphia chromosomes i.e. chromosome 9 and 22 are involved in this disease.
Clinical features.
This disease can occur in both male and female. There is weight loss, anorexia (loss of appetite) , tachycardia, epistaxis and Gout are some clinical features of Chronic myeloid leukemia.
Management of leukemia.
Patients that have acute leukemia deteriorate quickly. Untreated acute leukemia leads to rapid fatal cancers.
In order to treat these kind of leukemia, early recognition is paramount. Bone marrow transfusion from a matched donor can also be carried out.
Intensive chemotherapy should also be advised.
In the case of chronic leukemia, a flow cytometry can be done. A flow cytometry is done on a blood collected in a sequestrened tube (an EDTA tube). Drugs can also be used to manage leukemia.
It is neccessary to be informed of some of this things.
