Leukemia
What Is Leukemia? Symptoms, Diagnosis and Treatment Methods
Leukemia is a group of cancers that begin in the bone marrow, where blood cells are produced. Abnormal blood cells multiply and may affect the production and function of healthy blood cells. There are different types of leukemia; symptoms, the course of the disease and treatment approaches vary by type.
What are the types of leukemia?
Leukemias are classified according to the type of blood cell from which the disease originates and how quickly it generally progresses. The main types are:
- Acute lymphoblastic leukemia (ALL)
- Acute myeloid leukemia (AML)
- Chronic lymphocytic leukemia (KLL/CLL)
- Chronic myeloid leukemia (KML/CML)
The terms “acute” and “chronic” refer to the course of the disease. This classification alone does not indicate how an individual's disease will progress or which treatment they will benefit from.
What are the symptoms of leukemia?
Symptoms may vary depending on the type of leukemia and the extent to which healthy blood cells are affected. Possible symptoms include:
- Persistent fatigue, weakness, paleness or shortness of breath
- Frequent or prolonged infections and fever
- Easy bruising, nosebleeds or bleeding gums, small red-purple spots on the skin
- Bone or joint pain
- Swollen lymph nodes
- Abdominal fullness or swelling
- Loss of appetite, unintentional weight loss or night sweats
These symptoms are not specific to leukemia; infections, anemia and many other conditions can cause similar symptoms. Symptoms alone do not establish a diagnosis of leukemia.
How is leukemia diagnosed?
The diagnostic evaluation usually begins with a complete blood count and white blood cell differential. Abnormal results may raise suspicion of leukemia; however, a complete blood count alone does not determine the type of leukemia or establish a definitive diagnosis.
Depending on the doctor's assessment, a blood smear, bone marrow aspiration or biopsy, flow cytometry and tests examining chromosomal or genetic changes may be requested. These investigations help identify the type of leukemia and guide treatment planning. The tests required vary depending on the individual and the suspected type of leukemia.
How is leukemia treated?
Treatment is planned by the hematology team according to the type of leukemia, the characteristics of the disease cells, the individual's overall health and other clinical findings. Options may include chemotherapy, targeted medicines, immunotherapy and, in some patients, stem cell transplantation. For some types of chronic leukemia, regular monitoring rather than immediate treatment may be considered appropriate. The same treatment approach is not used for every patient.
When should you see a doctor?
A medical assessment should be sought if there is unexplained and persistent fatigue, recurrent infections, easy bruising or bleeding, prolonged fever or significant abnormalities in blood counts. Severe bleeding, shortness of breath or a rapid deterioration in the person's general condition requires emergency medical attention.
Frequently asked questions
Does leukemia occur only in children?
No. Leukemia can occur in both children and adults; the frequency of the different types varies by age group.
Can a complete blood count diagnose leukemia?
A complete blood count may raise suspicion of leukemia; additional investigations considered appropriate by the doctor may be needed to establish a definitive diagnosis and identify the type.
Does fatigue or bruising mean I have leukemia?
No. These symptoms can have many different causes. Persistent or unexplained symptoms should be assessed by a doctor.