Do Not Ignore the Signs of Leukemia!

Living with Leukemia…*

Do Not Ignore the Signs of Leukemia!

During Children with Leukemia Week, November 02-08, we answered your questions about leukemia, one of the leading types of cancer seen in childhood…

How does leukemia develop?

Normal stem cells in the bone marrow give rise to 3 main cell types. Red blood cells carry oxygen to all body tissues, such as the heart, lungs and brain; platelets form the “plugs” that help stop bleeding after injuries; and white blood cells fight infections in the body. Leukemia cells multiply more than normal cells, live longer and, over time, become more crowded than normal cells.

What are the types of leukemia?

The speed of progression of leukemia, and how the cells displace normal blood and bone marrow cells, differs for each type of leukemia.

Acute Lymphoblastic Leukemia (ALL): Accounts for 80% of leukemias seen in children under 15 years of age. It can sometimes be seen in adults as well, but ALL over the age of 50 is extremely rare. It is a type of leukemia caused by an increase in immature blood cells called lymphoblasts, which should mature into a type of mature blood cell called lymphocytes. It is characterized by swelling of the lymph nodes.

Acute Myeloid Leukemia (AML): Accounts for 50% of leukemias detected in adolescence and in the 20s, and 20% of leukemias in adults. It presents with a decrease in red and white blood cells, called myeloblasts, which should develop into normal blood cells, together with frequent infections.

Chronic Lymphocytic Leukemia (CLL): Accounting for 30% of all leukemias, CLL is rarely seen under the age of 30. However, its frequency increases with age, and it is most commonly observed between the ages of 60 and 70. The leukemia cells that initiate the disease produce blood cells that function almost like normal cells. The number of red blood cells is usually below normal and causes anemia. Although the function of white blood cells is close to normal, their number is high and continues to increase. If the patient is not treated, this can cause serious problems. The white blood cell count can rise enough to slow down blood flow, and severe anemia develops. In CLL, cancer cells are found in the bone marrow, in the blood and in the lymph nodes, and the lymph nodes become enlarged.

Chronic Myeloid Leukemia (CML): This type of leukemia, which accounts for 20-30% of leukemias seen in adults and is observed between the ages of 25 and 60, presents with overproduction of myeloid cells (such as white blood cells) that look mature but have lost their function. This production continues until no normal cells remain.

What are the signs and symptoms?

Leukemia can show symptoms similar to other diseases. Special blood and bone marrow tests are needed to make a diagnosis. Signs and symptoms vary depending on the type of leukemia. Signs and symptoms of acute leukemia, which is more common in children, are:

Tiredness or weakness,

Shortness of breath during physical activity,

Pale skin,

Mild fever or night sweats,

Slow healing of cuts and excessive bleeding,

Black and blue spots (bruises) with no clear cause,

Pinhead-sized red spots under the skin,

Pain in joints such as the knees, hips or shoulders,

Decrease in white blood cells, especially the number of monocytes and neutrophils

How is it diagnosed?

Bone marrow tests (aspiration and biopsy) are usually performed to confirm the diagnosis and to observe chromosomal abnormalities. These tests explain the cell type of the leukemia.

How is it treated?

The goal of leukemia treatment is to completely eliminate the disease and restore the patient’s health. The type of treatment and the results to be obtained depend on the type of leukemia and the patient’s condition.

What are the social and emotional effects of leukemia?

Hearing “You have leukemia” can give the impression that a person’s life has suddenly changed completely. It is helpful to know that after diagnosis, many leukemia patients survive and live good, high-quality years. Many people with leukemia learn that they can cope over time with a situation that initially seems very difficult to accept. What is important during this period is that the patient seeks help not only for medical concerns, but also for emotional issues related to the disease and its treatment.

• This article was prepared using the text “Understanding Leukemia” prepared by the Hematology Specialists Association.