Understanding the Different Types of Leukemia

What is Leukemia?

Leukemia is a blood cancer that, in most cases, originates from a hematopoietic stem cell. There are different types of leukemia; some forms are more common in children, others in adults. Leukemia generally affects white blood cells, cells that are supposed to protect us from infections and that normally only multiply according to the body's needs.

When leukemia develops, the bone marrow produces large quantities of white blood cells that do not function properly. In addition, these uncontrolled cells prevent the normal growth of other cells produced by the bone marrow, namely red blood cells and platelets. The consequences are the appearance of infections, fatigue, and bleeding.

What are the symptoms of leukemia?

The symptoms of leukemia vary depending on the type of leukemia and are often nonspecific. The most common signs and symptoms are:

• Fever or chills
• Persistent fatigue or weakness
• Frequent infections
• Weight loss
• Enlarged lymph nodes, liver, and/or spleen
• Easy bleeding or bruising
• Small, purplish-red spots on the skin called petechiae
• Excessive sweating, often at night
• Bone pain

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Leukemia: Causes and Risk Factors

What are the causes of leukemia?

The causes of leukemia are unknown, but genetic and environmental factors appear to play a role. In general, it is believed that leukemia develops when certain blood cells acquire mutations in the DNA - the site of information that regulates the activity of different cells. These abnormalities cause the cell to grow and divide faster and survive longer than a normal cell. Over time, these altered cells can overwhelm other normal cells in the bone marrow, causing the signs and symptoms of leukemia.

What are the risk factors for leukemia?

As described above, the cause of leukemia is unknown, but there may be conditions that increase the risk of developing leukemia.

• Prior antineoplastic treatment. Chemotherapy and/or radiotherapy treatment for another malignancy can increase the risk of developing leukemia.
• Congenital genetic diseases. Genetic abnormalities appear to play a role in the genesis of leukemia. Some genetic alterations present from birth, such as Down syndrome, can increase the risk of leukemia.
• Exposure to high doses of radiation. People exposed to high levels of ionizing radiation, such as survivors of nuclear disasters, have an increased risk of developing leukemia.
• Exposure to chemicals. Exposure to certain chemicals, such as benzene, is associated with an increased risk of leukemia.
• Family history of leukemia. If a family member has had leukemia, the risk appears to increase among relatives.

However, it must be taken into account that most people with known risk factors do not develop the disease, while many people with leukemia do not appear to have known risk factors.

Types of Leukemia

Acute Leukemia

In acute leukemia, there is an accumulation in the blood, bone marrow, and sometimes also in the spleen and lymph nodes of immature cells, called leukemic "blasts." These cells do not function properly, have a very long half-life and a great capacity for multiplication, so that the disease appears and progresses rapidly. Acute leukemia requires rapid and aggressive treatment.

Chronic Leukemias

Chronic leukemias are characterized by the accumulation in the blood, bone marrow, spleen, and often lymph nodes of white blood cells that mature almost normally, develop indefinitely, and tend to accumulate as they survive for a long time. For a while, they may function normally. Often, in the early stages, chronic leukemias give no symptoms and show no sign of themselves for a long time before diagnosis.

Lymphatic Leukemias

This type of leukemia involves lymphocytes, which are part of our immune system. Lymphocytes are found in the blood and circulating lymphatic tissues.

Myeloid Leukemias

This type of leukemia involves cells of the myeloid lineage, which give rise to red blood cells, white blood cells, and platelets.  

Main Subtypes of Leukemia

The main subtypes of leukemia are:

• Acute lymphoblastic leukemia is the most frequent acute leukemia in children, although it can occur in adults.
• Acute myeloid leukemia is a very common form of leukemia and is the most common form in adults, although it can also affect children.
• Chronic lymphocytic leukemia is the most common form of chronic leukemia in adults and may have an indolent and asymptomatic course for a long time, without the need for treatment.
• Chronic myeloid leukemia mainly affects adults. A person with this form of leukemia may have few symptoms or be asymptomatic for months or years before progressing to a stage of the disease where the cells begin to grow much faster.

Treatments

The treatment of leukemia depends on various factors, such as the type of disease (acute or chronic, myeloid or lymphoid leukemia), the age and physical condition of the patient, and the coexistence of other pathologies.

The main forms of therapy are as follows:

• Chemotherapy. This is the main treatment for leukemia and is based on the use of a drug or a combination of drugs, administered orally or intravenously, with the intention of killing diseased cells.
• Targeted therapy. This is based on the use of drugs targeting specific alterations present in cancer cells, thus blocking cell proliferation.
• Biological therapy. These are drugs that help the immune system recognize leukemia cells and control the disease.
• Radiation therapy. Administration of ionizing radiation to stop the proliferation of diseased cells. The whole body can be irradiated, but most often the irradiation targets a specific area, such as the bone marrow.
• Stem cell transplantation: This is a procedure in which diseased bone marrow is replaced by cells from healthy bone marrow. Before transplantation, high-dose chemotherapy and/or radiotherapy is administered to destroy the diseased bone marrow, and then the donor's stem cells are infused intravenously to repopulate the bone marrow.

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