Leukemia: Common Questions and Answers
What is leukemia? Which symptoms are typical? What does the treatment look like? Here you will find answers to common questions
What is leukemia?
Leukemia, colloquially blood cancer, is a generic term. It summarizes various diseases of the blood and especially the bone marrow. Experts differentiate between numerous forms of leukemia, which progress differently and are treated very individually. The So there is actually no such thing as leukemia.
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What types of leukemia are there?
There are a variety of forms. Leukemias are roughly divided into
- Acute leukemia: They usually become noticeable suddenly, get worse and need immediate treatment
- Chronic leukemia often progresses insidiously, sometimes over many years
Leukemias are also differentiated according to the type of blood cells from which the disease originates: Myeloid leukemias arise from so-called myeloid progenitor cells. Lymphatic or lymphoblastic leukemias arise from precursor cells of the lymphocytes.
More about important types of leukemia:
Acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL)
Chronic myeloid leukemia (CML)
Strictly speaking, it does not count as a leukemia, but as a malignant lymphoma
Chronic lymphocytic leukemia (CLL)
How does leukemia develop?
Leukemia occurs when the body produces faulty blood cells. For the majority of patients, it remains unclear why this happens.
New blood cells are usually created continuously in the bone marrow. There they mature from progenitor cells in several stages. The finished blood cells survive in the organism for different lengths of time, fulfill important functions and are broken down again.
- White blood cells are part of the immune system
- Red blood cells are mainly used to transport oxygen
- Platelets are important for blood clotting
If certain errors creep into the genetic information of a precursor cell, many immature white blood cells, so-called leukemic blasts, may form. They can multiply uncontrollably. Experts assume that such errors in the genes of a progenitor cell often arise accidentally in the course of life. So they are usually not simply inherited.
In contrast to the healthy blood cells, the leukemic blasts do not mature into functional cells in acute leukemia. They also disrupt the production of normal blood cells, which can lead to a deficiency:
- If healthy white blood cells are missing, infections can occur frequently
- A lack of red blood cells results in anemia. Possible consequences are weakness and shortness of breath
- In the absence of platelets, bleeding may increase
The blasts can get from the bone marrow into the blood and then to other parts of the body, sometimes in large quantities.
In chronic myeloid leukemia, the white blood cells multiply at all stages of maturation. These are then also found in large quantities in the blood. This peculiarity also explains the name "leukemia": translated it means "white blood".
What causes and risk factors are known?
In most cases it is not clear why the leukemia developed. Certain factors increase the statistical risk of developing leukemia:
- Contact with certain chemical substances such as benzene
- Radioactive radiation and X-rays
- Some cytotoxic drugs that are used to treat cancer
However, a statistical correlation is only clearly evident at high doses. Not everyone who was exposed to a potential risk falls ill. Various other factors must probably come together.
- Genetic predisposition can also play a role. Certain genetic changes increase the risk of leukemia, such as trisomy 21.
- Viruses like HTLV-1 rarely cause a certain form of leukemia in this country. But leukemia is not "contagious".
- Chronic leukemia in particular becomes more common with increasing age.
Can you prevent leukemia?
The exact causes of leukemia are not known. As far as we know today, it is not possible to specifically prevent leukemia, for example through a healthy lifestyle.
Exactly how the lifestyle and the leukemia risk are related is still being researched. For example, there is evidence that smoking increases the likelihood of acute myeloid leukemia.
Risk factors (see section "What causes and risk factors are known?") Seem to be relevant only for a small fraction of the disease cases. Nevertheless, it is advisable to minimize potential risks as a precaution if possible.
What are the symptoms of leukemia?
There are many forms of leukemia and they can show up in very different ways. Therefore, no general statement can be made.
Chronic forms of leukemia often go unnoticed for a long time and are sometimes discovered by chance during a blood test in the blood count. Acute leukemia usually causes more pronounced symptoms that worsen quickly. Possible symptoms of leukemia are, for example
- Tiredness, weakness, shortness of breath
- Fever, night sweats
- Tendency to infections
- Tendency to bleed, such as bruises, punctiform skin bleeding (petechiae)
- Sensation of pressure in the upper abdomen
- Bone and joint pain
However, these signs do not have to be present in every case. They can all have other causes as well. In addition, other symptoms can occur with leukemia.
How does the doctor make a diagnosis?
A blood test may already provide clues. A bone marrow biopsy is often needed to confirm the diagnosis. The doctor takes a small sample from the inside of the bone under local anesthesia, usually from the iliac crest.
How are leukemia treated?
The therapy depends on the exact form of the leukemia. The individual genetic characteristics of the modified cells are becoming increasingly important. General statements cannot be made here. The treatment can be very different and take different lengths of time.
Depending on the case, chemotherapy, for example, special drugs such as tyrosine kinase inhibitors or monoclonal antibodies are used. A blood stem cell transplant may be an option.
Rapid therapy is required in acute leukemia. Patients with chronic myeloid leukemia are usually treated immediately. Strictly speaking, chronic lymphocytic leukemia is a lymphoma. In the case of this disease, doctors may first wait and only monitor the course of the disease.
What are the chances of a cure in leukemia?
There are numerous forms of leukemia (see section "What forms are there"). Therefore, no general statement can be made about life expectancy. The prognosis also depends heavily on individual factors such as age.
German Cancer Information Center, KID cancer information service:
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Competence network leukemia:
German Society for Hematology and Medical Oncology e.V .:
This text was created with the kind support of the cancer information service of the German Cancer Research Center Heidelberg.
Wendy Stock, MD, Michael J Thirman, MD, "Pathogenesis often acute myeloid leukemia" ", ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com (accessed November 2018)
https://www.krebsinformationsdienst.de/tumorarten/leukaemien/index.php, (accessed February 2019)
https://www.kompetenznetz-leukaemie.de/content/patienten/leukaemien/, (accessed February 2019)
Herold G and colleagues: Internal Medicine, 2019, Cologne Gerd Herold
This article contains general information only and should not be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor. Unfortunately, our experts cannot answer individual questions.