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Leukaemia : Causes, Symptoms, Diagnosis, Prevention And Treatment

Leukaemia is referred to as a cancer of the blood and bone marrow characterized by the body's inability to form healthy blood cells. The condition starts in the bone marrow where the production of new blood cells takes place [1] .

Bone marrow is responsible for the making of red blood cells (RBC), white blood cells (WBC) and platelets. In leukaemia, due to the immature cells or some defect in the cells of the bone marrow, the abnormal and functionless WBC are produced which are unable to fight against the infection and defend our body against foreign substances. Also, they obstruct the production of other blood cells by dividing quickly and crowding among normal cells [2] .

Leukaemia generally affects either of the two major types of WBC - lymphocytes and granulocytes. When it arises from lymphocytes, it is called lymphocytic leukaemia while with the latter, it is called myelogenous or myeloid leukaemia. The condition is either acute or chronic depending upon the type of leukaemia cells. It occurs more likely in men than in women and older people compared to adults. In children, generally, it occurs before age 10.

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Types Of Leukaemia

Leukaemia occurs in 4 types depending upon the progression speed and cell type involved. In acute leukaemia, the disease progresses quickly while in chronic leukaemia it progresses slowly. They are as follows:

  • Acute lymphocytic leukaemia (ALL): It occurs commonly in children when the immature lymphoid cells multiply rapidly and obstruct the production of other blood cells [3] .
  • Chronic lymphocytic leukaemia (CLL): It is a slow-growing form of leukaemia that usually affects people above age 55 [4] .
  • Acute myelogenous leukaemia (AML): It is a rapidly-growing and common form of leukaemia in which the myeloid cells don't develop normally and multiplies rapidly [5] .
  • Chronic myelogenous leukaemia (CML): It is caused because of an abnormality in myeloid cells due to a defective string of DNA, although it is not genetic [6] .

Causes Of Leukaemia

Leukaemia is caused when the DNA of the cells mutate and cause certain abnormalities in their functions. Meaning, every cell in our body comes with certain inbuilt instructions. When mutation due to unproven reasons occurs in the DNA of the cell, they grow and divide rapidly and form a crowd near the bone marrow among normal healthy cells. These cells do not die and in turn, accumulate more space preventing the formation of healthy new blood cells from the bone marrow [7] .

Symptoms Of Leukaemia

The symptoms of leukaemia may be mild at first but later certain symptoms do occur like the following [8] :

  • Anaemia [9]
  • Swollen lymph nodes
  • Bleeding from gums or in stool
  • Fatigue
  • Frequent infection
  • Excessive sweating
  • Bone tenderness [10]
  • Sudden weight loss
  • Fever
  • Easy bruises [8]
  • Seizures and headache, if it spreads to the central nervous system
  • Loss of muscle control
  • Enlarged liver or spleen [11]

Risk Factors Of Leukaemia

Risk factors of leukaemia include the following:

  • HIV [12]
  • Smoking [13]
  • Genetic predisposition [14]
  • People with Down syndrome
  • Alkylating chemotherapy due to previous cancer treatment
  • Exposure to petrochemicals like benzene [15]
  • Hair dyes

Complications Of Leukaemia

Leukaemia needs immediate treatment otherwise it can result in serious complications. However, common complications of leukaemia are as follows:

  • Urinary tract infection [16]
  • Skin infection
  • Sepsis [17]
  • Bleeding in the brain
  • Intestinal bleeding
  • Bleeding in the lungs
  • Death

Diagnosis Of Leukaemia

There are several symptoms of leukaemia which are similar to other disorders. Thus, a proper medical examination is necessary. The tests for diagnosing leukaemia are as follows:

  • Complete blood count test: To determine the count of WBCs, RBCs and platelets in the bloodstream or the formation of any abnormal cells.
  • Tissue biopsy scan: A test in which a small tissue is taken from the lymph nodes or bone marrow to identify the presence of leukaemia, its type and its growth rate [18] .
  • Genetic abnormality test: A test to determine the Philadelphia chromosome, genetic defect present in leukaemia cells.
  • Staging: This test helps determine the outlook of the patient based on the type of leukaemia.
  • Cytochemistry: A test in which stains are used to identify the tissue structure of the bone marrow cells [19] .
  • Lumbar puncture: A test performed by the spinal fluid to identify the spread of the leukaemia to the central nervous system.

Other methods of diagnosing include CT scan, MRI and ultrasound.

Treatment Of Leukaemia

The treatments are as follows:

  • Radiation therapy: Here, high energy beams or X-rays are used to inhibit the growth of leukaemia cells [20] .
  • Chemotherapy: In this method, a single or combination of drugs are used to treat leukaemia.
  • Targeted therapy: Here, specific drugs are used to control certain vulnerabilities of the leukaemia cells or to halt certain function of the leukaemia cells which prevents its further growth.
  • Stem cell transplant: A treatment in which diseased bone marrow is replaced with healthy bone marrow [21] .
  • Biological therapy: This treatment includes antibodies, cytokines and tumour vaccines which help the immune system to identify the cancerous cells and attack them.

Other treatment method includes

  • Blood or platelet transfusions
  • Antiviral or antibiotics medications
  • Vaccines against flu
  • Anti-nausea drugs
  • Immunoglobulins injections [22]

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Prevention Of Leukaemia

As leukaemia is generally related to DNA and occurs suddenly in many cases, there are no specific prevention tips for the following. However, a few precautionary methods are as follows:

  • Quit smoking [13]
  • Avoid exposure to petrochemical
  • If working in the petrochemical industry, avoid direct contact with the chemicals [15] .

FAQs About Leukaemia

1. Can you survive leukaemia?

Yes. The 5-year survival rate for all leukaemia subtypes is 61.4%.

2. Is leukaemia hereditary?

No. The mutation of cells is genetic but not hereditary as the abnormalities are not often inherited.

3. How long can you live with leukaemia?

Survival years with leukaemia depends upon the type and age of the patient. People below age 55 have higher leukaemia survival rates.

4. Does leukaemia lead to a painful death?

No. With proper medication and care, the symptoms of leukaemia can be managed.

5. Can you suddenly get leukaemia?

Yes. Chronic leukaemia is very slow-growing and does not cause symptoms at first.

6. Can you suddenly die from leukaemia?

No, but when multiple myeloma cells grow unchecked, people may die from multiple causes.

View Article References
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