Acute Leukemia: Causes and Symptoms

Cancer affecting the white blood cells is known as leukaemia. Acute leukaemia signifies that cancer spreads rapidly requiring immediate medical attention. 

The cancer of blood and bone marrow is known as Acute  Leukemia. It starts in the bone marrow (soft inner part of the bone-responsible for blood cell production) and spread quickly to the blood and different parts of the body like the liver, the spleen, the brain, the spinal cord, the lymph nodes, and also the testicles in men. 

These are classified into 2 types of Acute Lymphoblastic leukemia ( ALL) and Acute Myeloid Leukemia ( AML ).

Acute Leukemia is characterised by abnormal and underdeveloped blood cells referred to as blast cells.  

Causes and risk factors

The exact cause of Acute leukemia remains unknown. Genetics is thought to play an important role in its development. The risk of Acute Leukemia  is high in case of:

  • Smokers

  • Exposure to prior chemotherapy

  • Exposure to certain chemicals such as benzene and high doses of radiation

  • Presence of certain blood disorders such as myelofibrosis or thrombocythemia.

  • Genetic conditions like Down’s Syndrome, neurofibromatosis type 1, and Li-Fraumeni syndrome, Ataxia  Telangiectasia

  • A parent or sibling having Acute leukemia

Symptoms of Acute Leukemia

The most common symptoms of Acute Leukemia  include:

  • Headache, fever, and shortness of breath

  • Unusual bleeding

  • Swollen liver or spleen 

  • Bony pains

  • Pale skin-due to anemia

  • Lethargy and fatigue

  • Frequent bouts of infections 

Diagnosis of Acute Leukemia

Your physician will check for the symptoms related to Acute lekemia. If you have any of the symptoms mentioned above, the physician may refer you to a Medical Oncologist//hemato-Oncologist. The speciality physician may carry out some diagnostic tests to confirm Acute leukemia. 

  1. A blood test to determine the number of white blood cells, red blood cells, and platelets. Patients with AML generally have too many WBC than RBC and platelets.

  2.  Bone marrow biopsy by taking a sample of your bone marrow from the hip bone and sending it to the laboratory. The bone marrow biopsy test is done to confirm AML.

  3. Flow cytometry is a test performed to Diagnose the Type of Leukemia which could be either Myeloid or Lymphoid.

  4. Genetic tests are done to decide upon the Prognosis and in they also help us choose the targeted treatment ( which could be a chemotherapy-free treatment)

  5. The lumbar puncture test is also a diagnostic test done to check for leukaemia cells  If  CNS involvement is suspected, this is majorly in the pediatric age group. In this test, the physician draws some of the fluid from the spinal canal of the lower back with the help of a small needle. 

Treatment of Acute Leukemia

The main objective of Acute Leukemia treatment is to destroy unhealthy immature blood cells in your bone marrow and blood. The treatment of Acute leukemia is categorized into two phases

  • Remission induction therapy which aims to destroy the blood and bone marrow leukaemia cells. But not all the leukemic cells are destroyed by this treatment. Thus, the second phase of treatment is needed to avoid the return of cancer cells. Usually, systemic medications known as chemotherapy is used during this phase. 

  • Consolidation therapy, whose objective is to kill the remaining leukaemia cells and decrease the risk of relapse. Therapies used in these phases may include

  • Reinduction and Mantienence treatment are an important part of ALL treatment

  • Bone marrow transplant, which helps replace unhealthy bone marrow with leukaemia-free stem cells. 

Post Treatment lifestyle

In some people, the symptoms of Acute leukemia may come back even after completing treatment. It is therefore recommended that all people who are undergoing treatment or have completed it to make sure of the following points

  • It is important to be up to date with all follow-up tests recommended by your oncologists. This will help to screen future risk and also possible side-effects of treatment

  • Eating a healthy balanced diet, regular exercising, quitting smoking and getting enough rest can also go a long way in your fight against cancer.

  • It is completely natural to feel depressed or anxiety post-treatment. However, you should seek professional help and also the emotional support of your friends and family during such periods.

 

 

Dr. Peush Bajpai

HOD And Consultant - Medical Oncology Sciences

Manipal Hospitals, Dwarka, Delhi

 

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