Leukemia is cancer of the blood cells - usually the white blood cells. Leukemic cells look different than normal cells and do not function properly.

What are the different types of leukemia?

There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine if the cancer is:

1. lymphocytic or myelogenous leukemia:
   Cancer can occur in either the lymphoid or myeloid white blood cells.
• When the cancer develops in the lymphocytes (lymphoid cells), it is called lymphocytic leukemia.
• When the cancer develops in the granulocytes or monocytes (myeloid cells), it is called myelogenous leukemia.
2. acute or chronic leukemia:
   Leukemia is either acute or chronic.
   • acute leukemia: The new or immature cells, called blasts, remain very immature and cannot perform their functions. The blasts increase in number rapidly, and the disease progresses quickly.
   • chronic leukemia: There are some blast cells present, but they are more mature and are able to perform some of their functions. The cells grow more slowly, and the number increases less quickly, so the disease progresses gradually.

Based on these findings, the leukemia is then classified into one of the four main types of leukemias:

• acute myelogenous leukemia (AML)
• chronic myelogenous leukemia (CML)
• acute lymphocytic leukemia (ALL)
• chronic lymphocytic leukemia (CLL)

There are other types and subtypes of leukemias.

What are the symptoms of leukemia?

The following are the most common symptoms of leukemia. However, each individual may experience symptoms differently. Symptoms may include:

• increased susceptibility to infections and fevers
• anemia
• bleeding
• bruising
• fever
• chills
• loss of appetite
• loss of weight
• swollen or tender lymph nodes, liver, or spleen
• petechiae - tiny red dots under the skin that are the result of very small bleeds.
• swollen or bleeding gums
• sweating
• bone or joint pain

In addition, acute leukemia may cause the following:

• headaches
• vomiting
• confusion
• loss of muscle control
• seizures
• swollen testicles
• sores in the eyes or on the skin

Chronic leukemia may cause no symptoms. The symptoms of acute and chronic leukemias may resemble other blood disorders or medical problems. Always consult your physician for a diagnosis.

How is leukemia diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for leukemia may include the following:

• bone marrow aspiration and/or biopsy - a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
• complete blood count (CBC) - a measurement of size, number, and maturity of different blood cells in a specific volume of blood.
• additional blood tests (may include blood chemistries, evaluation of liver and kidney functions, genetic studies, and flow cytometry, a state-of-the-art technology used to evaluate cell function)

Specific treatment for acute and chronic leukemias will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• Chemotherapy (more info)
• Radiation Therapy (more info)
• Bone Marrow Transplantation or peripheral stem cell transplantation (PSCT)
• Biological Therapy - using the body's immune system to fight cancer. Oral biological agents are now the mainstay of treatment for chronic myelogenous leukemia (CML). (more info)
• Blood Transfusion (red blood cells and/or platelets)
• Medications (to prevent or treat damage to other systems of the body caused by leukemia treatment)

No treatment may be required for some patients with chronic lymphocytic leukemia (CLL).

Patients at Huntington Hospital are eligible to participate in clinical trials for new leukemia treatments. Click here for more information about clinical trials available at Huntington Hospital.