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Leukemia is a cancer of the bone marrow and blood. Although it is the most common childhood cancer, it actually afflicts more adults than children each year. About 43,000 adults and 3,500 children are expected to be diagnosed with leukemia in the United States this year.
Wellstar Health System provides superior care for leukemia, offering a comprehensive spectrum of top-notch physicians, treatment options and diagnostic tools. In addition Wellstar offers innovative advances in the fight against leukemia, including:
Leukemia begins with cells in the bone marrow, the soft tissue deep inside the bone that produces blood cells.
Leukemia cells grow faster than normal marrow cells and eventually crowd out the good cells. This, in turn, causes a reduction or imbalance in the blood cells that fight infection, carry oxygen to different parts of the body, and clot blood. Most people who get the disease are adults, but leukemia is the most common childhood cancer.
Blood is comprised of three different types of cell. Generally, red blood cells carry oxygen from the lungs to the rest of the body, white blood cells combat infection, and platelets form blood clots.
Leukemia is classified two different ways. One way is whether it is acute, or very fast-growing; or chronic, or slow-growing. Acute leukemia is characterized by a rapid build-up of about a trillion nonfunctional marrow cells, which rapidly reduces the production of blood cells. The abnormal In chronic leukemia, the marrow produces blood cells that are almost normal. Usually, it produces too few red blood cells (anemia), but often produces too many white blood cells that are not quite normal, as well as platelets. The abnormal while blood cells become so numerous that they slow blood flow and anemia becomes acute.
The other classification is by the type of marrow cell, and therefore blood cells, affected. One of the types of marrow cells produces lymphocytes, a type of white blood cell critical in fighting infection. If the leukemia originated in these cells, it is called lymphocytic leukemia.
The other type of marrow cells produce red blood cells, platelets, and some other types of white blood cells. Leukemia of these cells is called myeloid leukemia.
Immature, partially differentiated cells are called blast cells. Immature lymphocytes are called lymphoblasts (or "blasts"); myeloblasts mature into the other types of blood cells. Normally, blasts cells do not leave the marrow, but some forms of leukemia produce so many blasts that they overflow into the blood stream.
Combining these two classifications produces the four main types of leukemia:
Chronic myeloid leukemia (CML) mostly affects adults, and slightly more men than women. Treatment for both forms of acute leukemia typically begins as soon as possible after diagnosis, while treatment for some types of chronic leukemia can wait.
Wellstar supports scientific research that shows certain lifestyle choices can lower a person's risk of some cancers. Many patients with leukemia had no risk factors for developing the illness, but it is still important to do all that you can to reduce your risk factors for all cancers. We have also linked cigarette smoking to numerous cancers, including leukemia. Wellstar endeavors to help patients who want to stop smoking through a variety of smoking cessation efforts.
As with many cancers, there is no screening test for leukemia. If you exhibit symptoms of leukemia, such as extreme fatigue, frequent infections, easy bruising, and excessive bleeding, your Wellstar physician will want to perform blood tests to determine whether you may have leukemia. A blood test can show whether you have leukemic cells. In addition, your Wellstar physician may want to examine tissue from your bone marrow. To do that, a long needle will be inserted into your bone, usually at the hip, to extract marrow. Because there are many different subtypes of leukemia, this bone marrow aspiration will also help determine what kind of leukemia you have and what kind of treatment you are most likely to respond to.
When leukemia is diagnosed, your Wellstar physician will categorize it by the type and subtype. Leukemia is not "staged" as other cancers are, because typically staging refers to how large a tumor is and whether it has spread to other parts of the body. Leukemia already has spread to parts of the body because it is a blood cancer, and thus staging in the traditional sense of cancer staging is not meaningful.
Your Wellstar physician will, however, determine certain key aspects of your leukemia to give you and your treatment team a clear understanding of the progression of your disease.
Adult acute lymphocytic leukemia (ALL) is classified as:
Chronic myeloid leukemia (CML) is classified as:
Chronic lymphocytic leukemia is classified in more traditional staging:
Once leukemia has been detected and classified your team of specialists in oncology, radiation oncology, and pathology will work together to assess your best course of treatment for your leukemia. This will include formulating a coordinated plan of personalized treatment consistent with the highest standards of care. Your treatment will be tailored to the type of leukemia you have, and may include a combination of radiation, chemotherapy, bone marrow transplant, and the use of drugs known as biological agents. Also, you may want to explore clinical trials, which are studies that test the efficacy of experimental treatments not yet approved by the FDA. Because these are experimental, there is no guarantee that the treatments work. Talk to your Wellstar physician to determine whether a clinical trial may be important for you. Most children with leukemia are enrolled in a clinical trial of some type.
Typically leukemia is not treated with surgery. Because it is a cancer in the blood, there is no solid tumor mass to remove. Very infrequently, a patient with chronic lymphocytic leukemia (CLL) will need to have his or her spleen removed.
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Chemotherapy is typically used for leukemia patients and occasionally used in concert with radiation.
There are many types of chemotherapy drugs and many drug regimens to use to treat leukemia. The regimen will depend upon several factors. For example, childhood acute lymphocytic leukemia (ALL), is treated differently from adult ALL, which is treated differently from chronic lymphocytic leukemia (CLL). Your Wellstar physician is experienced in treating all forms of leukemia and is on the cutting edge of chemotherapy treatment options for your specific disease.
Radiation therapy uses high-powered beams of energy to kill cancer cells. Acute lymphocytic leukemia (ALL) patients may receive radiation targeted at a specific part of their bodies, or they may receive whole-body radiation. Late effects from radiation can be a problem particularly for children, and it is important to discuss these issues with your Wellstar physician, who is extremely expert in the late effects of radiation.
In addition to chemotherapy, which uses very strong drugs that kill many types of fast-growing cells in the body, new therapies that attack specific vulnerabilities within cells have been discovered to treat some cancers. These therapies do not work like traditional chemotherapy, and they also do not carry the side effects, such as nausea and hair loss, of traditional chemotherapy. A drug called Gleevec has been extremely successful in treating CML, for example, and recently two new drugs, Tasigna and Sprycel, have shown great benefits in treating CML Your Wellstar physician is on the cutting edge of leukemia research and will know whether you are a candidate for any targeted drug therapies.
In addition, drugs that help your immune system recognize and attack cancer cells have shown great promise in treating leukemia. Some of these are called monoclonal antibodies. These drugs not only have shown efficacy but they also have the added benefit in having fewer side effects than traditional chemotherapy in many people.
Because the production of leukemic cells begins in the stem cells in the bone marrow, a procedure to replace your diseased bone marrow is sometimes recommended. This is typically done if a person does not respond to other, first-line treatments, or if the cancer returns. Before the transplant occurs, you will be given high doses of chemotherapy to kill your diseased bone marrow. You then receive an infusion of healthy, blood-forming stem cells. These can come from a donor, and sometimes they can come from your own body. Many factors influence whether you are a candidate for a stem cell transplant, and if so, what kind. Your Wellstar physician and treatment team will guide you through this process with the utmost care.
You'll be referred after your recovery from leukemia to Wellstar's medical oncology team for treatment, surveillance and survivorship programs. These comprehensive programs focus on diet, exercise and nutrition to help you reduce the risk of recurrence.
Cancer care at Wellstar is more than advanced technology, clinical research, and highly specialized physicians and nurses. It includes an array of supportive care services to improve the patient experience before, during and after treatment. All of these services are available within the Wellstar system, including:
Wellstar's certified palliative care physicians and certified registered nurses are dedicated to providing compassionate, quality care in various settings, including home hospice, inpatient hospice nursing homes, assisted living facilities and nursing homes. Wellstar offers caring and compassionate hospice care for patients and their families in one of Georgia's oldest hospice programs serving Bartow, Cherokee, Cobb, Douglas and Paulding counties.