What is leukemia?

Leukemia is cancer of the blood cells. It starts in the bone marrow, the soft tissue inside most bones. Bone marrow is where blood cells are made.

• White blood cells help your body fight infection.
• Red blood cells carry oxygen to all parts of your body.
• Platelets help your blood clot.

When you have leukemia, the bone marrow starts to make a lot of abnormal white blood cells, called leukemia cells. They don't do the work of normal white blood cells. They grow faster than normal cells, and they don't stop growing when they should.

Over time, leukemia cells can crowd out the normal blood cells. This can lead to serious problems such as anemia, bleeding, and infections. Leukemia cells can also spread to the lymph nodes or other organs and cause swelling or pain.

Are there different types of leukemia?

There are several different types of leukemia. In general, leukemia is grouped by how fast it gets worse and what kind of white blood cell it affects.

• It may be acute or chronic. Acute leukemia gets worse very fast and may make you feel sick right away. Chronic leukemia gets worse slowly and may not cause symptoms for years.
• It may be lymphocytic or myelogenous. Lymphocytic (or lymphoblastic) leukemia affects white blood cells called lymphocytes. Myelogenous leukemia affects white blood cells called myelocytes.

The four main types of leukemia are:

• Acute lymphoblastic leukemia, or ALL.
• Acute myelogenous leukemia, or AML.
• Chronic lymphocytic leukemia, or CLL.
• Chronic myelogenous leukemia, or CML.

There are less common leukemias, such as hairy cell leukemia. There are also subtypes of leukemia, such as acute promyelocytic leukemia (a subtype of AML).

What causes leukemia?

Experts don't know what causes leukemia. Some things may increase your risk, such as being exposed to large amounts of radiation and being exposed to certain chemicals at work, such as benzene.

What are the symptoms?

Symptoms may depend on what type of leukemia you have, but common symptoms include:

• Fever and night sweats.
• Headaches.
• Bruising or bleeding easily.
• Bone or joint pain.
• A swollen or painful belly from an enlarged spleen .
• Swollen lymph nodes in the armpit, neck, or groin.
• Getting a lot of infections.
• Feeling very tired or weak.
• Losing weight and not feeling hungry.

How is leukemia diagnosed?

To find out if you have leukemia, a doctor will:

• Ask questions about your past health and symptoms.
• Do a physical exam. The doctor will look for swollen lymph nodes and check to see if your spleen or liver is enlarged.
• Order blood tests. Leukemia causes a high level of white blood cells and low levels of other types of blood cells.

If your blood tests aren't normal, the doctor may want to do a bone marrow biopsy. This test lets the doctor look at cells from inside your bone. This can give key information about what type of leukemia it is so you can get the right treatment.

How is it treated?

What type of treatment you need will depend on many things, including what kind of leukemia you have, how far along it is, and your age and overall health.

• If you have acute leukemia, you will need quick treatment to stop the rapid growth of leukemia cells.
• Chronic lymphocytic leukemia may not need to be treated until you have symptoms. But chronic myelogenous leukemia will probably be treated right away.

Treatments for leukemia include:

• Chemotherapy. This is the main treatment for most types of leukemia.
• Radiation.
• Stem cell transplant. Stem cells can rebuild your supply of normal blood cells and boost your immune system.
• Biological therapy. This is the use of special medicines that improve your body's natural defenses against cancer.

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