Leukemia, also known as blood cancer, is a type of cancer seen in white blood cells, which constitutes one third of the cancer types that occur in childhood, although it is usually seen in older individuals. Abnormal proliferation of lymphoid and myeloid cells in the white blood cells (white blood cells) formed by the bone marrow causes the emergence of leukemia.
What are the types of leukemia?
It is divided into acute and chronic leukemias according to their progression rate. Acute leukemias progress rapidly, and if not treated urgently, patients die within days or weeks. On the other hand, chronic leukemias progress slowly and some do not even need treatment. This type is more common in children and responds well to treatment.
Also, leukemias are divided into two groups as "Lymphocytic" and "Myeloid" leukemia according to the cell type they originate from; Lymphocytic leukemia: It is characterized by the uncontrolled increase of the stem cell that forms the white blood cells called lymphocytes. Myeloid leukemia: Leukocytes (neutrophils, monocyte, eosinophil, basophil) is the cancer of the stem cell that will form erythrocytes and platelets.
For example, the type of leukemia that occurs with the rapid proliferation of lymphocytes is called “acute lymphoblastic leukemia”. Acute Lymphoblastic Leukemia
What are the Causes of Blood Cancer (Leukemia)?
The cause of leukemia has not been determined yet.
However, it is thought that some of the patients received chemotherapy or radiotherapy in the past and the use of chemical drugs cause these diseases.
- In addition, it is more common in people with Down Syndrome, suggesting that there is a predisposition in those with a genetic disease.
- Smoking,
- infections (eg Ebstein-Barr virus),
- unhealthy diet,
- chemical While causes such as exposure to substances,
- alcohol use cause blood cancer in adults,
- the disease occurs in children due to genetic problems rather than environmental factors.
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What are the Symptoms of Blood Cancer (Leukemia)?
Symptoms of leukemia may differ in children and adults.
- In case of impact, bruises that occur very disproportionately according to the effect of the blow,
- Anemia,
- Enlargement in the liver or spleen,
- Red blood cells in the blood count and low hemoglobin,
- The child's health is constantly deteriorating despite being well taken care of,
- Pain in the legs for no reason.
- Sudden high fever,
- Weakness,
- Unexplained weight loss,
- Extreme fatigue,
- Infections that never heal ,
- Swelling in the gums,
- Bruises on the body,
- Anorexia,
- Lymph nodes in the armpit, groin and neck region Swellings that do not cause any pain, but
- Nosebleeds,
- Red spots the size of a pinhead under the skin,
- Cough,
- Shortness of breath,
- Sweating,
- Enlarged liver and/or spleen,
- Chest pain,
- Pain in bones and joints.
How is Leukemia Diagnosed?
- Physical examination is required for the diagnosis of blood cancer (leukemia).
- Patients who apply to the doctor generally have weakness, fatigue, discoloration, bruises on the body, and enlarged lymph nodes.
- Complete blood count and peripheral smear tests are performed on the patient as directed by the physician.
- If abnormal blood cells are found in the blood cells examined under the microscope, the diagnosis of leukemia can be made.
How is Blood Cancer (Leukemia) Treated?
- Diagnosed patients vary according to risk group. Treatment methods of increasing intensity and length are applied.
- The aims of leukemia treatment are to stop the progression of the disease and to achieve recovery (remission induction), to prolong the recovery period, to always protect the central nervous system against metastasis and to ensure the long-term maintenance of the response.
- The first method used in the treatment is drug therapy. Oral and intravenous chemotherapy drugs constitute the first stage of treatment.
- In addition to chemotherapy drugs given during leukemia treatment; blood and blood cell, protective and curative antimicrobial drugs are also given.
- In addition to all these therapeutic drugs, treatment methods that prevent the deterioration of the patient's psychological state are also parts of the leukemia treatment.
In Which Situations Is Bone Marrow Transplant Applied? ?
Patients in the high-risk group may need to perform stem cell transplantation after high-dose chemotherapy used in recurrent lymphoma or solid tumor treatments. It can also be obtained from another transmitter. If the stem cell is taken from one of the patient's close relatives (such as a mother, father, spouse, child or sibling), the incompatible tissues in the stem cell are removed before the transplant.
What is the Success Rate of Leukemia Treatment?
Leukemia treatment, which has 90% successful results in children, has a success rate of 50-80% in elderly patients compared to the risk group.
What is Acute Lymphoblastic Leukemia (ALL)?
It is the most common and rapidly developing leukemia type of childhood. The success rate is high with rapid diagnosis and treatment. It constitutes 80% of childhood leukemias and 20% of adult leukemias.
Symptoms and diagnostic methods are similar to leukemia types. There is no standard staging of ALL in adults. Before starting the treatment planning, it is determined whether the leukemia has spread (metastasized) to other organ systems (lung, rib cage bones, brain, etc.).
After all data are collected, standard treatment methods are used. These are:
- Chemotherapy,
- Radiation therapy,
- Stem cell transplantation,
- Targeted therapies (immunotherapy) : Today, as in many cancer treatments, treatments have been developed for the treatment of blood cancer, which do not harm normal cells, but recognize and destroy cancerous cells from the receptors on them.
What is Acute Myeloid Leukemia (AML)?
Acute myeloid leukemia is the most common leukemia in the adult age group.
In this disease, white blood cells (leukocytes) Mature cells such as neutrophils and monocytes cannot be formed from its subgroups and the body remains vulnerable to infections. The cells formed are immature forms and cannot function. Thus, patients experience fever, anemia, and bleeding.
What are AML Risk Factors?
- Male gender,
- smoking use,
- having received chemotherapy or radiotherapy in the past,
- exposure to radiation or chemicals,
- having myelodysplastic syndrome are risk factors for AML
How is Bone Marrow Aspiration Performed?
AML symptoms and diagnostic methods are similar to ALL.
Bone marrow aspiration and biopsy are all leukemia It is important for AML as well as for other types. The pelvis is anesthetized with regional (local) anesthesia or general anesthesia and a bone marrow sample is taken into the injector by entering with a special needle. This process is called aspiration. In biopsy, a small sample is taken with the help of a special biopsy needle. The samples taken are examined under the microscope by the hematologist and pathologist. Chromosome examination tests are also requested.
Bone marrow biopsy is required for definitive diagnosis. A blast count above 20% in a sample taken from the bone marrow or in the surrounding blood smear makes the diagnosis of acute leukemia.
How to Staging in AML?
ALL Similarly, a complete staging cannot be done. Instead, the disease is divided into 3 groups;
- Untreated AML: Used for newly diagnosed patients. More than 20% of the cells in the bone marrow are composed of blastic, ie leukemia cells. bsp;
- AML in remission: Remission means the absence of leukemicblasts in the blood and bone marrow and the restoration of the normal structure and function of the bone marrow. Complete blood count is normal. The number of blasts (leukemic cells) in the bone marrow is 5% or less.
- Relapsed AML: It is the reappearance of AML that has been treated and in remission (healed) after a while.
How AML Is it Treated?
The standard treatments for AML are chemotherapy and stem cell transplantation. Stem cells from the donor (donor) are taken from the bone marrow or from the vein after stem cell stimulating therapy. It is prepared by suppressing the immune system before the recipient receives new stem cells. Suppression continues to prevent rejection after transplantation. Today, 50-80% compatible transplantation, called haploidentic, can be performed for patients whose tissue compatibility is not fully achieved. Haploidentic transplantation provides disease control and normal life for patients who are at risk of frequent recurrence and have difficulty in finding tissue.
What is Chronic Lymphocytic Leukemia (CLL)?
Chronic lymphocytic leukemia ( CLL) is a cancer of the mature stem cell that will form lymphocytes. The difference from ALL is an extremely benign disease compared to ALL. In
95% of CLL patients, leukemic change is seen in the B lymphocyte. The remaining 5% is caused by T lymphocytes or D (natural killer) cells.
CLL is more common in people aged 60 and over. It is not seen in children.
What are the Symptoms of CLL?
CLL usually gives symptoms over time. There are no symptoms in the early stages of the disease. The results of blood tests performed for another disease raise doubts about the disease. An increase in the number of white blood cells (lymphocyte) is a stimulus for the diagnosis of CLL. The signs and symptoms of CLL are similar to those of many other diseases;
· Fatigue quickly: As a result of the decrease in the number of healthy red blood cells, the energy of the person decreases.
· Shortness of breath during normal activities: It is due to the decrease in the number of healthy red blood cells and the proliferation of CLL cells.
· Enlargement of lymph nodes and spleen: CLL cells can accumulate in lymph nodes or spleen
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