Unlike other cancers, leukemia doesn’t generally form
a mass (tumor) that shows up in imaging tests, such as X-rays or CT scans.
There are many types of leukemia. Some are more common
in children, while others are more common in adults. Treatment depends on the
type of leukemia and other factors.
Leukemia begins in bone
marrow, the soft spongy tissue in the inner cavity of your bones, where your
body’s blood cells are made. Blood cells go through multiple stages before
reaching their fully mature forms. Mature, normal blood cells include: red
blood cells (cells that carry oxygen and other vital materials); white
blood cells (cells that fight infection) and platelets (cells that help
your blood clot).
These blood cells start as
hematopoietic (hemo = blood, poiesis = make) stem cells. The stem cells develop
into either myeloid (MAI-uh-loyd) cells or lymphoid (LIM-foyd) cells. If blood
cells were to continue to develop normally, the mature forms of these cells are
as follows: myeloid cells develop into red blood cells, platelets
and certain types of white blood cells (basophils, eosinophils and neutrophils)
and lymphoid cells develop into certain white blood cells (lymphocytes and
natural killer cells).
However, if you have leukemia,
one of the developing blood cells begins to multiply out of control. These
abnormal cells — called leukemia cells — begin to take over the space inside of
your bone marrow. They crowd out the cells trying to develop into healthy red
blood cells, white blood cells and platelets.
There are four main types of leukemia and
several subtypes. Healthcare providers classify leukemia based on how fast the
disease worsens and whether leukemia cells arise from myeloid cells or lymphoid
cells.
Scientists don’t know what causes these developing
cells to mutate. They’ve been able to identify some common mutations that
people diagnosed with different types of leukemia share.
Results from routine blood work can alert your healthcare provider that
you may have an acute or chronic form of leukemia that requires further
testing. Or they may recommend a workup if you have leukemia symptoms.
Diagnostic
exams and tests may include: a physical exam; complete blood count; blood cell
examination; bone marrow biopsy; imaging and other tests and lumbar
puncture.
Treatments for leukemia depend on the type of
leukemia you have, your age and overall health, and if the leukemia has spread
to other organs or tissues.
Common treatments often include a combination of
the following: chemotherapy; immunotherapy (biologic therapy): targeted
therapy; radiation therapy; hematopoietic cell transplant (stem cell
or bone marrow transplant) and chimeric antigen receptor (CAR) T-cell
therapy:
Clinical trials are also available to test new cancer treatments.