LEUKEMIA, CHRONIC

 Basic information

description

• Leukemia is cancer of the cells in the bone marrow. Bone marrow is the soft material in the center of bones and all blood cells are formed there. White blood cells fight infections, red blood cells carry oxygen, and platelets help control bleeding. With leukemia, the cancerous cells replace the normal bone marrow cells. As the amount of normal white blood cells, platelets, and red blood cells decrease, the body then develops infections, anemia, or bleeds easily. Chronic leukemia develops over a long period of time. Forms of chronic leukemia include:
  • Chronic lymphocytic leukemia (CLL). It affects adults only and is twice as common as CML.
  • Chronic myeloid (myelogenous) leukemia (CML). It is rare in children and mostly affects adults.

FREQUENT SIGNS & SYMPTOMS

• Sometimes, no symptoms occur.
• Low fever, chills, and sweating.
• Tiredness and weakness.
• Anemia (pale skin, fatigue).
• General ill feeling.
• Easy bruising or bleeding or cuts that heal slowly.
• Pin-head size spots on the skin.
• Repeated infections.
• Bone or joint pain.
• Appetite and/or weight loss. Fullness in the stomach.
• Other symptoms if cancer cells collect in organs, such as brain, lungs, genitals, digestive tract, or kidneys.

causes

Exact cause unknown. It is believed to develop from a combination of genetic and environmental factors.

risk increases with

• Men more than women; whites and Hispanics.
• Excess exposure to radiation.
• Exposure to benzenes and other toxic chemicals.
• Weak immune system due to illness or drugs.
• Smoking.

PREVENTIVE MEASURES

Cannot be prevented. If you have a family history of leukemia, get genetic counseling before starting a family.

expected outcomes

Depends on the type of leukemia, the patient's health, and response to treatment. Remission occurs when there is no evidence of leukemia in the blood or bone marrow. Remission over 5 years often indicates a cure.

possible complications

• Hemorrhage or uncontrolled infection (can be fatal).
• Failure of leukemia to respond to chemotherapy.
• Relapse (leukemia recurs after remission).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms. Medical tests include blood studies. Samples of bone marrow (liquid and solid) will be taken for viewing with a microscope. Other tests are done to see if the cancer has spread.
• Treatment depends on the leukemia type and other factors. Treatment for CML may include anticancer drugs (chemotherapy), bone marrow transplant, stem cell transplant, and biologic therapy. CLL patients may not need any immediate treatment. Follow-up exams are done. If disease progresses, then chemotherapy may be recommended.
• Chemotherapy uses drugs, and radiation therapy uses radiation to attack the cancer cells. Biologic therapy uses the body's immune system to fight cancer.
• Bone marrow transplant involves replacing the leukemia-affected marrow with healthy bone marrow.
• Stem cell transplant replaces blood cells destroyed in treatment with stem cells (immature blood cells).
• Blood and platelet transfusions may be needed.
• Surgery may be done to remove the spleen.
• Counseling may help you cope with having cancer.
• Get good dental care to avoid infections and bleeding.
• To learn more: National Cancer Institute, 6116 Executive Blvd., MSC8322, Bethesda, MD 20892; (800) 422-6237; website: www.cancer.gov.

medications

• You will usually be prescribed anticancer drugs. They can be taken by mouth or given through a vein (IV).
• Antibiotics may be prescribed for infections.
• Biologic therapy drugs may be prescribed.

activity

As tolerated. Avoid strenuous activities (such as lifting).

diet

A healthy diet helps you feel better. Ask for medical advice and help if you are having problems with eating.

 notify our office if

• You or your child has symptoms of leukemia.
• After diagnosis, symptoms cause you any concern.

Special Notes: