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Leukemia

Leukemia, Symptoms and Causes

Leukemia is one of a group of cancers of the blood and lymphatic systems known as hematologic malignancies that are treated by the world-renowned specialists at the Hematologic Program North Shore-LIJ Cancer Institute. Our cancer experts include world-renowned leaders in both the study and frontline treatment of hematologic cancers. They work closely with an interdisciplinary team of specialists to provide compassionate and individualized care using the latest protocols of chemotherapy, immunotherapy and targeted drug therapy.

International Leader in Leukemia Treatment

Our Institute is one of the largest acute leukemia treatment centers in the nation. We have been designated a “Myelodysplastic Syndrome Center of Excellence” by the Myelodysplastic Syndrome Foundation. Our basic science research program for chronic lymphocytic leukemia, led by Dr. Nicholas Chiorazzi, and clinical therapeutic trials program under the leadership of Dr. Kanti Rai, are models in their field and enjoy an international reputation for excellence. 

Regional Leaders in Leukemia and Stem Cell Transplants

Our dedicated leukemia and stem cell transplant centers are among the largest in the New York area. Our Adult and Pediatric Bone Marrow and Stem Cell Transplant Programs are the only transplant programs in the Long Island, Queens, and Brooklyn area accredited by the prestigious Foundation for Accreditation in Cellular Therapy (FACT) for exceptional patient care and medical practices. 

World Leaders in Chronic Lymphocytic Leukemia Treatment

Our Chronic Lymphocytic Leukemia Research and Treatment Program has become a world-renowned landmark for patients with chronic lymphocytic leukemia (CLL), one of the most common forms of leukemia in adults.
 
Our expert physicians have received international acclaim for the study and frontline treatment of hematologic cancers, and we are consistently listed among the top three medical centers for leukemia research in the United States. Our prominent researchers have led major trials through the Leukemia Group B (CALBG) and Community Clinical Oncology Program (CCOP), both supported by the National Cancer Institute (NCI). 

Leukemia: An Overview

What Is Leukemia?

Leukemia is cancer of the blood cells--usually the white blood cells. Leukemic cells look different from normal cells and do not function properly. 

What Are the Different Types of Leukemia?

There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine if the cancer is:
  • Lymphocytic or myelogenous leukemia
  • Cancer can occur in either the lymphoid or myeloid white blood cells.
    • When the cancer develops in the lymphocytes (lymphoid cells), it is called lymphocytic leukemia.
    • When the cancer develops in the granulocytes or monocytes (myeloid cells), it is called myelogenous leukemia.
  • Acute or chronic leukemia
  • Leukemia is either acute or chronic
    • Acute leukemia – The new or immature cells, called blasts, remain very immature and cannot perform their functions. The blasts increase in number rapidly, and the disease progresses quickly.
    • Chronic leukemia – There are some blast cells present, but they are more mature and are able to perform some of their functions. The cells grow more slowly, and the number increases less quickly, so the disease progresses gradually. 
Based on these findings, the leukemia is then classified into one of the four main types of leukemias:
  • Acute myelogenous leukemia (AML)
  • Chronic myelogenous leukemia (CML)
  • Acute lymphocytic leukemia (ALL)
  • Chronic lymphocytic leukemia (CLL)
There are additional types and subtypes of leukemias. 

What Are the Symptoms of Leukemia?

The following are the most common symptoms of leukemia. However, each individual may experience symptoms differently. Symptoms may include:
  • Increased susceptibility to infections and fevers
  • Anemia
  • Bleeding
  • Bruising
  • Fever
  • Chills
  • Loss of appetite
  • Loss of weight
  • Swollen or tender lymph nodes, liver, or spleen
  • Petechiae – tiny red dots under the skin that are the result of very small bleeds
  • Swollen or bleeding gums
  • Sweating
  • Bone or joint pain 
In addition, acute leukemia may cause the following:
  • Headaches
  • Vomiting
  • Confusion
  • Loss of muscle control
  • Seizures
  • Swollen testicles
  • Sores in the eyes or on the skin 
Chronic leukemia may affect the skin, central nervous system, digestive tract, kidneys and testicles.
The symptoms of acute and chronic leukemias may resemble other Hematology & Blood Disorders or medical problems. Always consult your physician for a diagnosis. 

How Is Leukemia Diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for leukemia may include the following:
  • Bone marrow aspiration and/or biopsy – a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size and maturity of blood cells and/or abnormal cells
  • Complete blood count (CBC) – a measurement of size, number and maturity of different blood cells in a specific volume of blood
  • Additional blood tests (may include blood chemistries, evaluation of liver and kidney functions, and genetic studies)
  • Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
  • X-ray – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Ultrasound (also called sonography) – a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. Ultrasounds are used to view internal organs as they function and to assess blood flow through various vessels.
  • Lymph node biopsy – a procedure performed to remove tissue or cells from the body for examination under a microscope
  • Spinal tap/lumbar puncture – a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord. 

How Is Leukemia Treated?

Specific treatment for acute and chronic leukemias will be determined by your physician based on:
  • Your age, overall health and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disease
  • Your opinion or preference 
Treatment may include:
  • Chemotherapy
  • Radiation therapy
  • Bone marrow transplantation
  • Biological therapy – using the body's immune system to fight cancer
  • Blood transfusion (red blood cells, platelets)
  • Medications (to prevent or treat damage to other systems of the body caused by leukemia treatment) 

Leukemia Clinical Trials 

The North Shore-LIJ Cancer Institute offers a full array of clinical trials. The result of this research not only impacts survival, but also enhances the quality of life. For more information about clinical trials for Leukemia, visit Cancer Clinical Trials.

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