Leukemia

Leukemia is a blood cancer caused by the body producing too many abnormal white blood cells. Leukemia can occur in both adults and children.

White blood cells are part of the immune system which are produced in the bone marrow. When bone marrow function is disrupted, the white blood cells produced will change and no longer carry out their role effectively.

Leukemia is often difficult to detect because the symptoms mimic those of other diseases. Therefore, early examination needs to be done so that leukemia can be treated quickly.

Types of Leukemia

Leukemia can be chronic or acute. In chronic leukemia, the cancer develops slowly with initial symptoms that are usually mild. While in acute leukemia, the development of cancer cells occurs very quickly and symptoms can get worse in a short time. Acute leukemia is more dangerous than chronic leukemia.

Based on the type of white blood cells involved, leukemia is divided into four main types, namely:

Acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) or acute lymphoblastic leukemia occurs when the bone marrow produces too many immature white blood cells (lymphocytes).

Chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) or chronic lymphocytic leukemia occurs when the bone marrow produces too many abnormal lymphocytes and slowly causes cancer.

Acute myeloblastic leukemia

Acute myeloblastic leukemia (AML) or acute myeloblastic leukemia occurs when the bone marrow produces too many immature myeloid cells or myeloblasts.

Chronic myelocytic leukemia

Chronic myelocytic leukemia (CML) or chronic myelocytic leukemia occurs when the bone marrow is unable to produce mature myeloid cells.

Apart from the four types of leukemia above, there are several other types of leukemia which are rare, including:

• Hairy cell leukemia ( hairy cell leukemia )
• Chronic myelomonocytic leukemia ( chronic myelomonocytic leukemia )
• Acute promyelocytic leukemia ( acute promyelocytic leukemia )
• Large granular lymphocytic leukemia ( large granular lymphocytic leukemia )
• Juvenile myelomonocytic leukemia , which is a type of myelomonocytic leukemia that attacks children under 6 years of age.

Causes of Leukemia

Leukemia is caused by abnormalities in the white blood cells that make them grow uncontrollably. It is not known exactly why this happens, but there are several factors that are thought to increase the risk of developing leukemia, namely:

• Have a family member who has had leukemia
• Suffering from genetic disorders, such as Down Syndrome
• Suffer from a blood disorder, such as myelodysplastic syndrome
• Have a smoking habit
• Have had cancer treatment with chemotherapy or radiotherapy
• Working in an environment exposed to chemicals, such as benzene

Symptoms of Leukemia

At first, leukemia often causes no signs. New symptoms appear when the cancer cells are growing and starting to attack the body's cells. Symptoms that appear also vary, depending on the type of leukemia suffered. However, in general, complaints experienced by people with leukemia are:

• Fever and chills
• Fatigue that doesn't go away even after resting
• Weight loss drastically
• Anemia symptoms
• Red spots on the skin
• Nosebleed
• The body bruises easily
• Excessive sweating (especially at night)
• Easy to get infection
• A lump appears in the neck due to swollen lymph nodes
• The stomach feels uncomfortable because the liver and spleen are swollen

More severe symptoms can appear when cancer cells block blood vessels in certain organs. Symptoms that can appear include:

• Terrible headache
• Nausea and vomiting
• Muscles out of control
• Bone pain
• dazed
• seizures

When to see a doctor

Immediately see a doctor if you experience repeated and prolonged fever, or nosebleeds . The symptoms of leukemia often mimic those of other infectious diseases, such as the flu . Therefore, examinations need to be carried out to detect early the possibility of cancer and prevent the development of the disease.

If you are an active smoker and find it difficult to stop smoking , then consult your doctor about steps you can take to quit smoking . This is because smoking is one of the factors that can increase the risk of leukemia.

Leukemia treatment requires a long time. Therefore, it is advisable to regularly consult a doctor during the treatment period. That way, the progress of the disease can always be monitored.

Diagnosis of Leukemia

The doctor will ask about the patient's symptoms and perform a physical examination. Through a physical examination, the doctor can detect signs of leukemia, such as bruising on the skin, pale skin due to anemia, and swollen lymph nodes, liver or spleen.

However, the diagnosis of leukemia cannot be confirmed only by physical examination. Therefore, the doctor will carry out other tests to confirm the diagnosis and find out the type of leukemia the patient is suffering from. The types of inspections carried out include:

Blood test

A complete blood count is done to determine the number of red blood cells, white blood cells, and platelets. Doctors can suspect a patient has leukemia if the number of red blood cells or platelets is low and the shape of the blood cells is not normal.

Bone marrow aspiration

The bone marrow aspiration procedure is performed by taking a sample of bone marrow tissue from the hip bone using a long, thin needle. This sample will then be examined in the laboratory to detect cancer cells.

In addition to the diagnostic tests above, the doctor will also perform other tests to check for organ abnormalities due to leukemia. The types of tests that can be done are:

• Scans, such as ultrasound, CT scan, and MRI
• Lumbar puncture
• Liver function test
• Spleen biopsy

Leukemia Treatment

A specialist in hematology oncology (blood and cancer specialist) will determine the treatment method based on the type of leukemia and the patient's overall condition. The following are treatment methods for dealing with leukemia:

• Chemotherapy , which is a method of treatment using drugs to kill cancer cells. The medicine given can be in the form of drinking tablets or infusion injections.
• Immune therapy or immunotherapy, which is the administration of drugs to boost the body's immune system and help the body fight cancer cells. Types of drugs used for example interferon .
• Targeted therapy, namely the use of drugs to inhibit the production of proteins that cancer cells use to grow. One of the types of drugs used is imatinib .
• Radiotherapy, which is a procedure to destroy and stop the growth of cancer cells using high-energy radiation beams.
• Bone marrow transplant , which is a procedure to replace damaged bone marrow with healthy bone marrow.

Sometimes, surgery is also performed to remove an enlarged spleen ( splenectomy ). An enlarged spleen organ can exacerbate the symptoms of leukemia experienced by patients.

Leukemic complications

Leukemia can cause complications if not treated immediately. Some of the complications that can occur are:

• Bleeding in an organ, such as the brain or lungs
• The body is susceptible to infection
• The risk of developing other types of blood cancer, such as lymphoma .

Complications can also occur as a result of the treatment measures taken. Here are some complications due to leukemia treatment:

• Graft versus host disease , which is a complication of bone marrow transplant
• Hemolytic anemia
• Tumor lysis syndrome (tumor lysis syndrome)
• Impaired kidney function
• Infertility
• Cancer cells reappear after treatment

Children with leukemia are also at risk of developing complications due to the treatment. Types of complications that can occur include central nervous system disorders, developmental disorders, and cataracts.

Leukemia Prevention

There is no effective way to prevent leukemia. However, there are several efforts that can be made to reduce your risk of developing leukemia, including:

• Exercise regularly
• Stop smoking habit
• Use personal protective equipment , especially if you work in an environment that is prone to exposure to chemicals, such as benzene
• Undergo regular health checks to detect cancer early, especially if you have a family history of cancer.