General Practice 2022

Leukemia: what é, types, symptoms, causes and treatment

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Leukemia: what é, types, symptoms, causes and treatment
Leukemia: what é, types, symptoms, causes and treatment

Leukemia is a type of cancer that affects white blood cells, also known as leukocytes, which are the body's defense cells. This disease starts in the bone marrow, which is the innermost part of the bones, popularly known as 'bone marrow' and spreads through the body through the blood, preventing or disrupting the production of red blood cells, platelets and white blood cells, and because of this anemia, infections and hemorrhages arise.

Leukemia is a serious disease that needs treatment, which can be done with chemotherapy, radiotherapy or bone marrow transplant, for example. The choice of treatment varies depending on the type of leukemia a person has and its severity, which also determines whether the person can be completely cured or not.

Types of Leukemia

There are 2 main types of leukemia, Lymphoid and Myeloid, which can be classified as either Acute or Chronic, but there are still 4 other subtypes, as indicated below:

  • Acute Myeloid Leukemia: It develops rapidly and can affect adults or children alike. Treatment can be done through chemotherapy and/or bone marrow transplantation and has an 80% chance of cure.
  • Chronic Myeloid Leukemia: It develops slowly and is more frequent in adults. Treatment can be done with the use of specific medications for life.
  • Acute Lymphoblastic Leukemia: Advances rapidly and can occur in children or adults. Treatment can be done with radiotherapy and chemotherapy, but bone marrow transplantation is also an option when previous treatments fail to cure the disease.
  • Chronic Lymphoid Leukemia: It develops slowly and most often affects the elderly. Treatment is not always necessary.
  • T or NK Granular Lymphocytic Leukemia: This type of leukemia is slow growing, but a small number can be more aggressive and difficult to treat.
  • Aggressive NK cell leukemia: It can be caused by the Epstein-Barr virus, affects adolescents and young adults, being aggressive. Treatment is with chemotherapy.
  • Adult T-cell leukemia: It is caused by the virus (HTLV-1), a retrovirus similar to HIV, and is very serious. The treatment is not very effective, but it involves chemotherapy and bone marrow transplantation.
  • Hairy cell leukemia: It is a type of chronic lymphocytic leukemia, which affects cells that appear to have hair, affects more men, not being found in children.

The type of leukemia a person has is determined through specific tests, being essential to know which treatment is most suitable.

Symptoms of Leukemia

The first symptoms of leukemia are high fever followed by chills, night sweats and weight loss for no apparent reason, then other symptoms may appear such as:

  • Inflamed tongues in the neck, armpits, and just behind the elbow bone, technically called the elbow fossa, which is one of the hallmarks of the disease;
  • Spleen enlargement causing pain in upper left abdomen;
  • Anemia that generates symptoms such as tiredness, pallor and drowsiness;
  • Low concentration of platelets in the blood;
  • Infections, such as oral and stomach thrush (thrush) or atypical pneumonia;
  • Pain in bones and joints;
  • Night sweat;
  • Purple spots on the skin;
  • Pain in bones and joints;
  • Easy bleeding from the nose, gums or heavy bleeding for no apparent reason.
  • Headache, nausea, vomiting, double vision and disorientation occur when the central nervous system is affected.

These symptoms are more common in acute leukemia, as chronic leukemia progresses slowly, it can be asymptomatic being discovered in a routine exam such as a complete blood count, for example.

Diagnosis of leukemia

The diagnosis is made by the hematologist or oncologist after observing some signs and symptoms and with the results of tests such as blood count, myelogram, computed tomography, magnetic resonance and more specifically, bone marrow biopsy. In some cases, it may be necessary to perform a CSF examination, called a lumbar puncture, to evaluate the fluid that coats the central nervous system.

Treatments for Leukemia

Leukemia can be treated with the following options: chemotherapy, immunotherapy, radiotherapy, bone marrow transplantation or a combination of different treatments, depending on the type of leukemia the person has, and the stage at which the disease develops. finds.

In the case of acute leukemia, treatment should be started as soon as possible to combat the symptoms and prevent the disease from getting worse. Many cases can be completely cured, with the treatments indicated by the doctor. In the case of chronic leukemia, the disease may have no symptoms, but it can hardly be cured, although the person may have 'maintenance' treatment to prevent the manifestation of symptoms throughout life and to keep this type of cancer under control.


Chemotherapy consists of the application of specific drugs against cancer, which can be injected directly into a vein during hospital stay.This treatment is usually done in cycles, because they are performed once a week, with only 1 medication, or a combination of 2 or 3. In some cases, the sessions can be carried out with an interval of weeks or months.


Immunotherapy is a treatment similar to chemotherapy, because it consists of the application of drugs directly into the vein, but these drugs act differently, and they are monoclonal antibodies, which are substances that bind to cells cancer cells, allowing the body's defense system to eliminate tumor cells in the blood and bone marrow.


Consists of the application of radiation aimed at the spleen, brain or other parts of the body, in some cases it can be directed to the whole body, as happens before a bone marrow transplant, for example.

Bone marrow transplant

Bone marrow transplantation consists of removing a part of the bone marrow from the hip of a he althy person and compatible with the sick person, and these are frozen until they can be used at the ideal time.The ideal time to place the donated bone marrow is decided by the doctor, and it can happen after finishing the chemotherapy and radiotherapy treatments. The goal is to take the place of malignant cells and return to producing he althy blood cells.

Is leukemia curable?

In some cases leukemia is curable, especially when it is diagnosed early and treatment is instituted quickly, however there are cases where the individual's body is already so weakened that the cure of the disease is difficult to achieve. Bone marrow transplantation may represent a cure for leukemia for some, but it has complications and is therefore not always an option indicated by doctors for all affected people.

Currently some patients with acute leukemia achieve complete remission of the disease and last many years, and many children with acute lymphocytic leukemia can be cured.The ideal is to talk to the doctor who is monitoring the case to find out what the next steps of the treatment will be and what to expect.

What causes leukemia

The causes of leukemia are not fully known, but what is known is that some genetic predispositions favor the development of this disease. Leukemia is not hereditary and does not pass from parent to child, nor is it contagious and therefore cannot be passed on to other people. Some factors that can cause leukemia to occur include effects of irradiation, exposure to drugs including cigarette smoking, immune factors, and certain types of viruses.

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