Leukemia – Part II

Last week, we started a discussion about leukemia, which is a type of blood cancer that starts in white blood cells. Today, we will continue that discussion to include the typical signs and symptoms, as well as how leukemia is diagnosed.

What are the symptoms and signs of leukemia?

Symptoms can vary depending on the type of leukemia. Chronic leukemias may cause milder symptoms than acute leukemias. Here are some of the common signs and symptoms:

• Fatigue and/or weakness
• Weight loss that is unintentional
• Fever
• Repeated infections, or recurrent mouth sores
• Swollen lymph nodes
• Enlarged liver and/or spleen
• Easy bruising or bleeding, including recurrent nosebleeds
• Excessive sweating, including night sweats
• Tiny red or purple spots in your skin, especially where clothing fits more closely
• Other types of skin changes, including chronic itching
• Bone pain or tenderness

What are the risk factors that increase your risk of developing some types of leukemia?

Many people with leukemia have no known risk factors, and most people with known risk factors don't get leukemia, but here are some factors that can increase your risk of developing leukemia:

• Previous cancer treatment – Some types of chemotherapy and radiation treatment can increase your risk of developing certain types of leukemia.
• Genetic conditions – Certain genetic conditions, including Down syndrome, are associated with an increased risk of leukemia.
• Chemical exposure – Exposure to some chemicals, such as benzene, increases risk.
• Smoking – Cigarette smoking increases the risk of acute myelogenous leukemia.
• Family history of leukemia

How is leukemia diagnosed?

As I mentioned last week, chronic leukemia often has few if any symptoms in the early stages. It may be found on routine blood tests done on a yearly physical exam or for other reasons. If you have some of the signs or symptoms of leukemia, or your routine blood work results are concerning for leukemia, your doctor will do a physical exam to look for signs of leukemia, such as swollen lymph nodes, pale skin or mucous membranes, or an enlarged liver or spleen.

Blood tests are the next thing after the physical exam to look for leukemia. A complete blood count (CBC) tells us the levels of white blood cells, red blood cells, and platelets in the blood, along with some other things like the size of the cells. An extra test can be added to the CBC, where a pathologist looks at the blood cells under the microscope to count the different types of white blood cells, and to look for abnormal leukemia cells (although leukemia cells may not be in the blood sample even when leukemia is present).

The next test would be a bone marrow test. Your doctor will use a long, thin needle to remove a small sample of bone marrow from your hip bone. This sample is sent to the lab for several tests to look for leukemia cells. If leukemia cells are present, other tests will be done to look for characteristics to classify the leukemia and to determine the best treatment options for your particular leukemia.

Next week, we will wrap up our discussion of leukemia by talking about the different treatment options.

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Dr. Anita Bennett MD - Health Tip Content Editor