Overview
What is cancer?
Cancer is when cells in the body change and grow out of control. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them and die when your body no longer needs them. Cancer is made up of abnormal cells that grow when your body doesn't need them. In most types of cancer, the abnormal cells grow together to form a lump or mass called a tumour.
What is leukaemia?
Leukaemia is different from most other types of cancer. Leukaemia is a cancer that starts in the bone marrow. The bone marrow is where new blood cells are made. Normal cells in the bone marrow develop from very immature cells into mature cells that are ready to leave the bone marrow. Leukaemia cells are early and less mature forms of blood cells, sometimes called blasts. They are usually white blood cells that normally help fight infections. If you have leukaemia, your body makes too many blood cells that aren't normal. They don't work as they should. They also interfere with the production of other blood cells, usually red blood cells and platelets.
Leukaemia cells do not usually form tumours, but they can travel around the body in the blood. This means they can go to almost any organ. This means that leukaemia can take many different forms, depending on which organs are affected.
The mortality of leukaemia in all age groups of malignant tumours in China accounted for the sixth (male) and eighth (female), and in children and under 35 years old group accounted for the first. At present, there are more than 2 million children with leukaemia in China, and the number is increasing at a rate of 30-40 thousand per year.
Symptoms
These are the most common symptoms of leukaemia. However, each person's symptoms may be different.
Symptoms may include：
·Increased susceptibility to infection and fever
·Anaemia
·Bleeding
·Bruising
·Fever
·Chills
·Loss of appetite
·Weight loss
·Swollen or tender lymph nodes, liver or spleen
·Petechiae - tiny red spots under the skin caused by very small bleeding
·Swollen or bleeding gums
·Sweating
·Bone or joint pain
Acute leukaemia may also cause the following
·Headache
·Vomiting
·Confusion
·Loss of muscle control
·Seizures
·Swollen testicles
·Sores in the eyes or on the skin
The symptoms of leukaemia can be similar to other systemic diseases or medical problems. Always see your doctor as soon as possible for a diagnosis.
Types
Two types of abnormal white blood cells can develop into leukaemia: lymphoid cells and myeloid cells. If the leukaemia is in the lymphoid cells, it is called lymphocytic or lymphoblastic leukaemia. If the leukaemia is in the myeloid cells, it is called myelogenous or myeloid leukaemia.
There are two types of leukaemia:
- Acute or chronic, depending on how quickly the cells grow
- Lymphocytic or myeloid, depending on the type of white blood cell that has become leukaemic.
In acute leukaemia, abnormal blood cells are usually young cells (immature blasts) that do not work properly. These cells grow quickly. Acute leukaemia gets worse quickly if it is not treated right away.
In chronic leukaemia, young blood cells are present but mature, functional cells are also made. In chronic leukaemia, the blasts grow slowly. It takes longer for the disease to get worse.
These categories give rise to 4 combinations that make up the main types of leukaemia:
ALL is the most common type of leukaemia in children. However, about a third of ALL cases occur in adults.
AML is one of the most common types of acute leukaemia in adults. AML can also occur in children. It accounts for about 1 in 4 leukaemias in children.
CLL is also one of the most common types of leukaemia in adults. It is most common in older adults. It is sometimes seen in younger adults, but rarely in children.
CML is a slightly less common type of leukaemia, most commonly seen in adults. Very few children get this type of leukaemia.
Diagnosis
In addition to a complete medical history and physical examination, the following may be used to diagnose leukaemia
·Bone marrow aspiration and biopsy
During a bone marrow aspiration and biopsy, bone marrow cells and a small bone 'chip' are taken from the bone marrow for examination. A pathologist will look at the bone marrow, blood and bone under a microscope to look for signs of cancer. These cells can also be used for flow cytology, fusion gene, gene mutation, chromosome and FISH detection to help make an accurate diagnosis.
·Cytogenetic analysis
In this laboratory test, the cells in a sample of blood or bone marrow are examined under a microscope to look for certain changes in the structure or number of chromosomes in the lymphocytes.
·Immunophenotyping
Immunophenotyping is a test that looks at the cells in a sample of blood or bone marrow under a microscope to see if the malignant lymphocytes (cancer) are B lymphocytes or T lymphocytes. The process identifies cells based on the types of antigens or markers on the surface of the cell. It is used to diagnose certain types of leukaemia and lymphoma by comparing cancer cells with normal immune system cells.
• Complete blood count (CBC)
·Blood tests
Your evaluation may include specific blood tests, including (but not limited to) cell counts, measurements of various blood chemistries, and markers of inflammation. In some cases, genetic testing may be recommended.
·CT scan
·MRI SCAN
·X-ray
·Ultrasound
·Lymph node biopsy
·A lymph node biopsy is the removal of all or part of a lymph node. A pathologist will look at the tissue under a microscope to check for cancer cells.
·Lumbar puncture (spinal tap): A lumbar puncture (also called a spinal tap) can be used to test the fluid in the spinal cord. This test is useful for assessing tumours in the spine and also for measuring whether certain cancers have spread to the brain.
Treatments
Treatment for Acute and Chronic Leukaemias
Specific treatment for acute and chronic leukaemia will be determined by your doctor based on
·Your age, general health and medical history
·The extent of the disease
·Your ability to tolerate certain medications, procedures or therapies
·Expectations for the course of the disease
·Your opinion or preference
·Local and systemic treatments
Cancer can be treated either locally or systemically.
Local treatments remove, destroy or control the cancer cells in an area. Radiotherapy is an example of a local treatment.
Doctors use systemic treatments to destroy or control cancer cells throughout your body. If you take the treatment by mouth or by injection, it is called systemic treatment. Chemotherapy is an example of a systemic treatment. In most cases, treatment for leukaemia is systemic because the cancer cells are in your bloodstream all over your body.
You may have one type of treatment or a combination of treatments. Different types of treatment have different aims.
·What treatment may include
Blood and bone marrow transplants
A specialized therapy to transplant healthy bone marrow cells into a patient after their unhealthy bone marrow has been removed.
Chemotherapy
The use of cancer drugs to shrink or kill cancer cells and reduce the spread of cancer to other parts of the body.
Radiation therapy
The use of high-energy radiation to kill or shrink cancer cells, tumours and non-cancerous diseases.
Immunotherapy
Immunotherapy (also known as biological therapy, biological response modifier therapy or biotherapy) aims to boost the body's immune system to fight cancer. The cells, antibodies and organs of the immune system work to protect and defend the body against foreign invaders, such as bacteria or viruses. Doctors and researchers have discovered that the immune system may also be able to tell the difference between healthy cells and cancer cells in the body and to eliminate the cancer cells.
Targeted therapies
Targeted therapies can attack cancer cells without affecting healthy tissue, unlike radiation and chemotherapy.
Some newer drugs specifically target abnormal proteins, such as those caused by the Philadelphia chromosome. Drugs such as imatinib (Glivec) and dasatinib (Sprycel) may help treat ALL with this chromosome. These drugs are taken as pills every day.
Biological therapy
Biological therapy is treatment with substances that are produced naturally in the body or that can block the growth of cancer cells. This approach is designed to minimise the side effects associated with traditional treatments such as chemotherapy.
Biologic include non-specific immunomodulating agents, interferons, interleukins, colony-stimulating factors, monoclonal antibodies and vaccines.
Donor Lymphocyte Infusion (DLI)
Donor lymphocyte infusion (DLI) is a cancer treatment that can be used after stem cell transplantation. Lymphocytes (a type of white blood cell) from the stem cell donor are taken from the donor's blood and may be frozen for storage. The donor's lymphocytes, if frozen, are thawed and then given to the patient through one or more infusions. The lymphocytes see the patient's cancer cells as foreign and attack them.
Blood transfusion (red blood cells, platelets)
Medicines
To prevent or treat damage to other systems of the body caused by leukaemia treatment.
·Lu Daopei's hospital expertise
Patients with leukaemia are assessed and treated in the General Haematology and Bone Marrow Transplant Unit by a team of excellent doctors. We offer advanced treatment protocols for leukaemia. We aim to improve patients' survival and quality of life.
(The above content is extracted from stanfordhealthcare.org)
