Leukemia is a type of cancer that manifests itself by an above-normal proliferation of blood cells, especially white blood cells.
Damage to the marrow occurs when a high number of immature and malignant cells replace normal marrow cells. Thus, the number of platelets involved in blood clotting and leukocytes involved in defense begin to decrease. This, in turn, leads to intense bruising and bleeding in leukemia patients, making patients easily infected. The defense mechanism weakens. In the advanced stages, a lack of red blood cells can cause anemia, shortness of breath. In addition, there are also symptoms such as weakness and fatigue, fever, some neurological symptoms, swelling of the gums and bleeding.
Leukemias are cancers that affect the blood production system in the body (lymphatic system and bone marrow). Leukemias are classified as acute or chronic (they are divided into subgroups according to their appearance under a microscope) and according to the characteristics of the spread and development of the tumor. In general, acute leukemia occurs in children, while chronic leukemia tends to occur more often in adults.
There are types of blood cancer according to the cell type (for example, myeloid, lymphoid) and according to the duration of the disease (inveterate and had). Some types show a faster and worse course. In childhood, types of leukemia are observed more often than other types of cancer.
Although the exact causes are unknown, it is believed that both genetic and environmental factors play an important role. Mutations occurring in the DNA in somatic cells cause oncogenes to be activated or tumor suppressor genes to be inactivated. Thus, the regulation of cell death and division suffers damage. In addition to genetic causes, this damage is caused by petrochemicals, radiation, carcinogenic substances and some viruses (e.g. HIV) is thought to be the cause.
Varieties
Acute Leukemias
In acute leukemia, there is a constant increase in blood cells, and as a result, they become more numerous than healthy-normal blood cells. These abnormal cells can also spread to other organs, making the organ unable to function. The classification of acute leukemia is mainly based on the types of immature cells:
- Acute Lymphoid Leukemia (ALL) : It is characterized by an increase in immature blood cells called lymphoblasts, which normally need to turn into a mature blood cell type called lymphocytes. The number of these lymphoblasts increases by a large amount and they usually accumulate in the lymph nodes, causing swelling. ALL is the most common childhood cancer, and 80% of leukemias observed in children under the age of15 are ALL. Although it can sometimes also occur in adults,ALL over the age of 50 is extremely rare.
- Acute Myeloid Leukemia (AML) : Anemia (anemia – a decrease in red blood cell production) and frequent infection (a decrease in white blood cell production) may occur in stem cells called myeloblasts that need to turn into normal blood cells (red blood cells, platelets). AML accounts for 50% of leukemias detected in adolescence and 20s, and 20% of leukemias in adults.
Chronic Leukemias
Chronic leukemia is characterized by an overproduction of blood cells that are apparently mature, but cannot do what normal mature blood cells do. Chronic leukemia progresses more slowly and its consequences are less dramatic. There are basically two subgroups:
- Chronic Lymphoid Leukemia (CLL): It manifests itself by overproduction of mature-looking lymphocytes in the bone marrow. These abnormal cells look like fully matured normal lymphocytes, but they cannot protect our body against infections like normal lymphocytes. In CLL, cancer cells are found in the bone marrow, blood, and lymph nodes, and swelling occurs in the lymph nodes. CLL accounts for 30% of all leukemias. they are rarely seen under the age of 30, but their incidence increases with age and is most often observed between the ages of 60-70 Dec. Hairy cell leukemia; it is a lymphocyte-derived chronic leukemia, but it is different from CLL. Unlike CLL, hair cell leukemia can often be treated with drug therapy.
- Chronic Myeloid Leukemia (CML): This leukemia manifests as an overproduction of myeloid cells (such as white blood cells) that look mature but have a loss of function. This overproduction continues until there are no normal cells left. A chromosomal anomaly called the Philadelphia chromosome often occurs in those with CML. It is believed that there is a gene in this chromosomal abnormality that causes the production of an enzyme that causes this disease. CML accounts for 20-30% of the leukemias observed in adults and is observed between the ages of 25-60 Dec. In some patients, this disease can be treated with a bone marrow transplant.
In general, leukemias account for 2% of all cancers. Leukemia is observed more often in men. It is also more common in the white race. The frequency of being diagnosed with leukemia in adults is 10 times higher than in children, and the risk increases with age. Among children, it is observed more often under the age of 4. Dec.
There are signs that leukemia may be partially familial; especially in certain types, such as CLL, there is a concentration in some families. It is known that some types of leukemia are also observed more often in certain genetic diseases (such as Down syndrome). However, a definite genetic and familial risk has not yet been determined. In cases of myeloid leukemia, there are studies showing that exposure to ionizing radiation and gasoline (found in unleaded gasoline) is effective in the development of the disease.
Symptoms
Symptoms of the disease, which has a progressive course, occur as a result of abnormal (malignant) cells blocking the construction of normal cells in blood-forming organs. Anemia occurs with a decrease in the production of normal red blood cells; susceptibility to infection, microbial diseases and fever as a result of a decrease in the production of normal white blood cells; various bleeding (such as nosebleeds, gum bleeds, subcutaneous bleeding) occurs with a decrease in the production of blood pulses (platelets) involved in blood clotting. Bruises often occur on the skin or bleeding is stopped with difficulty when a cut occurs.
In addition, some other signs of the disease are also attributed to the fact that malignant cells invade certain organs and secrete various chemical substances. All this rapid cell construction and destruction also leads to weight loss and sweating. In patients, the spleen is usually enlarged, and swellings are also detected in the lymph nodes. There is a feeling of bloating in the abdomen.
Early symptoms are usually overlooked because complaints during this period are similar to common cold or other common disease complaints. (Weakness, bone and joint pains, headaches, skin rashes, hair loss)
Diagnosis
First of all, it is necessary to suspect the patient’s complaints and examination findings, and the diagnosis can be clarified with blood tests. Then a bone marrow biopsy, special blood tests and genetic tests are performed.
In general, chronic leukemia progresses more slowly than acute leukemia. CML patients are typically normal for 3-5 years. Then an AML-like picture occurs.
At the moment, no exact method of protecting against leukemia is known. But in the coming years, genetic tests can be used to identify people at high risk of developing leukemia. Until then, first-degree relatives of leukemia patients should regularly be examined by their doctors and have a blood test.
Treatment
Although very important steps have been taken in the treatment of the disease in recent years, treatment for the cause cannot be performed because the causes cannot be known. The main goal of the treatments applied today is to eliminate malignant cells. Treatment schemes vary according to the types and stages of the disease. Radiation therapy (shua), the administration of various cancer drugs, immunization (or immune system strengthening) therapy (immunotherapy) and bone marrow transplantation are the main forms of treatment. Bone marrow transplantation can be performed by the delivery of a person’s own cells (autotransplantation) or the cells of a suitable donor (allotransplantation) at the time when the crisis (attack) has been overcome. In addition to these forms of treatment, many new methods are at the trial stage and give positive results. Oct. The most important reasons for the loss of patients are excessive weakness, microbial diseases, bleeding and organ failure due to occupation.
With the applied treatments, the disease crisis (attack) can be overcome. However, sometimes the disease can reappear after short and sometimes years of decrepitude.
