Question

How do the clinical presentations, prognosis, and management of acute and chronic leukemia differ?

Answer 1

Leukemia is a blood cancer situatation. It forms when blood cells in the bone marrow malfunction and form cancerous cells. The cancerous blood cells then overrun the normal blood cells. This interferes with the body's ability to fight infections, control bleeding, and deliver oxygen to normal cells. The cancerous cells can also invade the spleen, liver, and other organs.

Chronic leukemia develops slowly, and the early symptoms may be mild and go unnoticed. Acute leukemia develops quickly. This is because the cancerous cells multiply fast.

Causes:

Both environmental and genetic factors are thought to be involved in Leukemia formation.

Leukemia may occur due to changes in the DNA of your cells. Chronic myeloid leukemia (CML) may also be associated with a gene mutation called the Philadelphia chromosome. This gene mutation isn’t inherited.

Some studies show that a combination of genetic and environmental factors are involved in childhood leukemia. Some children may not have inherited the particular version of genes that can get rid of harmful chemicals. Exposure to the chemicals might increase their risk for leukemia.

Chronic Leukemia Signs & Symptoms:

Chronic leukemia is most commonly diagnosed after a routine blood test. You may have low-level symptoms for years before it’s diagnosed. The symptoms may be vague and could occur due to many other medical conditions. The signs and symptoms may include:

• general feelings of malaise, such as tiredness, bone and joint pain, or shortness of breath
• weight loss
• a loss of appetite
• a fever
• night sweats
• anemia
• infections
• bruising or bleeding, such as nosebleeds
• enlarged lymph nodes that aren’t painful
• pain or a full feeling in the upper-left abdomen, which is where the spleen is located.

  Acute Leukemia Signs & Symptoms:

  The common signs and symptoms of acute leukemia are:

• low white blood cell counts
• infections
• tiredness that doesn't go away with rest
• shortness of breath
• pale skin
• sweating at night
• a slight fever
• bruising easily
• bone and joint aches
• slow healing of cuts
• tiny red dots under the skin.

  Diagonosis:
  All types of leukemia are diagnosed by examining blood samples and bone marrow. A complete blood count will show the levels and types of:

• white cells
• leukemia cells
• red cells
• platelets
  
  Bone marrow and other tests will give your doctor further information about your blood to confirm a diagnosis of leukemia. Your doctor may also look at a blood smear under a microscope to see the shape of the cells. Other tests may grow your blood cells to help your doctor identify changes to the chromosomes or genes
  
  Prevention

• No early screening tests for leukemia are available. If the patient manifests risk factors and symptoms, he/she should ask the doctor about blood tests.

  It's important to keep copies of your treatments, the dates, and the drugs that were used. These will help you and your future doctors if your cancer comes back.

  Experts haven’t found ways to prevent leukemia. Being proactive and telling your doctor if you notice any symptoms of leukemia may improve your chances of recovery.
  
  Treatment
  1. Chronic leukemia

  Chronic leukemia progresses slowly. You may not be diagnosed until symptoms, such as enlarged lymph nodes, appear. Chemotherapy, corticosteroids, and monoclonal antibodies may be used to control the cancer. Your doctor may use blood transfusions and platelet transfusions to treat the decrease in red blood cells and platelets. Radiation may help reduce the size of your lymph nodes.

  If you have CML and also have the Philadelphia chromosome, your doctor may treat you with tyrosine kinase inhibitors (TKIs). TKIs block the protein produced by the Philadelphia chromosome. They may also use stem cell therapy to replace cancerous bone marrow with healthy bone marrow.

  2. Acute leukemia

  People with acute leukemia will generally begin treatment quickly following a diagnosis. This is because the cancer can progress quickly. Treatment may include chemotherapy, targeted therapy, or stem cell therapy, depending on the type of acute leukemia you have.

  The treatment for acute leukemia is generally very intense in the beginning. The main goal of treatment is to kill the leukemia cells. Hospitalization is sometimes necessary. The treatment often causes side effects.