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Cancer that starts in blood-forming tissues such as the bone marrow and causes large numbers of blood cells to be produced and enter the blood stream is called leukemia. In leukemia, the bone marrow makes abnormal white blood cells. The abnormal cells are leukemia cells and like normal blood cells, leukemia cells don’t die when they should. They may crowd out normal white blood cells, red blood cells, and platelets, making it hard for normal blood cells to do their work.

Types of leukemia can be grouped based on how quickly the disease develops and gets worse. Leukemia is either chronic in which the disease usually gets worse slowly, and the leukemia cells can still do some of the work of normal white blood cells. Leukemia can also be acute in which the disease gets worse quickly and the leukemia cells can’t do any of the work of normal white blood cells. The types of leukemia can also be grouped based on the type of white blood cell that is affected. The four common types are chronic lymphocytic leukemia (CML), chronic myeloid leukemia (CLL), acute lymphocytic leukemia (ALL), and acute myeloid leukemia (AML).

No one knows the exact cause of leukemia but there are certain risk factors that increase the chance that a person will get this disease. Risk factors include being exposed to high levels of radiation, atomic bomb explosions, smoking, benzene, chemotherapy, down syndrome and certain other inherited diseases, myelodysplastic syndrome and certain other blood disorders, human T-cell leukemia virus type 1, and family history of leukemia.

The symptoms of leukemia depend on the number of leukemia cells and where these cells collect in the body. With chronic leukemia people may not have symptoms and the doctor may find the disease during a routine blood test. With acute leukemia people usually go to the doctor because they feel sick. Common symptoms of chronic or acute leukemia may include swollen lymph nodes that usually don’t hurt, fevers or night sweats, frequent infections, feeling weak or tired, bleeding and bruising easily, swelling or discomfort in the abdomen, weight loss for no known reason, and pain in the bone or joints.

During your appointment with a physician a personal and family medical history will be taken. Additional tests include blood tests, physical exam, cytogenetics, spinal tap, chest x-ray, and bone marrow biopsy. A bone marrow biopsy is the only sure way to know if there are leukemia cells in you bone marrow. During the biopsy a small amount of bone marrow is removed for a pathologist to examine under a microscope to check for leukemia cells. When final test results are received the doctor will discuss treatment options consisting of watchful waiting, chemotherapy, targeted therapy, biological therapy, radiation therapy, and stem cell transplant.

The choice of the treatment depends mainly on the type of leukemia, age, and if leukemia cells were found in your cerebrospinal fluid. Your doctor can describe your treatment choices, expected results, and possible side effects. Together you and your healthcare team will develop a treatment plan to meet your needs.

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