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Cancer Type

Acute Leukemia

Risk Factors

Acute leukemia is a cancer that starts from the early version of white blood cells called lymphocytes in the bone marrow (the soft inner part of the bones, where new blood cells are made). Leukemia cells usually invade the blood fairly quickly. They can then spread to other parts of the body, including the lymph nodes, liver, spleen, central nervous system (brain and spinal cord), and testicles.

Acute Leukemia can be divided into two types:

  1. Acute myeloid leukemia –AML: is a cancer as a result of abnormalities in cells of the myeloid category. It is more common than lymphoblastic leukemia and can be found in people of all ages; however it is most prevalent in the elderly.
  2. Acute lymphoblastic leukemia – ALL: is a cancer as a result of abnormalities in cells of the lymphoid category. It is often found in younger or older patients. May be caused by lymphadenopathy and responds well to treatment comparably.

The onset of acute leukemia can be severe and sudden in the space of days or weeks and is directly affected by an increase of white blood cells. Patients will often experience rapid deterioration and should seek immediate treatment. 

Causes

Currently the direct causes is determined, however the following are risk factors of developing acute leukemia:

  • Ageing
  • Patient has previously received radiotherapy or chemotherapy
  • History of exposure to radiation i.e. nuclear
  • History of receiving Benzene or Formaldehyde
  • Patients with genetic disorders such as down syndrome
  • Patients with MDS (Myelodysplastic syndrome)
  • Patients affected by certain types of virus such as HTLV – 1
  • Some patients may have acute leukemia without displaying any risk factors

Symptoms

  • Weariness, paleness, abnormal bleeding
  • Fever and weight loss without clear cause
  • Lumps found in lymph nodes
  • Tight abdomen due to liver or spleen enlargement
  • Bleeding of gums, swollen and inflamed gums
  • Difficulty breathing – Hyper leukocytosis

Diagnosis

  • Bone marrow test- Analysis of cells, determine type of cancer, and evaluate chromosomes for risk factors
  • Blood Test – To determine blood and platelets as well as determine function of liver, kidneys etc.
  • Blood Coagulation Test – To determine risk of bleeding such as AML-M3
  • Lumbar puncture (spinal tap) – To be used if there are suspicions that cancer has spread to nervous system

Treatment

Your medical team will evaluate physical function and age of patient as well as type of leukemia before the most appropriate treatment methods are selected. These may include:

  • Chemotherapy in the form of injection or oral consumption (sometimes both). Chemotherapy will target and destroy cancer cells and allow the bone marrow to produce normal white blood cells. During treatment, most patients will require blood and platelet transfusions as well as antibiotics as required.
  • Allogeneic stem cell transplantation is effective in fully treating the cancer. In the most common type allogeneic transplant, the stem cells come from a donor whose tissue type closely matches the patient’s. Selection of this treatment method may be suggested by your doctor early on.
  • Lekaphereis is a procedure in which white blood cells are separated from a sample of blood. It is utilized in cases where patients have a high white blood cell count or display symptoms of hyperleukoctosis such as weariness and confusion.
  • Intrathecal Chemotherapy is utilized in cases where the cancer has spread to the brain or spinal area. This is usually administered through the cerebrospinal fluid (CSF) and will continue till there are no longer any cancer cells.

Radiation Therapy: Is considered for acute leukemia that propose risk of spreading to the brain

Center of Excellence

  • A medical team specialized in hematological malignancy on hand to provide comprehensive and continuous consultation and treatment. This may include chemotherapy or stem cell transplant
  • A medical team specialized in stem cell transplant that includes HLA (Human Leukocyte Antigen) and matching related stem cell transplantation. The Bangkok Blood and Marrow Stem Cell Transplant Center is highly experienced in HLA stem cell transplant and Haploidentical stem cell transplantation. Treatment decision will be based on doctor’s recommendation based on severity of cancer, patient’s chromosomes, and other factors.
  • The Blood and Marrow Stem Cell Transplant Center is well-equipped to offer services that meet international standards
  • Multidisciplinary team versed in many fields such as infectious diseases, lung disease, or heart disease on hand to provide treatment for any complications during and after chemotherapy
  • Specialized nurse team at chemotherapy unit is well-experienced, prepared to deal with any complications that may occur during chemotherapy.

Author

Dr. Nuchanan Areethamsirikul
Hematologist