Leukemia or blood cancer refers to a group of malignant diseases of the blood-forming system. The maturation of the white blood cells (leukocytes) is disturbed in all forms of this cancer . As a result, immature blood cells develop, which suppress the healthy. There are several forms of leukemia, which are characterized by different symptoms and require different forms of treatment. Thus, one differentiates between acute and chronic as well as between myeloid and lymphatic forms of leukemia. We provide information about the symptoms, treatment and healing chances of leukemia.
Leukemia: Detecting signs
Since the acute forms of leukemia deteriorate quite rapidly, the symptoms are usually more pronounced. Chronic leukemias can remain unrecognized for many years, as patients often do not show any signs of blood cancer at the outset. Many complaints are caused by the suppression of normal blood formation:
- Red blood cells: anemia with fatigue, pallor, and cardiac arrest
- White blood cells: increased susceptibility to infections
- Blood platelets: Coagulation disorders, which can manifest themselves, for example, by increased bruises or small skin bleeding
Other symptoms of leukemia
Unspecific symptoms of leukemia may also include fever, night sweats, loss of appetite, and weight loss. Other symptoms can be expressed by the fact that the cancer cells settle (form metastases) in other organs and cause displacement phenomena or functional disturbances there. This often leads to an enlargement of the lymph nodes, the spleen and the liver or the removal of leukemia cells in the brain or spinal cord.
In the case of chronic lymphocytic leukemia (CLL), several stages are distinguished, depending on whether and which further structures are affected, whether anemia is present or whether the blood platelets are diminished.
Leukemia: diagnosis and therapy
Often, the symptoms already provide initial evidence of a leukemia disorder. Important is first the exact blood examination (differential blood picture) - with the blood picture, the diagnosis leukemia almost always has to be placed. With an examination of the bone marrow, which is usually taken from the pelvic cavity under local anesthesia, the leukemia form can be precisely determined, which is indispensable for therapy and prognosis.
In leukemia two basic treatment strategies are available, which are often combined and supplemented by further therapies.
Chemotherapy for leukemia
Chemotherapies are used for the treatment of all types of leukemia. The goal is the destruction of cancer cells. Particularly susceptible to cytotoxic agents are cells, which often share, which is why leukemia cells can be destroyed very well. If only one part is destroyed, one speaks of partial remission. If no cells are detectable in the blood (which does not mean that there are not any more in the bone marrow), this is referred to as full discharge.
However, the drugs used in chemotherapy also harm other cells, so that a number of side effects have to be expected. Particularly endangered are normal blood cells, which is why there is a high risk of infection. In recent years, new active ingredients have been developed which specifically attack certain cancer cells and inhibit their multiplication. Some are already on the market (eg imatinib for CML - chronic myelogenous leukemia), others are still in the trial phase.
Bone marrow transplantation in leukemia
A bone marrow transplant often increases the healing potential of a leukemia disorder. Before transplantation, the bone marrow is first destroyed by irradiation, then the bone marrow is transferred by an appropriate donor by infusion. When everything goes well, the stem cells located therein settle in the bone marrow and produce healthy blood cells again.
Disadvantage of bone marrow transplantation is that the patient must take a means to suppress the body's immune system so that the cells are not repelled. Thus, especially in the beginning, there is a great risk of infection, which is why leukemia patients often have to spend therapy in specially protected rooms.
Treatment of various types of leukemia
Depending on the type of leukemia, various forms of therapy are used in the course of the disease:
- ALL (acute lymphoblastic leukemia): several blocks of intensive chemotherapy, then over one to two years of lower-dose treatment; Additionally irradiation of the skull and injection of medicaments into the brain and spinal fluid; Possibly bone market transplantation.
- AML (acute myelogenous leukemia): intensive chemotherapy, followed by maintenance therapy; Possibly bone marrow transplant, especially in younger patients.
- CLL (chronic lymphocytic leukemia): depends on the stage; The treatment takes place only with a certain number of blood corpuscles or complications. Chemotherapy (tablets, infusions), possibly cortisone and local irradiation of lymph nodes. In younger patients possibly bone market transplantation.
- CML (chronic myelogenous leukemia): first interferon injection into the abdominal wall, then chemotherapy (tablets or syringes); Special drugs such as imatinib.
In addition, any symptoms or disorders such as anemia or infections are treated specifically.
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