GeneHealth - Your precision medicine

Leukemia

Disease Details

Family Health Simplified

Buy Membership

Description: Leukemia is a type of cancer that affects the blood and bone marrow, characterized by the overproduction of abnormal white blood cells.
Type: Leukemia is a type of cancer that affects the blood and bone marrow. There are several main types of leukemia, including:

1. Acute Lymphocytic Leukemia (ALL)
2. Acute Myeloid Leukemia (AML)
3. Chronic Lymphocytic Leukemia (CLL)
4. Chronic Myeloid Leukemia (CML)

Leukemia is generally not inherited in a straightforward manner and does not typically follow simple patterns of genetic transmission like autosomal dominant or recessive conditions. However, certain genetic mutations and chromosomal abnormalities can increase the risk of developing leukemia. Additionally, some inherited syndromes (such as Down syndrome, Li-Fraumeni syndrome, and neurofibromatosis) can predispose individuals to leukemia. Environmental factors and changes in specific genes primarily contribute to the development of this disease.
Signs And Symptoms: The most common symptoms in children are easy bruising, pale skin, fever, and an enlarged spleen or liver.Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may easily become bruised, bleed excessively, or develop pinprick bleeds (petechiae).White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the person's immune system to be unable to fight off a simple infection or to start attacking other body cells. Because leukemia prevents the immune system from working normally, some people experience frequent infection, ranging from infected tonsils, sores in the mouth, or diarrhea to life-threatening pneumonia or opportunistic infections.Finally, the red blood cell deficiency leads to anemia, which may cause dyspnea and pallor.Some people experience other symptoms, such as fevers, chills, night sweats, weakness in the limbs, feeling fatigued and other common flu-like symptoms. Some people experience nausea or a feeling of fullness due to an enlarged liver and spleen; this can result in unintentional weight loss. Blasts affected by the disease may come together and become swollen in the liver or in the lymph nodes causing pain and leading to nausea.If the leukemic cells invade the central nervous system, then neurological symptoms (notably headaches) can occur. Uncommon neurological symptoms like migraines, seizures, or coma can occur as a result of brain stem pressure. All symptoms associated with leukemia can be attributed to other diseases. Consequently, leukemia is always diagnosed through medical tests.
The word leukemia, which means 'white blood', is derived from the characteristic high white blood cell count that presents in most affected people before treatment. The high number of white blood cells is apparent when a blood sample is viewed under a microscope, with the extra white blood cells frequently being immature or dysfunctional. The excessive number of cells can also interfere with the level of other cells, causing further harmful imbalance in the blood count.Some people diagnosed with leukemia do not have high white blood cell counts visible during a regular blood count. This less-common condition is called aleukemia. The bone marrow still contains cancerous white blood cells that disrupt the normal production of blood cells, but they remain in the marrow instead of entering the bloodstream, where they would be visible in a blood test. For a person with aleukemia, the white blood cell counts in the bloodstream can be normal or low. Aleukemia can occur in any of the four major types of leukemia, and is particularly common in hairy cell leukemia.
Prognosis: The success of treatment depends on the type of leukemia and the age of the person. Outcomes have improved in the developed world. The average five-year survival rate is 65% in the United States. In children under 15, the five-year survival rate is greater (60 to 85%), depending on the type of leukemia. In children with acute leukemia who are cancer-free after five years, the cancer is unlikely to return.Outcomes depend on whether it is acute or chronic, the specific abnormal white blood cell type, the presence and severity of anemia or thrombocytopenia, the degree of tissue abnormality, the presence of metastasis and lymph node and bone marrow infiltration, the availability of therapies and the skills of the health care team. Treatment outcomes may be better when people are treated at larger centers with greater experience.
Onset: Leukemia is a type of cancer that affects blood-forming tissues, including the bone marrow and lymphatic system. Its onset can vary greatly depending on the type of leukemia:

1. **Acute Leukemia:** Symptoms often appear suddenly and progress rapidly. Examples include Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML).
2. **Chronic Leukemia:** Symptoms develop slowly over time and many patients may not exhibit symptoms in the early stages. Examples include Chronic Lymphocytic Leukemia (CLL) and Chronic Myeloid Leukemia (CML).

"Nan" typically refers to "Not a Number," which indicates an invalid or missing data point, so its relevance to leukemia is unclear in this context.
Prevalence: Leukemia is a type of cancer that affects the blood and bone marrow. The prevalence of leukemia varies based on its specific types (such as acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia) and the demographic factors.

- In the United States, approximately 60,000 new cases of leukemia are diagnosed each year.
- Overall, leukemia represents about 3.5% of all new cancer cases in the U.S.
- The prevalence rates can differ globally, with variations due to genetic, environmental, and lifestyle factors.

Leukemia can occur at any age, but it is most commonly diagnosed in older adults. However, certain types like acute lymphoblastic leukemia (ALL) are more common in children.
Epidemiology: In 2010, globally, approximately 281,500 people died of leukemia. In 2000, approximately 256,000 children and adults around the world developed a form of leukemia, and 209,000 died from it. This represents about 3% of the almost seven million deaths due to cancer that year, and about 0.35% of all deaths from any cause. Of the sixteen separate sites the body compared, leukemia was the 12th most common class of neoplastic disease and the 11th most common cause of cancer-related death. Leukemia occurs more commonly in the developed world.
Intractability: Leukemia can be challenging to treat and, in some cases, may be considered intractable. The intractability of leukemia depends on various factors, including the type of leukemia (acute or chronic, lymphocytic or myeloid), the patient's age, overall health, genetic mutations, and response to treatment. Advances in medical treatments, such as targeted therapies, stem cell transplants, and immunotherapies, have improved outcomes for many patients, but some cases remain difficult to manage.
Disease Severity: Leukemia is a type of cancer that affects the blood and bone marrow. Disease severity in leukemia can vary widely depending on several factors, including the specific type of leukemia (acute or chronic), the patient's age, overall health, genetic mutations, and response to treatment. Some forms of leukemia progress rapidly and require immediate, aggressive treatment, while others may progress more slowly and be managed over a longer period. Treatment options and outcomes can vary, making close monitoring and individualized care essential.
Healthcare Professionals: Disease Ontology ID - DOID:1240
Pathophysiology: Leukemia is a type of cancer that affects the blood and bone marrow. The pathophysiology involves the uncontrolled proliferation of abnormal white blood cells. These malignant cells originate from the hematopoietic stem cells in the bone marrow. They do not function properly and crowd out normal cells, leading to anemia, infection, and bleeding disorders. The classification of leukemia is based on the type of white blood cells affected (lymphoid or myeloid) and the rate of progression (acute or chronic). Factors contributing to its pathogenesis include genetic abnormalities, chromosomal translocations, and environmental exposures.
Carrier Status: Leukemia is a type of cancer that affects the blood and bone marrow. It is not typically associated with a "carrier status" because it is not a hereditary condition passed in the same way as genetic disorders like cystic fibrosis. Instead, leukemia is caused by mutations in the DNA of blood-forming cells. These mutations can occur due to a variety of factors, including environmental exposures and sometimes inherited genetic predispositions, but you don't "carry" leukemia in the way that you might carry a recessive gene for a hereditary disease.
Mechanism: Leukemia is a type of cancer that affects the blood and bone marrow, characterized by the uncontrolled proliferation of abnormal white blood cells.

**General Mechanism:**
- Leukemia originates in the bone marrow, where blood cells are produced.
- In leukemia, the bone marrow produces excessive amounts of abnormal white blood cells, which do not function properly.
- These abnormal cells crowd out normal blood cells, impairing the body's ability to fight infections, carry oxygen, and control bleeding.

**Molecular Mechanisms:**
- **Genetic Mutations:** Leukemia is often driven by genetic mutations that alter the function of hematopoietic stem cells (HSCs). These mutations can lead to unchecked cell division and impaired apoptosis (programmed cell death).
- **Chromosomal Translocations:** Many leukemias are associated with specific chromosomal translocations. For example, the Philadelphia chromosome, resulting from a translocation between chromosomes 9 and 22, creates the BCR-ABL fusion gene in chronic myeloid leukemia (CML). This fusion gene encodes an abnormal tyrosine kinase that promotes cancer cell growth.
- **Oncogenes and Tumor Suppressor Genes:** Mutations in oncogenes (genes that promote cell division) and tumor suppressor genes (genes that regulate cell division and ensure cell death of faulty cells) play a pivotal role. For instance, mutations in the FLT3 and NPM1 genes are common in acute myeloid leukemia (AML).
- **Epigenetic Changes:** Alterations in DNA methylation and histone modification can affect gene expression without changing the DNA sequence. These epigenetic changes can contribute to the development and progression of leukemia by turning off tumor suppressor genes or activating oncogenes.

In summary, leukemia results from a complex interplay of genetic and molecular abnormalities that disrupt the normal regulation of blood cell production, leading to the proliferation of malignant cells.
Treatment: Most forms of leukemia are treated with pharmaceutical medication, typically combined into a multi-drug chemotherapy regimen. Some are also treated with radiation therapy. In some cases, a bone marrow transplant is effective.
Compassionate Use Treatment: Compassionate use treatment for leukemia involves providing access to investigational therapies outside of clinical trials for patients with serious or life-threatening conditions when no comparable or satisfactory alternative treatment options are available. This process allows patients to receive potentially beneficial treatments that are still in the experimental stage.

Off-label treatments involve using approved drugs for indications that are not specifically listed in the drug's official labeling. For leukemia, some drugs originally approved for other types of cancer or diseases may be used off-label based on emerging clinical evidence and physician judgment. Examples include certain chemotherapeutic agents, targeted therapies, or immunotherapies.

Experimental treatments refer to therapies that are still in the research phase and have not yet received regulatory approval. These might include novel targeted therapies, CAR-T cell therapies, gene therapies, or new combinations of existing drugs. Patients can access these treatments through clinical trials or expanded access programs.

Both compassionate use and off-label treatments are implemented under strict regulatory guidelines to ensure patient safety. Experimental treatments usually require informed consent and are subject to rigorous clinical evaluation.
Lifestyle Recommendations: Leukemia is a type of cancer that affects blood cells and bone marrow. While lifestyle changes cannot cure leukemia, leading a healthy lifestyle can support overall well-being and potentially improve treatment outcomes. Here are some lifestyle recommendations for individuals with leukemia:

1. **Balanced Diet**: Eat a well-rounded diet rich in fruits, vegetables, lean proteins, and whole grains. This helps maintain strength and energy levels.
2. **Stay Hydrated**: Drink plenty of fluids to help support bodily functions and overall health.
3. **Regular Exercise**: Engage in moderate physical activity, like walking or gentle yoga, as tolerated, to maintain muscle tone and reduce fatigue. Always consult with a healthcare provider before starting any new exercise regimen.
4. **Adequate Rest**: Ensure you get sufficient sleep and rest. Fatigue is common in leukemia; managing rest can help improve quality of life.
5. **Infection Prevention**: Due to compromised immunity, it’s important to practice good hygiene, avoid sick individuals, and stay up-to-date with vaccinations as advised by your healthcare provider.
6. **Avoid Smoking and Alcohol**: Smoking and excessive alcohol consumption can further weaken the immune system and interfere with treatment. Avoid these substances to support overall health.
7. **Stress Management**: Techniques like meditation, deep-breathing exercises, and counseling can help manage stress and support mental health.
8. **Regular Medical Follow-ups**: Keep up with regular appointments and follow the treatment plan prescribed by your healthcare provider.

Discuss any lifestyle changes with your healthcare provider to tailor these recommendations to your specific situation.
Medication: Leukemia is treated using various medications including chemotherapy drugs, targeted therapies, and immunotherapies. Some commonly used medications are:

1. Chemotherapy drugs: Cytarabine, Cyclophosphamide, and Doxorubicin.
2. Targeted therapies: Imatinib, Dasatinib, and Nilotinib.
3. Immunotherapies: Blinatumomab and Rituximab.

The treatment regimen depends on the specific type of leukemia (e.g., Acute Lymphoblastic Leukemia, Chronic Myeloid Leukemia) and the patient's overall health condition.
Repurposable Drugs: For leukemia, several repurposable drugs have shown promise:

1. **All-trans retinoic acid (ATRA)**: Originally used for acne, it is now an effective treatment for acute promyelocytic leukemia (APL).
2. **Arsenic trioxide**: Historically used for various conditions, now approved for APL.
3. **Dasatinib, Nilotinib**: Initially developed for chronic myeloid leukemia (CML), they are also being studied for other leukemia subtypes.
4. **Venetoclax**: Approved for chronic lymphocytic leukemia (CLL), shows potential in other hematologic malignancies.
5. **Methotrexate**: Commonly used in rheumatoid arthritis, effective in certain types of leukemia.
6. **Thalidomide**: Initially used for morning sickness, now used for multiple myeloma and under study for leukemia.

These drugs are explored for their existing profiles in other diseases, potentially accelerating the development of new leukemia treatments.
Metabolites: In leukemia research, metabolites can serve as biomarkers for diagnosis, prognosis, and treatment response. These small molecules are products of metabolic processes and can provide insights into the dysregulated metabolism of leukemic cells. Metabolomic profiling can help identify unique patterns of metabolites that distinguish leukemic cells from normal cells, potentially aiding in early detection and personalized treatment strategies.
Nutraceuticals: Nutraceuticals are products derived from food sources that provide additional health benefits beyond basic nutritional value. In leukemia, certain nutraceuticals may show promise in supporting overall health and potentially aiding in treatment. These include:

1. Curcumin: Found in turmeric, it possesses anti-inflammatory and anti-cancer properties.
2. Green Tea Extract: Contains polyphenols like EGCG, which have shown anti-cancer effects.
3. Resveratrol: Found in grapes and berries, it may inhibit cancer cell growth.
4. Omega-3 Fatty Acids: Present in fish oil, they have anti-inflammatory effects and may support immune function.

For nanotechnology (nan), it is emerging as a promising approach in leukemia treatment due to its potential for targeted drug delivery. Nanoparticles can be designed to deliver chemotherapy drugs directly to leukemia cells, minimizing damage to healthy cells and reducing side effects. This targeted approach can increase the efficacy of treatment and is an area of ongoing research and development in oncology.
Peptides: Peptides are short chains of amino acids that play roles in biological processes, including cell signaling and immune responses. In the context of leukemia, peptides have been explored for their potential use in targeted therapies and as components of vaccines to stimulate the immune system against leukemia cells.

Nanotechnology (nan) in leukemia involves the use of nanoparticles for diagnostic and therapeutic purposes. Nanoparticles can be engineered to deliver drugs specifically to leukemia cells, minimizing damage to healthy cells and improving the efficacy of treatments. Additionally, nanoparticles can aid in imaging and early detection of leukemia by enhancing the visibility of cancer cells under imaging technologies.