Leukemia or blood cancer refers to a group of malignant diseases of the hematopoietic system. In all forms of this cancer, the maturation of white blood cells (leukocytes) is disturbed. As a result, increasingly immature blood cells, which displace the healthy ones. There are several leukemia types that are characterized by different symptoms and require different forms of treatment. Thus one differentiates mainly between acute and chronic as well as between myeloischen and lymphatic forms of the leukemia. We inform about the symptoms, therapy and chances of cure of leukemia.
Leukemia: detecting signs
As the acute forms of leukemia worsen quite quickly, the symptoms are usually more pronounced. Chronic leukemia can go undetected for many years, as sufferers often show no signs of blood cancer at the beginning. Many complaints are caused by the suppression of normal blood formation:
- Red blood cells: anemia with fatigue, tiredness, paleness and tachycardia
- white blood cells: increased susceptibility to infections
- Platelets: coagulation disorders, which may occur, for B. expressed by increased bruising or small skin bleeding
Other symptoms of leukemia
As nonspecific symptoms of leukemia can also occur fever, night sweats, loss of appetite and weight loss. Other symptoms can be expressed by the fact that the cancer cells in other organs settle (metastases form) and there cause repression or dysfunction. Thus, there is often an enlargement of lymph nodes, spleen and liver or the removal of leukemia cells in the brain or spinal cord.
In chronic lymphocytic leukemia (CLL), a distinction is made between several stages, depending on whether and which other structures are involved, whether anemia is present or whether the platelets are reduced.
Leukemia: diagnosis and therapy
Often the symptoms are already the first evidence of a leukemia disease. The first important thing is the exact blood test (differential blood picture) - with the blood picture the diagnosis of leukemia is almost always already to be made. With a study of the bone marrow, which is usually taken under local anesthesia from the iliac crest, the leukemia form can be accurately determined, which is indispensable for therapy and prognosis.
In leukemia, two principal treatment strategies are available, which are often combined and supplemented by further therapies.
Chemotherapy for leukemia
Chemotherapies are used to treat all types of leukemia. The goal is the destruction of cancer cells. Cytostatic agents are particularly susceptible to cells that divide frequently, which is why leukemia cells can be destroyed very well. If only one part is destroyed, this is called partial remission. If no cells are detectable in the blood (which does not mean that they are not yet in the bone marrow), this is called full remission.
However, the drugs given in chemotherapy also damage other cells, so there are a number of side effects. Particularly endangered are normal blood cells, which is why there is a high risk of infection. In recent years, new drugs have been developed that target specific cancer cells and inhibit their multiplication. Some are already on the market (eg imatinib for CML - chronic myeloid leukemia), others are still in the trial phase.
Bone marrow transplantation in leukemia
Bone marrow transplantation often increases the chances of a leukemia disease. Before transplantation, the bone marrow is first destroyed by irradiation, then the bone marrow is infused by a suitable donor. If all goes well, the stem cells in it settle in the bone marrow and produce healthy blood cells again.
Disadvantage of bone marrow transplantation is that the patient must take drugs that suppress the body's immune system, so that the cells are not rejected. This is especially at the beginning of a large risk of infection, which is why leukemia patients often have to spend the therapy in specially protected rooms.
Treatment of various leukemia types
Depending on the type of leukemia, different forms of therapy are used during the course of the disease:
- ALL (acute lymphocytic leukemia): several blocks of intensive chemotherapy, followed by one to two years maintenance treatment at a lower dose; in addition, radiation of the skull and injection of drugs into the cerebro-spinal fluid; possibly bone marrow transplantation.
- AML (acute myeloid leukemia): intensive chemotherapy followed by maintenance therapy; possibly bone marrow transplantation, 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 radiation of lymph nodes. In younger patients possibly bone marrow transplantation.
- CML (chronic myeloid leukemia): First, injecting interferon into the abdominal wall, then chemo (tablets or syringes); special medications like imatinib.
In addition, any symptoms or disorders such as anemia or infections are treated specifically.
Leukemia: course and chances of recovery
The prognosis depends on the type of leukemia and the age and whether genetic changes are present. Especially good are the chances of recovery under treatment in ALL, especially in children between the ages of 3 and 7 (90 percent). The healing burrs in AML are between 50 and 85 percent, and a bone marrow transplantation increases them additionally. The chances of recovery worsen in over 20-year-olds. If the acute leukemia is not treated, it leads to death within weeks to months.
CML has a five-year survival rate of 60 percent in combination therapy. A bone marrow transplantation can even lead to healing. The CLL can stay without symptoms for over 20 years. Thereafter, the prognosis depends on the affected organs and the cells in the blood.