Acute Leukemia Treatment- Cancer/Oncology

What is Acute Leukemia?

Leukemia is a group of different types of blood-related cancers. Acute leukemia is a malignant disease which arise from either lymphoblasts (known as Acute Lymphocytic Leukemia) or myeloblasts (Acute Myeloid Leukemia). Both types of acute leukemias are characterized by the multiplication of immature, non-functional cells in the bone marrow which are consequently released into the bloodstream.

• Acute Lymphocytic Leukemia (ALL): It is also known as acute lymphoblastic leukemia and is the most common type of cancer in children.
• Acute Myeloid Leukemia (AML): It is also known as acute myelogenous leukemia and is more common in adults.

A medical oncologist i.e. a phsyician who is trained in mangement and treatment of cancer should be consulted for management of leukemia.

Symptoms:

• Fever
• Recurrent infections
• Fatigue and weakness
• Enlargement of lymph nodes, spleen or liver
• Night sweats
• Headache
• Bleeding (e.g. nosebleeds, heavy periods, bleeding while brushing teeth etc.)
• Bone and joint pain
• Abnormal bruising

In patients with AML, nodular skin lesions with a purple or gray-blue color appear. Painless lymphadenopathy mainly occurs in patients with ALL.

Diagnosis:

Different tests are done to diagnose acute leukemia. As a first step, a complete blood count (CBC) and peripheral smear is done to diagnose this disease. A bone marrow aspiration and biopsy are done to identify an augmented number of blasts in acute leukemia. To distinguish AML and ALL, cytochemistry and flow cytometry are done. Cytogenetic analysis is done to identify abnormal numbers and common characteristics of chromosomes during leukemia. Techniques such as fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR) are done to recognize abnormalities in genes and chromosomes which cannot be identified by cytogenetics.

Treatment:

The main treatment for acute leukemia is generally aggressive induction chemotherapy followed by additional chemotherapy. This is followed by maintenance therapy or a bone marrow/peripheral stem cell transplant. As chemotherapy does not enter well into the brain and spinal cord, preventive treatment is frequently required in patients with ALL to inhibit tumor cells from persisting and growing. During preventive treatment, medicines are injected directly into the spinal fluid.

References:

• https://www.amboss.com/us/knowledge/Acute_leukemia
• https://www.verywellhealth.com/what-is-leukemia-514157

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