What Is Leukemia?
Leukemia is cancer of the blood cells—usually the white blood cells—and develops in the bone marrow. Leukemic cells look different than normal cells and do not function properly.
The bone marrow is the soft, spongy center of the long bones that produces the three major blood cells:
- White blood cells to fight infection
- Red blood cells that carry oxygen
- Platelets that help with blood clotting and stop bleeding
Leukemia is the most common form of cancer in childhood. It affects approximately 3,000 children each year in the United States, accounting for about 30% of childhood cancers.
What Are the Symptoms of Leukemia?
The following are the most common symptoms of leukemia. However, each individual may experience symptoms differently.
Symptoms may include:
- Increased susceptibility to infections and fevers
- Loss of appetite
- Loss of weight
- Swollen or tender lymph nodes, liver, or spleen
- Petechiae—tiny red dots under the skin that are the result of very small bleeds.
- Swollen or bleeding gums
- Bone or joint pain
In addition, acute leukemia may cause the following:
- Loss of muscle control
- Swollen testicles
- Sores in the eyes or on the skin
Chronic leukemia may affect the skin, central nervous system, digestive tract, kidneys, and testicles.
The symptoms of acute and chronic leukemias may resemble other blood disorders or medical problems. Always consult your doctor for a diagnosis.
How Is Leukemia Diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for leukemia may include the following:
Bone marrow aspiration biopsy
Bone Marrow Aspiration and Biopsy
Bone marrow aspiration and biopsy involves the removal of bone marrow, blood, and a small piece of bone by inserting a needle into the hipbone or breastbone. This type of biopsy is performed either from the sternum (breastbone) or the iliac crest hipbone (the bone area on either side of the pelvis on the lower back area). The skin is cleansed and a local anesthetic is given to numb the area. A long, rigid needle is inserted into the marrow, and cells are aspirated for study; this step is occasionally uncomfortable. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer. A core biopsy (removing a small bone ‘chip’ from the marrow) may follow the aspiration.
Complete blood count
Complete Blood Count (CBC)
A complete blood count (CBC) measures the size, number, and maturity of the different blood cells in a specific volume of blood. This is one of the most common tests performed.
- Red blood cells are important for carrying oxygen and fighting anemia and fatigue. The hemoglobin portion of the CBC measures the oxygen carrying capacity of the red blood cells while the hematocrit measures the percentage of red blood cells in the blood.
- White blood cells fight infection. Increased numbers of white blood cells, therefore, may indicate the presence of an infection. Decreased levels may indicate certain rheumatic diseases or reaction to medication.
- Platelets prevent the body from bleeding and bruising easily. It is usually performed to check for a blood infection.
What Is a Blood Test?
Your evaluation may include the performance of specific blood tests, including (but not limited to) cell counts, measurement of various blood chemistries and markers of inflammation. We can measure many things in your blood such as salts, blood cell counts and protein markers specific to the heart (one is called BNP). Additional tests may include blood chemistries, evaluation of liver and kidney functions, and genetic studies). In some cases, genetic testing may be recommended. In addition, we may ask you to join our ongoing studies by allowing us to collect and store some of your blood for future analysis.
Computed tomography scan (CT or CAT scan) is a non-invasive diagnostic imaging procedure that uses a combination of special X-ray equipment and sophisticated computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body.
Lymph node biopsy
Lymph Node Biopsy
A lymph node biopsy is the removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells. During an excisional biopsy, an entire lymph node will be taken out whereas only a part of a lymph node will be removed during an incisional biopsy.
Lumbar Puncture (Spinal Tap)
A lumbar puncture (also called a spinal tap) can be used to analyze the fluid in the spinal cord. This test is helpful for spinal tumor assessment and also for measuring whether certain cancers have spread to the brain. In this procedure, a special needle is inserted into the lower back spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF), the fluid in the brain and spinal cord, can be removed and sent for testing to determine if there is an infection or other problems.