Leukemia is a term used to indicate a set of malignant blood diseases that originate from the tumor proliferation of a hematopoietic cell. Hematopoietic cells are housed in the bone marrow (itself contained within some types of bone) and their function is to produce normal blood cells: red blood cells, white blood cells and platelets.
In individuals with leukemia, the bone marrow loses the ability to generate normal cells by acquiring the pathological ability to produce cancer cells. Cancer cells, escaping from the physiological mechanisms of control, tend to accumulate in the marrow itself and, invading it, progressively alter its function. Sometimes it can happen that this accumulation of cancer cells in the marrow also extends to the blood causing an abnormal increase in the number of leukemic white blood cells.
The four types of leukemia
On the basis of the rapidity of the course, acute (rapidly evolving) or chronic (slow evolving) leukemias are recognized. Based on the type of hematopoietic cell involved, lymphoid or myeloid leukemias are recognized. Therefore the main forms known to us are: acute lymphatic leukemia, chronic lymphatic leukemia, acute myeloid leukemia and chronic myeloid leukemia.
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by Letizia Gabaglio
The numbers
The incidence of acute lymphoid leukemia is 2 new cases per 100,000 individuals per year, that of chronic lymphocytic leukemia 5 new cases per 100,000 individuals per year. The incidence of acute myeloid leukemia is 5 new cases per 100,000 individuals per year, that of chronic myeloid leukemia 2 new cases per 100,000 individuals per year. Including all 4 forms of leukemia, estimates for Italy indicate a total of about 8000 new cases per year with a male: female ratio of about 2: 1.
Acute lymphoid leukemia is a predominantly pediatric disease; in fact it represents about 80% of the child’s leukemia. In contrast, chronic lymphoid leukemia, acute myeloid leukemia and chronic myeloid leukemia are typical of adulthood with the highest incidence above the age of 60.
Chronic lymphatic leukemia, Ghia (San Raffaele): “To guarantee all patients the tests for mutations”
Symptoms and Diagnosis
Symptoms are an expression of the progressive invasion of the bone marrow and its consequent loss of function. It is not infrequent that in chronic leukemia the patient does not complain of any symptoms and the diagnosis is made occasionally on the basis of routine tests. On the contrary, in acute leukemias the symptoms can be of marked intensity, determining a significant impact on the quality of life.
In general, the most characteristic symptoms are weakness (due to anemia), a tendency to bleed (caused by a reduction in platelets) and a tendency to develop infections (caused by a reduction in normal white blood cells). The patient with leukemia may also complain of fever, night sweats, weight loss, bone or joint pain.
There is also a series of symptoms linked to the specific characteristics of leukemia and to any infiltration sites outside the bone marrow. In this sense, enlargement of the lymph nodes, spleen and / or liver, skin lesions, neurological disorders (such as headache, paralysis, confusion), testicular swelling can be observed.
The tests useful to diagnose it
Diagnosis of leukemia requires a blood count and bone marrow sampling. Both on the blood and on the bone marrow chromosomal and genetic investigations are carried out which are indispensable for the diagnosis and for the therapeutic choice. Additional examinations are also performed such as radiological ones (ultrasound, CT scan, magnetic resonance imaging) and the collection of cerebrospinal fluid with lumbar puncture to exclude or confirm the involvement of other organs in the leukemic process.
* Contents by the Italian Association against leukemia-lymphomas and myeloma (AIL)
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