The different types of leukemia

What is Leukemia?

Leukemia is a type of cancer that affects the white blood cells in the body. There are multiple types of leukemia, classified as either acute (which can grow quickly) or chronic (slower growing). They are also further divided into the types of cells they start in. The main types of leukemia are:

  • Acute Lymphocytic Leukemia (ALL)
  • Acute Myeloid Leukemia (AML)
  • Chronic Lymphocytic Leukemia (CLL)
  • Chronic Myeloid Leukemia (CML)
  • Chronic Myelomonocytic Leukemia (CMML)

Signs and Symptoms

The exact signs and symptoms that are associated with leukemia can differ based on the type of leukemia someone has. People with acute, quickly-growing leukemia, they may develop symptoms quickly and severely. For those who have chronic leukemia, they may not have any symptoms, and if they do, they may be mild. Generalized symptoms of leukemia include:

  • Unexplained fevers
  • Chills
  • Unintentional weight loss
  • Being very tired or feeling weak
  • Bruising without any injury to the skin
  • Bleeding, such as nosebleeds or gum bleeding
  • Feeling dizzy or lightheaded
  • Night sweats
  • Pale skin
  • Enlarged lymph nodes

Diagnosis

When someone presents with the above symptoms, the healthcare team may order testing to help determine the cause of what they’re experiencing. One of the most commonly ordered blood tests is a complete blood count (CBC). This blood test evaluates the numbers of white blood cells, red blood cells, and platelets. These levels can be significantly abnormal (both higher and lower than normal) in someone with leukemia. 

Along with CBC, a blood smear may also be done. This test allows the pathologist to look at how the different blood cells look under the microscope, to check for the presence of early white blood cells, called blasts, which can signify leukemia. 

Additional blood tests, such as flow cytometry, can be done to evaluate the white blood cells in a specific way. This test looks to see if leukemia cells are present in the sample. 

A bone marrow biopsy is often done when leukemia is suspected. This test takes a sample of bone and bone marrow (where blood cells are made) from the hip bone to evaluate for the presence of leukemia cells in the bone marrow. 

Once a diagnosis of leukemia is made, further testing is often done evaluating chromosomes of the cells to help further clarify the diagnosis. Exactly what tests are done can be a bit different for each type of leukemia. 

Imaging Tests

A CT scan may be done to check out the organs of the body, such as the lungs, liver, and spleen, to see if they look normal. A PET scan may also be done to look for the presence of leukemia cells outside of the bone marrow or bloodstream. 

Treatment

How leukemia is treated depends upon the type of leukemia someone has. Treatments can vary from no treatment needed except observation to intensive chemotherapy and bone marrow transplant. 

 

Lymphoma

What is Lymphoma?

Lymphoma is a cancer of the lymphocytes, which have a role to play in your immune system. When the lymphocytes become abnormal, they no longer function normally and become cancerous. Lymphoma can start in either the B lymphocytes or T lymphocytes of the immune system. 

There are many types of lymphoma, which are separated into two general groups: Hodgkin lymphoma and non-Hodgkin lymphoma. To further subdivide non-Hodgkin lymphoma, there are over 50 subtypes. 

Signs and Symptoms

There can be many signs and symptoms associated with lymphoma. These can include:

  • Enlargement of lymph nodes in the neck, armpits, or groin
  • Unexplained fevers or chills
  • Drenching night sweats
  • Unintentional weight loss
  • Severe itching
  • Extreme fatigue
  • Pale skin
  • Persistent cough
  • Difficulty breathing

Diagnostic tests

If someone is suspected of having lymphoma, or is experiencing symptoms that are suspicious and need further evaluation, a variety of tests may be ordered. 

Tests can include x-rays, which can show abnormal masses in the lungs that may be causing cough or shortness of breath. 

Another test that may be done is a CT scan, which can see abnormal lymph nodes as well as the other organs in the body to check for abnormalities. 

If lymphoma is confirmed or strongly suspected after the above tests, a PET scan may also be done. This type of imaging test shows not only the location of any abnormality, but also if those areas are actively growing or not. A sugar is attached to a radioactive tracer and given through an IV before the PET scan is done. The tracer is given time to circulate through the body, and then the person is scanned. Any areas of the body that take up alot of sugar, and are seen to be active, will be seen as bright areas on the screen. These areas may be very suspicious for cancer involvement. 

Biopsy

Ultimately a diagnosis of lymphoma is made through a biopsy. During a biopsy, a tissue sample from the suspicious lymph node is removed and tested for cancer cells. A biopsy can be done through a few different ways. 

In an excisional biopsy, an entire lymph node is removed to be evaluated for cancer. This is preferred when lymphoma is suspected, as sometimes just taking a small sample of a lymph node can miss the cancer cells. 

A needle biopsy may be done of a lymph node. During this procedure, a needle is placed into the suspicious area, and tissue is removed from it. Because less tissue is removed, it may not be as accurate of a way to diagnose lymphoma. 

Sometimes a bone marrow biopsy is done as well. During this procedure, a sample of bone and the marrow inside of it is removed from the hip area. The bone marrow is where blood cells are made, and it can be important to know if lymphoma cells are present there. This procedure is often done with anesthesia for patient comfort. 

Additional testing for specific chromosome changes and other markers may be done on the lymphoma tissue. This can help the oncologist with their treatment planning.

Are you interested in learning more about Lymphoma Staging and Treatments? Check out our next article on this topic.

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