What is Leukemia? Leukemia begins in the immature cells of the bone marrow in the central cavities of bones. The bone marrow produces all types of blood cells: red blood cells that carry oxygen and other materials to the tissues of the body, white blood cells that fight infection, and platelets that help the blood clot. Hundreds of billions of new blood cells are produced in the bone marrow each day, providing the body with a constant supply of fresh, healthy cells. In a patient with leukemia, many of the white blood cells produced in the bone marrow do not mature normally. These abnormal cells, called leukemic cells, are unable to fight infection the way healthy white cells can. As they accumulate, the leukemic cells also interfere with the production of other blood cells. Eventually, the body has too few red cells for supplying oxygen to the body’s tissues, too few platelets for proper clotting and too few healthy white cells for fighting infection. As a result, people with leukemia are at risk for bruising, bleeding and infections.
What are the Types of Leukemia?
The main types of leukemia are myelogenous and lymphocytic, and each type has an acute (rapidly progressing) and a chronic (slowly progressing) form. Acute leukemia mainly affects cells that are immature, or not fully developed, preventing them from maturing and functioning normally. Chronic leukemia develops more slowly, so that the body still has some healthy cells available to fight infection.
Acute Myeloid Leukemia (AML) - Acute myeloid leukemia is the most common type of leukemia in adults, although it also can occur in children. If untreated, this form of leukemia usually progresses quickly.
Chronic Myeloid Leukemia (CML) - Chronic myeloid leukemia originates from the presence of a genetic abnormality in blood cells, called the Philadelphia chromosome, and progresses through distinct phases. CML occurs mainly in adults, but a very small number of children also develop this disease.
Acute Lymphoblastic Leukemia (ALL) - Acute lymphoblastic leukemia is the most common type of leukemia in young children in developed countries, but it also affects adults, especially those ages 65 and older. ALL starts in the inner part of the bones, known as bone marrow, but often moves quickly into the blood.
Chronic Lymphocytic Leukemia (CLL)- Chronic lymphocytic leukemia usually gets worse slowly. CLL is the second most common form of leukemia in adults and rarely occurs in children. More than half of people diagnosed with CLL are older than 70, and cases rarely occur in individuals younger than 40.
What are the Causes of Leukemia?
Most causes of leukemia are not known. However, the disease has been linked to;
Exposure to large amounts of high energy radiation
Occupational exposure to the chemical benzene
Other risk factors for leukemia include the following:
Human T-cell leukemia virus 1 (HTLV-1)
Down syndrome and other genetic diseases
What are the Symptoms of Leukemia?
Symptoms of leukemia include:-
Fever, chills, night sweats and other flu-like symptoms
Weakness and fatigue
Swollen or bleeding gums
Enlarged liver and spleen
Pinhead-size red spots on the skin
How is Leukemia Diagnosed? To diagnose leukemia, the doctor must examine cells from the blood and, in most cases, the bone marrow. An initial blood test (complete blood count [CBC]) showing an abnormal white cell count may indicate the need for a bone marrow biopsy to confirm the diagnosis and to identify the specific type of leukemia. During this procedure, the doctor removes a sample of bone marrow tissue (biopsy) from a pelvic bone and tests the sample for cancer cells. The cells also are examined for chromosomal abnormalities.
What are the various Stages of Leukemia?
Stages of Leukemia and Acute Leukemia - Acute leukemia isn't classified in stages. Acute myelogenous leukemia (AML) is classified by the subtype of AML that affects the patient, and whether or not the cancer has spread from the blood and bone marrow to other parts of the body.
Adult acute lymphocytic leukemia (ALL) is staged in three categories:
The staging of childhood ALL uses risk groups:
Standard risk (low risk)
Chronic Leukemia Stages - Chronic leukemia stages depend on the type of leukemia diagnosed. Chronic myelogenous leukemia (CML) and chronic lymphocytic leukemia (CLL) are staged in different ways.
CML is divided into three phases:
Chronic lymphocytic leukemia stages are usually classified using Rai stages in the United States. The Rai stages are:
Stage 0: Low risk
Stages 1 and 2: Intermediate stages
Stages 4 and 5: High risk.
Leukemia Final Stages - Because of the different types of leukemia and accompanying staging methods, it’s difficult to generalize about leukemia final stages. Generally, the final stages of leukemia include:
Involvement of other organs
Resistance to treatment
Significant levels of abnormal blood cells.
Each type of leukemia responds to treatment differently and progresses at different rates. Individual response to treatment and disease progression are more useful prognostic indicators than classification systems.
How is Leukemia Treated?
Treatment depends on the type of leukemia, certain features of the leukemic cells, the extent of the disease, and whether the leukemia has been treated before. Following are the types;
Biologicaltherapy is treatment with substances that affect the immune system's response to cancer. Interferon, a drug used against some types of leukemia, is a form of biological therapy. Biological therapy or immunotherapy uses the body’s immune system to fight cancer, using antibodies to target and destroy leukemia cells
Chemotherapyis given in cycles, a treatment period followed by a recovery period, and then another treatment period and so on. Chemotherapy destroys cancer cells by stopping them from growing or multiplying. Some healthy cells are destroyed as well, which is what causes the side effects, but normal cells are often able to repair themselves after treatment. Different types of drugs are used for the different types of leukemia.
Sometimes Radiation therapy is used for leukemia in the central nervous system or testicles as well as for pain caused by bone destruction. However, radiation is not the primary treatment for leukemia. In high doses radiation therapy kills cells and/or keeps them from growing and dividing. Radiation therapy is helpful in treating cancer because cancer cells reproduce faster than most normal cells.
Bone Marrow Transplants
Bone Marrow Transplants are probably the best bet for a cure in many cases of leukemia. Doctors perform this procedure when leukemia is in remission or when the patient relapses during or after treatment. Patients are given a bone marrow transplant so that their body can be given higher doses of chemotherapy drugs that would not be tolerated otherwise. Chemotherapy also destroys normal cells in the bone marrow, making the bone marrow transplant necessary in order to make up for the destruction of normal cells.
Surgeryis less likely to be considered for patients of leukemia because leukemia cells are spread throughout the body making it difficult to target one specific area. However, in some cases surgery is done to remove the spleen. The spleen may be removed because blood cells have accumulated, causing the spleen to swell and displace other organs in the abdomen.
Follow-Up for Leukemia Treatment
After completion of treatment, the diagnostic studies are repeated to see how the treatment has affected the leukemia. Many people have a reduction or even a disappearance of leukemia cells in their blood and bone marrow. This is called remission.
Benefits of Leukemia Treatment
The rate of leukemia has not changed much, but more people are surviving longer, thanks mainly to advances in chemotherapy. ALL, for example, represents one of the most dramatic success stories in cancer treatment. Almost 90 percent of children diagnosed with the disease attain remission, and more than half are cured completely. The 5-year survival rate for all patients with ALL has risen from 4 percent in the 1960s to more than 50 percent in the 1990s.
Adult patients treated for ALL have an 80 percent to 90 percent chance of attaining remission; about 40 percent of those who do so survive at least another five years, with a chance of a full cure. Patients treated for AML have a 60 percent to 70 percent chance of remission; about 20 percent of those survive at least three years, with a possibility of a full cure.
Leukemia Treatment in India A host of medical options are available to patients traveling to India for medical treatment, especially cancer treatment like Leukemia. All the specialist knowledge, medical talents, advanced diagnostic equipment and surgical tools in the world count for nothing if the commitment to deliver them in the best possible way to the patient is not there. India hospitals are known for its effective and efficient services. What many people do is get diagnosed in the their home country and have a treatment recommended for them before beginning research to find a suitable hospital in India where they can have that treatment for a fraction of the cost of what it would be in the US or UK. Physicians in India are also developing alternative approaches to treating certain types of leukemia that may actually eliminate the need for transplant.
Cities in India that where best hospitals provide various leukemia treatment are as follows;
Cost of Leukemia Treatment in India
Substantial savings can be made by travelling to India for Leukemia. Medical Tourism is becoming more popular with prices for treatment in India becoming highly reasonable for patients from all parts of the globe. The price comparisons for complicated procedures like leukemia take into account flights and hotel bills for the expected length of stay. This will include almost everything related to Leukemia like operating room fees, Anesthesia, hospital accommodation in a private and well equipped room with complete sanitation, medications, doctor’s fees and nursing care.
Some of the common countries from which patients travel to India for surgery are: