Leukemia is a cancer of the blood and bone marrow characterized by an excess production of immature white blood cells. There are four main types of leukemia - acute lymphocytic, acute myelogenous, chronic lymphocytic, and chronic myelogenous - defined by how quickly the disease progresses and what types of blood cells are involved. While there is no cure, treatment options aim to induce remission through chemotherapy, radiation, stem cell transplants, or other therapies. The exact causes are unknown but risk factors include genetic disorders, prior cancer treatment, chemical exposure, and smoking.

1. Leukemia

2. • Leukemia is a blood cancer caused by a rise in the number of
white blood cells in your body.
• Those white blood cells crowd out the red blood cells and
platelets that your body needs to be healthy. The extra white
blood cells don’t work right

3. Leukemia Symptoms
• Different types of leukemia can cause different problems. You might not notice any signs
in the early stages of some forms. When you do have symptoms, they may include:
• Weakness or fatigue
• Bruising or bleeding easily
• Fever or chills
• Infections that are severe or keep coming back
• Pain in your bones or joints
• Headaches
• Vomiting
• Seizures
• Weight loss
• Night sweats
• Shortness of breath
• Swollen lymph nodes or organs like your spleen
•

4. • Blood has three types of cells: white blood cells that fight infection,
red blood cells that carry oxygen, and platelets that help blood clot.
• Every day, your bone marrow makes billions of new blood cells, and
most of them are red cells. When you have leukemia, your body
makes more white cells than it needs.
• These leukemia cells can’t fight infection the way normal white blood
cells do. And because there are so many of them, they start to affect
the way your organs work. Over time, you may not have enough red
blood cells to supply oxygen, enough platelets to clot your blood, or
enough normal white blood cells to fight infection

5. Leukemia Classification
• Leukemia is grouped by how fast it develops and gets worse, and by
which type of blood cell is involved.
• The first group, how fast it develops, is divided
into acute and chronic leukemia.
• Acute leukemia happens when most of the abnormal blood cells
don’t mature and can’t carry out normal functions. It can get bad
very fast.
• Chronic leukemia happens when there are some immature cells, but
others are normal and can work the way they should. It gets bad
more slowly than acute forms do.
•

6. • The second group, what type of cell is involved, is divided
into lymphocytic and myelogenous leukemia.
• Lymphocytic (or lymphoblastic) leukemia involves bone marrow
cells that become lymphocytes, a kind of white blood cell.
• Myelogenous (or myeloid) leukemia involves the marrow cells
that create red blood cells, platelets, and other kinds of white
blood cells

7. Types of Leukemia
• The four main types of leukemia are:
• Acute lymphocytic leukemia (ALL). This is the most common form
of childhood leukemia. It can spread to your lymph nodes and central
nervous system.
• Acute myelogenous leukemia (AML). This is the second most common
form of childhood leukemia and one of the most common forms for
adults.
• Chronic lymphocytic leukemia (CLL). This is the other most common
form of adult leukemia. Some kinds of CLL will be stable for years and
won’t need treatment. But with others, your body isn’t able to create
normal blood cells, and you’ll need treatment.
• Chronic myelogenous leukemia (CML). With this form, you might not
have noticeable symptoms. You might not be diagnosed with it until you
have a routine blood test. People 65 and older have a higher risk of this
type.

8. How leukemia forms
• In general, leukemia is thought to occur when some blood cells
acquire changes (mutations) in their genetic material or DNA. A
cell's DNA contains the instructions that tell a cell what to do.
Normally, the DNA tells the cell to grow at a set rate and to die
at a set time. In leukemia, the mutations tell the blood cells to
continue growing and dividing.
• When this happens, blood cell production becomes out of
control. Over time, these abnormal cells can crowd out healthy
blood cells in the bone marrow, leading to fewer healthy white
blood cells, red blood cells and platelets, causing the signs and
symptoms of leukemia.

9. Risk factors
• Previous cancer treatment. People who've had certain types of
chemotherapy and radiation therapy for other cancers have an increased
risk of developing certain types of leukemia.
• Genetic disorders. Genetic abnormalities seem to play a role in the
development of leukemia. Certain genetic disorders, such as Down
syndrome, are associated with an increased risk of leukemia.
• Exposure to certain chemicals. Exposure to certain chemicals, such as
benzene — which is found in gasoline and is used by the chemical
industry — is linked to an increased risk of some kinds of leukemia.
• Smoking. Smoking cigarettes increases the risk of acute myelogenous
leukemia.
• Family history of leukemia. If members of your family have been
diagnosed with leukemia, your risk of the disease may be increased.

10. Cont…….
• With regard to the specific genetic and environmental factors that are thought to be linked to
leukemia, and what causes bone marrow cells to mutate, researchers are evaluating certain
combinations of:
• A genetic predisposition
• Down syndrome
• Human T-lymphotropic virus (HTLV)
• Human immunodeficiency virus (HIV)
• Exposure to petrochemicals, such as benzene
• Extensive exposure to artificial ionizing radiation
• Alkylating chemotherapy agents administered to treat other types of cancer
• Tobacco use
• Use of certain hair dyes

11. Can Leukemia be cured?
• While there is no cure for leukemia at this point in time, and the cancer can still
recur, patients can reach a state of remission (in which there are no longer any
signs or symptoms of cancer). These days, there are a range of advanced treatment
options available for leukemia patients to achieve remission without recurrence,
including:
• Chemotherapy
• Radiation therapy
• Bone marrow transplants
• Monoclonal antibody therapy
• Immunotherapy
• Clinical trials

12. Treatments
• Induction chemotherapy to bring about bone marrow remission. For adults, standard induction
plans include prednisone, vincristine, and an anthracycline drug; other drug plans may
include L-asparaginase or cyclophosphamide. For children with low-risk ALL, standard therapy
usually consists of three drugs (prednisone, L-asparaginase, and vincristine) for the first month
of treatment.
• Consolidation therapy or intensification therapy to eliminate any remaining leukemia cells.
There are many different approaches to consolidation, but it is typically a high-dose, multi-drug
treatment that is undertaken for a few months. People with low- to average-risk ALL receive
therapy with antimetabolite drugs such as methotrexate and 6-mercaptopurine (6-MP). People
who are high-risk receive higher drug doses of these drugs, plus additional drugs.
• CNS prophylaxis (preventive therapy) to stop cancer from spreading to the brain and nervous
system in high-risk people. Standard prophylaxis may include radiation of the head and/or
drugs delivered directly into the spine.
• Maintenance treatments with chemotherapeutic drugs to prevent disease recurrence once
remission has been achieved. Maintenance therapy usually involves lower drug doses and
may continue for up to three years.
• Alternatively, allogeneic bone marrow transplantation may be appropriate for high-risk or
relapsed people.