Leukemia is a cancer of the blood and bone marrow. Marrow is the soft, fatty tissue inside the hard, outer part of the bones. Bone marrow makes blood stem cells, which become the different types of blood cells, including white blood cells, red blood cells, and platelets. Normally, white blood cells help your body fight infection and other diseases. Leukemia occurs when the body produces too many abnormal white blood cells. When this happens, the abnormal cells crowd out the normal blood cells needed by the body. The abnormal white blood cells cannot fight infections like normal white blood cells. Your red blood cell count and the number of platelets decrease, which causes you to have blood clotting problems and bleed easily.
There are many different types of leukemia. The type is determined by two things:
Whether the leukemia symptoms come on quickly (acute) or the disease develops slowly (chronic)
What type of white blood cell is affected (lymphocytes or myelocytes.)
Some of the most common types of leukemia include Acute Myelogenous Leukemia (AML), Chronic Myelogenous Leukemia (CML), Acute Lymphocytic Leukemia (ALL), and Chronic Lymphocytic Leukemia (CLL).
It is important to diagnose and treat leukemia as soon as possible. The main goals of treatment are to kill the cancer cells and prevent the cancer from spreading.
The cause of leukemia is not well known. However, there are things that increase your risk. These include:
Being exposed to radiation
Being exposed to certain chemicals, such as benzene
Having certain inherited diseases, such as Downâ€™s syndrome
Having certain pre-leukemic blood disorders, such as myelodysplastic syndrome
Being infected with Human T-cell leukemia virus type I (HTLV-I)
Family history of leukemia
What can I expect in the hospital?
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
You will be checked often by the hospital staff.
Your heart rate, blood pressure, and temperature will be checked regularly.
Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
Testing may include:
Blood tests to check your blood count and to check for cancer cells in the blood
Bone marrow biopsy: A biopsy is the removal of a small sample of bone marrow for testing.
Chest X-ray: Pictures of the inside of your chest to check for cancer
Genetic analysis: Blood or bone marrow tests to look at your genes to see if your leukemia may be linked to a condition you may have inherited and to look at changes in your leukemia cells to see how aggressive they are
Tests to check if the cancer has spread to other parts of your body, including:
Blood tests to check the level of certain hormones, proteins, or chemicals that may be high if you have cancer, or to check for cancer cells in the blood
Bone X-rays: Pictures of your bones to check for cancer
Bone scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the chest, abdomen, and pelvis
Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the chest, abdomen, and pelvis
Lumbar puncture: A test which uses a needle to get a sample of fluid from the area around your spinal cord to check for spread of cancer to the brain and spinal cord
Ultrasound scan: A test in which sound waves and their echoes are passed through your body from a small device (called a transducer) that is held against your skin to create pictures of the inside of the abdomen to look for spread to the abdominal organs or lymph nodes in the abdomen
Positron emission tomography (PET) scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.
The treatment for leukemia depends on the type of leukemia, the stage of disease, how well you respond to treatment, your overall health, and any complications you may have. Your chance of cure depends on how far the cancer has advanced. You may need to make lifestyle changes to stay as healthy as possible, manage other treatments you may need, or adjust to your leukemia diagnosis.
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
Treatments may include:
Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells.
Radiation therapy, which uses high-energy X-rays to kill cancer cells.
Biological therapy, which uses medicine designed to help your immune system fight the cancer or block the growth of cancer cells.
Your provider may prescribe medicine or other therapy to:
Treat or prevent an infection
Treat or prevent side effects, such as nausea, from the other treatments
Help your immune system fight cancer
You may need a bone marrow or stem cell (young blood cell) transplant after your treatment. Stem cells may be taken from your bone marrow or blood before treatment and kept frozen. Stem cells may also be donated from another personâ€™s bone marrow or blood, or from a newbornâ€™s umbilical cord blood.
If chemotherapy severely damages your bone marrow and its ability to make blood cells, the blood-forming stem cells can be given to you so that new, healthy cells can begin to replace the cells that were killed by the chemotherapy. If the stem cells were taken from bone marrow, the procedure is called a bone marrow transplant.
You may become temporarily or permanently sterilized by the treatment. Before treatment begins, women can freeze their eggs and men can freeze their sperm if they may want to have children in the future.
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Easy bruising or bleeding
Loss of appetite
Deep bone pain
Full feeling below the ribs, especially on the left
Swollen lymph nodes in the neck, underarms, and groin
Ask questions about any medicine or treatment or information that you do not understand.
How long will I be in the hospital?
How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. The average amount of time to stay in the hospital with leukemia is 8 to 16 days. Talk with your provider about how long your stay may be.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-22 Last reviewed: 2014-12-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Armitage, J. O., Doroshow, J. H., Kastan, M. B., Niederhuber, J. E., & Tepper, J. E. (2014). Abeloff’s Clinical Oncology [5th ed.]. Philadelphia: Elsevier Saunders.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp