Leukemia

Overview

Leukemia is cancer of the blood cells — usually the white blood cells. Leukemic cells look different than normal cells and do not function properly.

Because different types of leukemia cells behave differently, they require different types of treatment. Leukemia is considered to be either acute or chronic, depending on how fast the cells grow without therapy. And it's either lymphocytic or myeloid, depending on the type of white blood cell that has turned into leukemia. By looking at these factors, most cases of leukemia can be classified into one of four main types of leukemia. 

Our approach

The Hematologic Oncology Center is one of the top referral centers in the nation for acute and chronic leukemia.  The Chronic Lymphocytic Leukemia (CLL) Research and Treatment Program has become a landmark for CLL patients worldwide, offering comprehensive clinical care as well as providing extensive clinical and basic research of leukemia.

Over the years, the physicians have made a significant impact in the area of leukemia research:

  • Center investigators have been involved in the earliest testing of novel agents for the therapy of acute leukemia, including inhibitors of drug resistance, immunotherapies and new chemotherapeutic agents
  • In collaboration with Cold Spring Harbor and Ohio State University, the center’s oncologists have helped to identify subtypes of acute leukemia and developed prognostic models for the treatment of acute leukemia
  • The center has also been instrumental in bringing in promising new drugs like GS-1101 (formerly CAL-101) and PCI-32765 (ibrutinib) for the treatment of advanced CLL and mantle cell lymphoma

The center’s leukemia patients receive the finest inpatient care at North Shore University Hospital, which has the only dedicated 30-bed leukemia unit in Long Island, Queens and Brooklyn. The unit has been providing exceptional care for leukemia patients since 1992.

Symptoms

The following are the most common symptoms of leukemia. However, each individual may experience symptoms differently. Symptoms may include:

  • Increased susceptibility to infections and fevers
  • Feeling weak or tired
  • Pale skin
  • Shortness of breath
  • Bleeding
  • Bruising
  • Fever
  • Chills
  • Loss of appetite
  • Loss of weight
  • Swollen or tender lymph nodes, liver, or spleen
  • Petechiae. Tiny red dots under the skin that are the result of very small bleeds.
  • Swollen or bleeding gums
  • Sweating
  • Bone or joint pain

In addition, acute leukemia may cause the following:

  • Headaches
  • Vomiting
  • Confusion
  • Loss of muscle control
  • Seizures
  • Swollen testicles
  • Sores in the eyes or on the skin

Leukemia may also affect the skin, central nervous system, digestive tract, kidneys, and testicles.

The symptoms of acute and chronic leukemias may resemble other blood disorders or medical problems. Always consult a health care provider for a diagnosis.

Types

There are various types of leukemia. The first 4 are the most common:

  • Acute myeloid leukemia (AML)
  • Acute lymphocytic leukemia (ALL)
  • Chronic lymphocytic leukemia (CLL)
  • Chronic myelogenous leukemia (CML)
  • Hairy cell leukemia
  • Plasma cell leukemia
  • Prolymphocytic leukemia
  • Leukemic phase of lymphoma

Diagnosis

In addition to a complete medical history and physical examination, diagnostic procedures for leukemia may include the following:

  • Bone marrow aspiration and/or biopsy - A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.
  • Complete blood count (CBC) - A measurement of size, number, and maturity of different blood cells in a specific volume of blood.
  • Additional blood tests - These may include blood chemistries, evaluation of liver and kidney functions, and genetic studies.
  • Computed tomography scan (also called a CT or CAT scan) - A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Magnetic resonance imaging (MRI) - A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • X-ray - A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Ultrasound (also called sonography) - A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
  • Lymph node biopsy - A procedure performed to remove tissue or cells from a lymph node in the body for examination under a microscope.
  • Spinal tap/lumbar puncture - A special hollow needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection, leukemia cells in the CSF, or or other problems. CSF is the fluid that bathes the brain and spinal cord.

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