Why Choose Cedars-Sinai Marina del Rey Hospital for Leukemia Treatment?
Since 1969, our hospital has been providing the community of Los Angeles with quality healthcare in a calm and compassionate environment, as we place great emphasis on the comfort and wellbeing of the patient. If you struggle with leukemia, our skillful medical professionals can offer you the treatment you need, regardless of how complex your case may be, as Cedars-Sinai Marina del Rey Hospital has the privilege of being equipped with state-of-the-art technology, by virtue of which we can significantly improve the quality of your life.
Every year, over 27,000 people in the United States receive a leukemia diagnosis. As a cancer of the blood and bone marrow, leukemia involves white blood cells. Accordingly, if you have leukemia, the number of white blood cells in your body will be abnormally high, which will hinder the function of the red blood cells and platelets. Consequently, your general health will decline.
While leukemia is common in children, it often develops in adults as well. It is worthy of note that, in leukemia, the white blood cells, whose purpose is to protect your body from bacteria, viruses, and fungi, do not function properly. They divide too rapidly and eventually crowd out the other important blood cells. The majority of white blood cells are made in the bone marrow, but they can also stem from the lymph nodes, spleen, and thymus gland.
The sooner leukemia is found, the better the prognosis of the patient will be.
The treatment you will receive for leukemia will depend on the type of cancer you have, whether it has spread through the body, your age, your general health, and your preferences. Bone marrow transplant is often used as a treatment for leukemia, as the purpose of this procedure is to replace the unhealthy bone marrow with stem cells free of leukemia that will help regenerate healthy bone marrow. However, before you undergo a bone marrow transplant, you will have to receive very high doses of chemotherapy or radiotherapy to destroy the bone marrow that causes leukemia. There are 2 main types of bone marrow transplants, namely:
- autologous transplant: the stem cells for this type of bone marrow transplant come from your own body, which will be collected by medical professionals before you undergo chemotherapy, as this treatment is very aggressive and can easily damage your stem cells
- allogenic transplant: in this case, the stem cells that will produce bone marrow come from a donor and they are given to the leukemia patient after they undergo chemotherapy or radiotherapy
If your medical team cannot collect stem cells from your own body and is also unable to find a donor, there are fortunately other options available, such as:
- umbilical cord blood transplant: because the child no longer needs the umbilical cord following birth, stem cells from it will be used for bone marrow transplant in people with leukemia
- parent-child transplant and haplotype mismatched transplant: while stem cells from a parent, child, brother, or sister are not always a perfect match for people with leukemia, they are in 50% of cases, which is why bone marrow transplant can be performed by using stem cells from immediate family members
However, chemotherapy remains the main treatment for people with leukemia, as they do not have malignant tumors that can be removed by surgery. Instead, cancer is present throughout their entire body. Depending on the type of leukemia you have, you may receive a single medication or a combination of two if you undergo chemotherapy. The drugs for chemotherapy come in the form of a pill or intravenous injection. Here are the most effective medications for leukemia:
It is worthy of note that chemotherapy has numerous side effects, as it also affects healthy cells in the body and can thereby result in the following over time:
Radiotherapy is another effective treatment for keeping leukemia under control. It works by delivering X-rays or other high-energy beams to damage leukemia cells and prevent their growth. It damages the genetic material within malignant cells, which prevents them from growing and reproducing. The patient may receive radiation in a specific area of the body where leukemia has accumulated or they may receive radiation over their entire body.
Another effective treatment for leukemia is immunotherapy, which uses the immune system of the patient to fight cancer. In people with cancer, the immune system ceases to function properly, as malignant cells release proteins that help them hide from the immune system cells. Immunotherapy works by identifying these proteins and prompting the immune system to destroy malignant cells. Lastly, people who struggle with leukemia may be interested in participating in clinical trials, where they will receive the latest treatments available, which may prove to be very efficient in keeping their cancer under control.
Leukemia may be chronic or acute. In the former, cancer develops slowly and the patient will not experience bothersome symptoms, whereas, in the latter, the disease spreads rapidly, as numerous undeveloped malignant blasts replace normal cells in the blood and bone marrow. Accordingly, there are 4 types of leukemia, namely:
- acute myelogenous leukemia: as the most common type of leukemia, acute myelogenous leukemia develops when the bone marrow starts to make blasts, which are cells that have not yet completely matured, and this type of leukemia has a very rapid progress
- acute lymphocytic leukemia: this type of leukemia progresses very fast and occurs when abnormal white blood cells accumulate in the bone marrow
- chronic myelogenous leukemia: as a type of leukemia that develops at a slow pace, chronic myelogenous leukemia starts in lymphocytes in the bone marrow and spreads to the blood
- chronic lymphocytic leukemia: this type of leukemia has slow progress and develops in the blood-forming cells of the bone marrow and, over time, spreads to the blood
Symptoms of Leukemia
It is important to know that, in the early stages, people with leukemia rarely experience symptoms. However, as the disease progresses, they may notice some of the following symptoms:
- flu or cold symptoms
- shortness of breath when engaging in physical activity
- a pale complexion from anemia
- bleeding caused by low platelet count, black and blue marks occurring for no reason and/or because of a minor injury
- mild fever and chills
- swollen gums
- frequent minor infections such as pustules or sores in the anal area
- slow healing of cuts
- discomfort in bones or joints
- enlarged liver and spleen
- recurrent nosebleeds
- unexplained weight loss
- swollen lymph nodes
- tiny red spots on the skin
- excessive sweating, particularly at night
Diagnosis of Leukemia
The diagnosis of leukemia begins with a physical exam, during which your doctor will ask you about your general health, the symptoms you experience, and your family history of the disease. They will also examine your body for pale skin, bleeding, swollen lymph nodes, fever, bruising, and enlargement of your liver and spleen. Afterward, they will order some of the following tests and exams to assign you a correct and accurate diagnosis:
- Complete blood count: This blood test will measure the number and quality of white blood cells, red blood cells, and platelets, as leukemia usually causes abnormal blood cell levels. During a complete blood count, leukemia cells may also be found in your blood, but it is important to know that this is not always the case, as sometimes, leukemia cells remain confined to the bone marrow.
- Blood chemistry tests: They measure various chemicals in the blood, which will show how well certain organs are functioning. A blood chemistry test can also help the doctor find abnormalities in your blood. Furthermore, it helps your physician find problems with the liver or the kidneys that are caused by the spread of leukemia. Lastly, blood chemistry tests can help the medical professional stage leukemia. Usually, there will be high levels of the following chemicals in your blood if you have leukemia: blood urea nitrogen, creatinine, phosphate, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and uric acid.
- Bleeding and clotting factors: These tests measure blood-clotting factors to determine how well the body can clot blood since abnormal levels of blood clotting factors are often present in people with leukemia. They are measured by using the following tests: fibrinogen level, prothrombin time, partial thromboplastin time, and international normalized ratio.
- Bone marrow test: Also known as a biopsy, a bone marrow test entails a sample of bone marrow being collected from your hip bone, medically known as the pelvic bone, by using a long and thin needle. It will subsequently be analyzed by a pathologist in a laboratory to determine whether there are leukemia cells in it.
- Cytochemistry: It uses stains or dyes to identify tissue structures and components in blood or bone marrow. Certain stains will become attached to specific chemicals found in some types of leukemia cells and the results can only be seen under a microscope. Additionally, cytochemistry will help your doctor pinpoint the type of cells that are present with leukemia.
- Immunophenotyping: This is the study of the proteins released by malignant cells and the test is employed to determine the type or subtype of leukemia you have. Immunophenotyping uses a very precise antigen-antibody reaction to identify proteins. It employs monoclonal antibodies marked with a fluorescent label or specific enzyme label that binds only to certain proteins. The fluorescent or enzyme label will allow the doctor to identify the leukemia cells.
- Flow cytometry: This is a very helpful technique to sort and classify cells by using fluorescent labels on their surface. The cells are exposed to a laser, which makes them release light. Subsequently, the light is measured and analyzed by a computer. Flow cytometry will allow your physician to see many antibodies at the same time and to quickly collect data from thousands of cells in a single sample. Finally, this technique is very useful to define the unique features of leukemia cells and these features will help your doctor predict your prognosis and measure your response to various treatments.
- Lumbar puncture: Also known as a spinal tap, a lumbar puncture will remove a tiny amount of cerebrospinal fluid from the space around the spine. A pathologist will subsequently examine it to determine whether leukemia cells have spread to the spinal fluid.
- Lymph node biopsy: During this surgical procedure, a portion of a lymph node or the entire lymph node is removed to be examined by a pathologist for leukemia cells. It will help your doctor identify the type of leukemia you have, as well as determine how fast it is spreading.
- Chest X-rays: This test may be ordered for you to allow your physician to see whether you have enlarged lymph nodes in the middle of the chest, enlarged thymus gland, pleural effusion, or pneumonia.
- CT scan: During computed tomography, your doctor will be provided with clear images from the inside of your body. They will look at your spleen and liver to determine whether they are enlarged, as well as at the lymph nodes around the heart, the windpipe, and the back of the abdomen.
- MRI scan: Magnetic resonance imaging, which uses strong magnetic fields and radio waves, can show whether leukemia has spread to your brain.
- Ultrasound: Your doctor may order this test to see whether your organs are enlarged as a result of leukemia.
Although the exact cause of leukemia is not yet known, medical researchers believe that it is the result of complex interactions between genetic factors and the environment. However, there are certain factors that, if present, may increase the risk of developing leukemia, such as:
- exposure to hazardous agents, such as radiation or benzene
- smoking, as up to 20% of leukemia cases are thought to be the result of tobacco use
- history of chemotherapy or radiotherapy for another cancer
- myelodysplastic syndromes, such as bone marrow failure disorder, which one-third of leukemia patients have
- rare genetic syndromes, such as Down syndrome, Fanconi anemia, ataxia-telangiectasia, and Bloom syndrome
- a family history of leukemia, although the majority of people who develop this cancer do not have immediate family members with this disease
- certain blood disorders, such as chronic myeloproliferative disorders, which include polycythemia vera, idiopathic myelofibrosis, and essential thrombocytopenia
While there is little to do to prevent leukemia, you will have a lower risk of developing it if you avoid radiation exposure, wear protective equipment when working with toxic chemicals and quit smoking.