DR. WALKER

Overview of Leukemia

What is leukemia?

Leukemia is a cancer of the blood caused by an abnormal rise in the number of white blood cells in your body. These cells are usually immature (still developing) white blood cells that can crowd the bone marrow and interfere with the production of normal blood cells. These abnormal blood cells affect the body’s ability to produce healthy new blood cells and decrease the ability to effectively respond to infections. There are approximately 60,000 new diagnoses of leukemia made each year. The risk of developing leukemia increases with age, but the disease may develop in people under 20 years old.

What are the symptoms of leukemia?

Leukemia symptoms vary based on the different types of leukemia. You might not notice any signs in the early stages, but symptoms can sometimes be vague resembling other illnesses or conditions. When you do have symptoms, they may include:

Early leukemia symptoms:

• Swollen lymph nodes especially in the neck and armpits
• Weakness or fatigue
• Bruising or bleeding easily
• Fever or chills
• Infections that are severe or keep coming back
• Red spots on the skin
• Experience pain in bones
• Headaches
• Seizures
• Rapid weight loss
• Night sweats
• Shortness of breath
• Enlarged spleen
• Night sweats - excessive sweating, especially at night

What are some common types of leukemia?

•Acute Lymphocytic Leukemia (ALL)

Acute lymphocytic leukemia (ALL) is the most common kind of leukemia and is the most common form of leukemia in children. ALL starts in the lymphoid cells of the bone marrow then spreads to other parts of the body to include brain and spinal cord, liver, nodes, and spleen. More specific symptoms of ALL include fatigue, feeling dizzy or lightheaded, shortness of breath, persistent infections, small red or purple spots on the skin.

• Acute Myeloid Leukemia (AML) or Acute Myelogenous Leukemia

Acute Myeloid Leukemia (AML) or Acute myelogenous leukemia may start in white blood cells other than lymphocytes, to include red blood cells and platelets. This is the most common kind of aggressive leukemia in adults. Symptoms of AML could include fever, bone pain, fatigue, shortness of breath, pale skin, frequent infections, and easy bruising.

•Chronic Lymphocytic Leukemia (CLL)

Chronic lymphocytic leukemia is a slow-growing cancer that begins in lymphocytes in the bone marrow and extends into the blood. CLL usually affects older adults and usually presents with too many abnormal lymphocytes growth which then crowd out normal blood cells. CLL symptoms may include swelling of lymph nodes (neck, underarm, stomach or groin), fatigue, fever, infection, and weight loss.

Chronic Myelogenous Leukemia (CML)

Chronic myelogenous leukemia usually affects adults. It’s sometimes called chronic myeloid leukemia. This type of leukemia starts in the myeloid cells of the bone marrow. It grows slowly, so symptoms may not start for months or years. Symptoms when they begin may include fatigue, fever, weight loss and an enlarged spleen.

What are the risk factors for leukemia?

A few things that could increase your risk of developing some types of leukemia:
•Previous cancer treatment. People exposed to high doses of radiation or chemotherapy for other cancers have an increased risk of developing certain types of leukemia. These treatments may cause mutations, or changes in a cell’s DNA, that could lead to malignancies to include leukemia.
•Rare genetic syndromes. Genetic abnormalities such as Down’s syndrome, Bloom syndrome, neurofibromatosis, and Fanconi anemia seem to play a role in the development of leukemia.
•Exposure to certain chemicals. Exposure to solvents such as benzene — which is found in gasoline or exposure to exposure to Agent Orange have heightened risk factors.
•Smoking. Cigarette smoking contain dozens of cancer-causing chemicals and thereby increases the risk of acute myelogenous leukemia.
•Family history of leukemia. First-degree relative with leukemia — a parent, child, or sibling have up to 4-fold increased risk for developing CLL.
•Age: The risk of most leukemias increases as we age with median age of several leukemias like AML, CLL and CML is around 65 years older. ALL is the most common type of childhood cancer with approximately 75% of people are under age 20 and most cases occur between ages 2 and 5.

How is leukemia diagnosed?

To officially diagnose leukemia blood tests are typically done, followed by bone marrow tests in which a core of bone is removed with a long needle and the bone marrow is examined under a microscope. In some patients, the leukemia stays in the bone marrow and is not found in blood, hence marrow sampling is often required. The bone marrow sample is usually taken from the hip bone or other areas, such as a lymph node.

Complete blood count (CBC): This blood test is used to look at the overall health and could find a wide range of conditions, including infection, anemia, and leukemia. This test measures the amount of red blood cells, white blood cells and platelets in the blood.
Differential: A differential measures the number of each type of these white blood cells found in the patient's blood.
Peripheral blood smear: This blood test gives information about the number and shape of blood cells. This could require just a single drop of blood. The processing can be done manually or via an automated technique which spreads the blood out across a surface and then analyzed under a microscope. It is often done as part of or along with a complete blood count (CBC).

Self-Care Tips:

Supplements to consider:

Turmeric/curcumin. Curcumin is the active ingredient in turmeric, and has been used in traditional Indian medicine for centuries. Curcumin possesses natural antioxidants, anti-inflammatory, and analgesic properties. Additionally, curcumin has shown anti-proliferative effects on multiple tumors to include leukemia. Curcumin induces cell apoptosis in acute myeloid leukemia (AML) by suppressing the DNA action thus prevents cancer growth. As an antioxidant and anti-inflammatory, curcumin can also be useful in the treatment and possible prevention of certain other leukemia cancers.
Fish oil. Fish oil is a dietary source of omega-3 fatty acids. Fish oil contains two omega-3s called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Research in the past on fatty acids has shown that some metabolites of Omega-3 have the ability to selectively kill the leukemia-causing stem cells in mice. Importantly, the mice were completely cured of leukemia with no relapse. It appears that metabolites of Omega-3, are able to kill cancer-causing stem cells in the mice's spleen and bone marrow by activating a gene -- p53 -- in the leukemia stem cell that programs the cell's own death. Sources of omega-3 include salmon, mackerel, trout, oysters, and crab.
Magnesium. Magnesium is a mineral that is crucial to the body's function and has essential roles in the regulation of cell growth, division, and differentiation. Research on Magnesium found that magnesium deficiency can lead to the initiation and proliferation of several cancers. Low magnesium can also negatively affect permeability of the cell, and several studies have suggested that this can initiate cancers. Additionally, studies have demonstrated that a diet poor in magnesium increases the risk of developing cancer, specifically in solid malignancies. Scientists suspect that hypomagnesemia has similar detrimental association with blood cancers such as lymphoma also.
Vitamin D. Vitamin D is also known as the sunshine vitamin, that is produced by the body in response to skin being exposed to sunlight. Studies have shown a link between vitamin D deficiency and a worse prognosis in various types of cancer, including diffuse large B-cell lymphoma and chronic lymphocytic leukemia (CLL). One study noted that people in the highest vitamin D group had almost a 60% reduction in leukemia as compared to those in the lowest group.
Good foods in this category -- including some fish, fish liver oils, and egg yolks.
Vitamin C. Vitamin C/ascorbic acid is one of the most popular supplements given to people with cancers. Vitamin C helps protect cells from further damage and inhibits cancer cells from progressing. Studies suggest that vitamin C inhibits toxicity of several cancers in humans through direct interaction.
Green Tea. Green tea has a natural antioxidant known as epigallocatechin-3-gallate, EGCG which has been found to reduce the risk of several cancers to include CLL leukemic cell. Laboratory research showed that EGCG, can kill chronic lymphocytic leukemia cells. Another study showed that EGCG was found to reduce the survival of CLL leukemic cell. EGCG appears to kill leukemia cells by interrupting the communication signals they need to survive. Green tea has the highest amount of EGCG which is known to inhibit cancer cell growth, and even induce cell death. Also remember that antioxidants help to neutralize free radicals, and as a result will decrease overall body inflammation.