What Is Leukemia?
Leukemia is a cancer of the blood. Healthy blood cells are normally made in an orderly way in the bone marrow, the soft tissue inside the bones. In leukemia, that process breaks down. The bone marrow makes large numbers of abnormal, immature blood cells that crowd out healthy ones.
As a result, the body has too few normal white blood cells to fight infection, too few red blood cells to carry oxygen, and too few platelets to help stop bleeding. The name leukemia comes from a term meaning “white blood,” because white blood cells are involved.
Types of Leukemia
According to the American Cancer Society, leukemias are grouped in two ways: by how fast they grow and by the kind of blood cell they start in.
- Acute or chronic. Acute leukemias grow quickly and usually need treatment soon after diagnosis. Chronic leukemias grow more slowly and may not need treatment right away.
- Lymphocytic or myeloid. Lymphocytic leukemias start in lymphocytes, a type of white blood cell. Myeloid leukemias start in other blood forming cells in the bone marrow.
Together these give the four main types:
- Acute lymphocytic leukemia (ALL). A fast growing leukemia that is most common in children but also occurs in adults.
- Acute myeloid leukemia (AML). A fast growing leukemia that affects immature blood cells.
- Chronic lymphocytic leukemia (CLL). A slower growing leukemia that mostly occurs in adults.
- Chronic myeloid leukemia (CML). A slower growing leukemia that mostly occurs in adults.
There are other, less common types as well. Ask your care team which type applies to you. Read more about leukemia from the American Cancer Society.
Symptoms of Leukemia
Symptoms vary depending on the type of leukemia. Acute leukemia symptoms often come on suddenly, while chronic leukemia symptoms often appear gradually. Common symptoms include:
- Fever or chills
- Ongoing tiredness or weakness
- Frequent or serious infections
- Loss of appetite or unexplained weight loss
- Swollen lymph nodes, or an enlarged liver or spleen
- Easy bleeding or bruising, or repeated nosebleeds
- Small red spots on the skin
- Heavy sweating, especially at night
- Bone pain or tenderness
Leukemia Risk Factors
Leukemia occurs most often in adults over 55. Many types of leukemia share these risk factors:
- Earlier cancer treatment with certain types of chemotherapy or radiation
- Certain genetic disorders, such as Down syndrome
- Exposure to chemicals such as benzene
- Cigarette smoking, which raises the risk of acute myeloid leukemia
- A family history of leukemia
How Leukemia Is Diagnosed
Chronic leukemia is sometimes found on a routine blood test before symptoms begin. In other cases, testing follows symptoms or signs that suggest leukemia. Diagnosis may include:
- Physical exam. Your physician checks for signs such as pale skin, swollen lymph nodes, and an enlarged liver or spleen.
- Blood tests. A blood sample shows whether your red cells, white cells, or platelets are at abnormal levels.
- Bone marrow test. A sample of bone marrow is removed with a long, thin needle, usually from the hip bone, and checked in a lab for leukemia cells.
Specialized testing of the leukemia cells can reveal features that help guide treatment. The American Cancer Society notes that these tests may look for gene or chromosome changes and identify the exact type of leukemia.
Leukemia Treatment Options
Treatment depends on the type of leukemia. Northside’s Leukemia Program offers both standard treatments and clinical research trials, including:
- Chemotherapy. Medicines travel through the bloodstream to kill leukemia cells in the bone marrow and throughout the body. Because most chemotherapy does not reach the brain and spinal cord well, it is sometimes given into the fluid around them.
- Stem cell transplant. Higher doses of chemotherapy, sometimes with radiation, are given to kill cancer cells, followed by a blood or marrow transplant. An allogeneic transplant uses cells from a donor whose tissue type closely matches yours. An autologous transplant uses your own cells.
- Immunotherapy. Your own immune cells are modified to fight cancer more effectively, multiplied, and returned to your body to attack cancer cells.
- Radiation therapy. High energy rays damage or kill leukemia cells in a specific area. It can be used alone or with other treatments.
- Clinical trials. Research is central to Northside’s program, which offers leukemia clinical trials so that patients have access to new treatments.
Learn more about medical oncology and clinical trials at ACC, or visit the Northside Leukemia Program.
Leukemia Care Through Northside
The Leukemia Program at Northside Hospital Cancer Institute diagnoses and treats more than 300 new patients with leukemia and other blood cancers each year. The team includes hematologists and medical oncologists, pathologists who specialize in blood diseases, leukemia nurse coordinators, clinical research nurses, and clinical pharmacists. Each patient’s plan is set after the team reviews the case together at weekly meetings.
For patients who may need a transplant, the program begins looking for a donor early and offers a smooth transition into Northside’s Blood and Marrow Transplant Program. It is the only blood and marrow transplant program in the United States whose survival outcomes for donor transplants have been significantly above the expected rate for 17 reporting cycles in a row, from 2009 to 2025.
See the Northside Blood Cancer Program.
Leukemia Support and Survivorship
Ongoing support is an important part of leukemia care. At Northside, leukemia nurse coordinators guide patients through treatment. They explain the condition, answer questions about diagnosis, treatment, and side effects, help patients and their care team stay in touch, and connect patients with support groups and survivorship programs.
At ACC, our oncology social workers help patients and their families with counseling, community resources, transportation, financial concerns, and more. You can also learn about supportive care at ACC, or see all of Northside’s support and survivorship services.
Common Questions About Leukemia
Is leukemia a blood cancer?
Yes. Leukemia is a cancer of the blood that begins in the bone marrow, where blood cells are made.
What is the difference between acute and chronic leukemia?
According to the American Cancer Society, acute leukemias grow quickly and usually need treatment soon after diagnosis. Chronic leukemias grow more slowly and may not need treatment right away.
Can leukemia be found before it causes symptoms?
Sometimes. Chronic leukemia is sometimes found on a routine blood test before any symptoms appear.
Who is most likely to get leukemia?
Leukemia occurs most often in adults over 55. Risk factors include earlier treatment with certain chemotherapy or radiation, certain genetic disorders, exposure to chemicals such as benzene, cigarette smoking, and a family history of leukemia.
