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Leukemia

 

Leukemia is a type of blood cancer that begins in the bone marrow. Bone marrow is the soft tissue in the center of the bones, where blood cells are produced.

The term leukemia means white blood. White blood cells (leukocytes) are used by the body to fight infections and other foreign substances. Leukocytes are made in the bone marrow.

Leukemia leads to an uncontrolled increase in the number of white blood cells.

The cancerous cells prevent healthy red cells, platelets, and mature white cells (leukocytes) from being made. Life-threatening symptoms can then develop as normal blood cells decline.

The cancer cells can spread to the bloodstream and lymph nodes. They can also travel to the brain and spinal cord (the central nervous system) and other parts of the body.

Leukemia can affect children and adults.

Leukemias are divided into 2 major types:

  • Acute (which progresses quickly)
  • Chronic (which progresses more slowly)

The main types of leukemia are:

  • Acute lymphocytic leukemia (ALL)
  • Acute myelogenous leukemia (AML)
  • Chronic lymphocytic leukemia (CLL)
  • Chronic myelogenous leukemia (CML)
  • Hairy cell leukemia

 

References

Appelbaum FR. Acute leukemia in adults. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 98.

Campana D, Pui CH. Childhood leukemia. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 96.

 
  • Bone marrow aspiration - illustration

    A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.

    Bone marrow aspiration

    illustration

  • Acute lymphocytic leukemia - photomicrograph - illustration

    This picture shows the darkly-stained lymph cells (lymphoblasts) seen in acute lymphocytic leukemia (ALL), the most common type of childhood leukemia.

    Acute lymphocytic leukemia - photomicrograph

    illustration

  • Auer rods - illustration

    Note multiple Auer rods which are found only in acute myeloid leukemias, either myeloblastic or monoblastic. These rods consist of clumps of azurophilic granule material.

    Auer rods

    illustration

  • Chronic lymphocytic leukemia - microscopic view - illustration

    This is a microscopic view of bone marrow from a person with chronic lymphocytic leukemia; it shows predominantly small, mature lymphocytes.

    Chronic lymphocytic leukemia - microscopic view

    illustration

  • Chronic myelocytic leukemia - microscopic view - illustration

    This high-power microscopic view of a blood smear from a person with classical CML shows predominantly normal-appearing cells with intermediate maturity.

    Chronic myelocytic leukemia - microscopic view

    illustration

  • Chronic myelocytic leukemia - illustration

    Oil immersion field demonstrating myeloid cells of all degrees of maturity.

    Chronic myelocytic leukemia

    illustration

  • Chronic myelocytic leukemia - illustration

    Low power view showing marked hypercellularity with a broad-spectrum of myeloid and erythroid cell types and marked myeloid hyperplasia.

    Chronic myelocytic leukemia

    illustration

  • Cryoglobulinemia - of the fingers - illustration

    Cryoglobulinemia is caused by an abnormal protein that is occasionally found in the blood of people with multiple myeloma, leukemia, and certain forms of pneumonia. It causes blood to gel at low temperatures. In this picture, cryoglobulinemia has reduced blood flow in the fingers so much the fingers have turned dark; the black areas are gangrene resulting from lack of blood flow.

    Cryoglobulinemia - of the fingers

    illustration

  • Antibodies - illustration

    Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

    Antibodies

    illustration

    • Bone marrow aspiration - illustration

      A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.

      Bone marrow aspiration

      illustration

    • Acute lymphocytic leukemia - photomicrograph - illustration

      This picture shows the darkly-stained lymph cells (lymphoblasts) seen in acute lymphocytic leukemia (ALL), the most common type of childhood leukemia.

      Acute lymphocytic leukemia - photomicrograph

      illustration

    • Auer rods - illustration

      Note multiple Auer rods which are found only in acute myeloid leukemias, either myeloblastic or monoblastic. These rods consist of clumps of azurophilic granule material.

      Auer rods

      illustration

    • Chronic lymphocytic leukemia - microscopic view - illustration

      This is a microscopic view of bone marrow from a person with chronic lymphocytic leukemia; it shows predominantly small, mature lymphocytes.

      Chronic lymphocytic leukemia - microscopic view

      illustration

    • Chronic myelocytic leukemia - microscopic view - illustration

      This high-power microscopic view of a blood smear from a person with classical CML shows predominantly normal-appearing cells with intermediate maturity.

      Chronic myelocytic leukemia - microscopic view

      illustration

    • Chronic myelocytic leukemia - illustration

      Oil immersion field demonstrating myeloid cells of all degrees of maturity.

      Chronic myelocytic leukemia

      illustration

    • Chronic myelocytic leukemia - illustration

      Low power view showing marked hypercellularity with a broad-spectrum of myeloid and erythroid cell types and marked myeloid hyperplasia.

      Chronic myelocytic leukemia

      illustration

    • Cryoglobulinemia - of the fingers - illustration

      Cryoglobulinemia is caused by an abnormal protein that is occasionally found in the blood of people with multiple myeloma, leukemia, and certain forms of pneumonia. It causes blood to gel at low temperatures. In this picture, cryoglobulinemia has reduced blood flow in the fingers so much the fingers have turned dark; the black areas are gangrene resulting from lack of blood flow.

      Cryoglobulinemia - of the fingers

      illustration

    • Antibodies - illustration

      Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

      Antibodies

      illustration

    A Closer Look

     

    Talking to your MD

     

      Tests for Leukemia

       

       

      Review Date: 2/12/2016

      Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

       
       
       

       

       

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