Leukemia | Miami Cancer Institute | Baptist Health South Florida
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Young woman with leukemia at Miami Cancer Institute

Leukemia

Leukemia is a cancer of the white blood cells. It starts in the cells that form in the spongy inner parts of bones, called bone marrow. Normally, blood cells are made in an orderly, controlled way. When leukemia develops, the bone marrow produces abnormal cells that do not function properly.

They also impair the ability of the bone marrow to produce red blood cells and platelets, blood cells that help stop bleeding by clotting the blood. Leukemia occurs most often in adults over age 55, and it is the most common cancer in children younger than 15. Doctors characterize leukemia based on the kind of blood cells involved and how quickly the disease develops and gets worse (acute or chronic). Acute leukemia is a fast-growing cancer that usually gets worse quickly. Chronic leukemia is a slow-growing cancer that gradually gets worse over time. The symptoms and treatment for each type of leukemia vary.

There are four main types of leukemia:

  • Acute lymphocytic leukemia (ALL)​ begins when too many stem cells become lymphoblast, B lymphocytes or T lymphocytes, types of white blood cells produced by the bone marrow and organs of the lymph system, also called leukemia cells. The leukemia cells increase quickly and are not able to fight infection. Patients can also develop anemia and problems with bleeding. The disease requires treatment as soon as possible. ALL is more common in children than adults.
  • Acute myeloid leukemia (AML) begins when the bone marrow makes too many abnormal cells, called blasts or myeloblasts, red blood cells or platelets, and is the most common form of acute leukemia in adults. Eventually these blasts fill up the bone marrow, preventing healthy cells from being made. The blasts can also spread to other parts of the body. There are different subtypes of AML based on how different the cancer cells are from the normal cells and how developed the cells are at the time the cancer is identified. AML is also called acute myeloblastic leukemia, acute nonlymphocytic leukemia, acute granulocytic leukemia and acute myelogenous leukemia.
  • Chronic lymphocytic leukemia (CLL) begins when too many lymphocytes, a type of white blood cells, build up in the bone marrow. It develops slowly and is more common in older adults.
  • Chronic myeloid leukemia (CML) begins when the bone marrow makes too many cancerous white blood cells, called granulocytes. It develops slowly and is more common in older adults. It is the least diagnosed of all the leukemias.

What causes leukemia?

Researchers have identified several risk factors associated with leukemia. They include:

  • Exposure to high levels of radiation
  • Exposure to certain chemicals
  • Inherited syndromes, including Down syndrome, Klinefelter syndrome, Bloom syndrome, ataxia-telangiectasia and neurofibromatosis.
  • ​Family history

What are the symptoms of leukemia?

Patients may experience the symptoms of leukemia differently depending on the type of disease they have. The most common symptoms are:

  • Increased susceptibility to infections and fevers
  • Weakness or tiredness
  • Chills
  • Pale skin
  • Loss of appetite
  • Weight loss
  • Swollen or tender lymph nodes, liver or spleen
  • Swollen or bleeding gums
  • Bone or joint pain
  • Shortness of breath
  • Bleeding
  • Bruising
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To diagnosis leukemia, your doctor may order a number of tests. These tests will help your medical team get a full understanding of your cancer and develop a treatment plan to target your disease.

The most common tests for leukemia include:

  • Bone marrow aspiration or biopsy, in which the doctor takes a small amount of bone marrow fluid or tissue and examines the abnormal cells
  • Blood tests to measure the size, number and maturity of different blood cells
  • Lymph node biopsy, in which the doctor collects and evaluates tissue or cells from the lymph nodes
  • Imaging studies such as a CT scan, PET scan, MRI, X-ray and ultrasound
  • Spinal tap/lumbar puncture, in which the doctor collects and evaluates cerebral spinal fluid from the spinal canal
  • Immunophenotyping – a laboratory test used to diagnose subtypes of AML based on the type of antigens or markers on the cell surface
  • Cytogenetics – a lab test to look at the chromosomes (strands of DNA) of cells from samples of blood, bone marrow or lymph nodes. If abnormal chromosomes are found, the test can identify the type of leukemia. For example, people with CML have an abnormal chromosome called the Philadelphia chromosome
  • Reverse transcription  a polymerase chain reaction test (RT-PCR) in which the doctor takes a sample of tissue using chemicals to diagnose certain types of AML
  • FISH (fluorescence in situ hybridization) – a lab test used to look for certain changes in the chromosomes

At Miami Cancer Institute, our specialists use the latest research to treat leukemia. We understand that navigating medical care can be overwhelming and are here to help. Our physicians work together to tailor your treatments to your disease and medical needs. We will take time to discuss your choices, the side effects and the expected results.

The treatments may include (alone or in combination):

Many clinical trials are focused on innovative treatments, evaluating whether a new treatment is safe, effective and possibly better than the current standard treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery and new methods of treatment. Discuss with your doctor whether participating in a clinical trial is right for you.

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