Acute leukemia is a blood disorder that occurs due to changes in the bone marrow, which starts to release under-mature white blood cells into the bloodstream, and a large number of immature cells are also identified in the bone marrow.
Acute leukemia is more common in children and young adults and is characterized by the presence of more than 20% of blasts in the blood, which are young blood cells, and by the leukemic hiatus, which corresponds to the absence of intermediate cells between blasts and neutrophils. mature.
The treatment of acute leukemia is carried out through blood transfusions and chemotherapy in a hospital environment until clinical and laboratory signs related to leukemia are no longer detected.
Symptoms of acute leukemia
The main symptoms of acute leukemia are:
- Weakness, tiredness and indisposition;
- Bleeding from the nose and/or purple spots on the skin;
- Increased menstrual flow and tendency to nosebleeds;
- Fever, night sweats and unexplained weight loss;
- Bone pain, cough and headache.
The main characteristic of this type of leukemia is its rapid development, so that symptoms can appear and evolve in a short period of time.
In the presence of these signs and symptoms, it is important that the hematologist is consulted so that tests can be carried out to help confirm the cancer, identify the type and, thus, initiate the most appropriate treatment.
How to confirm the diagnosis
The diagnosis of acute leukemia must be made by a hematologist or onco-hematologist based on the initial assessment of the signs and symptoms presented, and it is also important that tests are carried out to assess the person’s general health, as well as check whether there are any signs of leukemia. .
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Tests for acute leukemia
The main tests that may be indicated if leukemia is suspected are:
- Complete blood countwhich indicates leukocytosis, thrombocytopenia and the presence of several young cells (blasts), whether of the myeloid or lymphoid lineage;
- Biochemical examssuch as dosage of uric acid and LDH, which are normally increased due to the increased presence of blasts in the blood;
- Coagulogramain which the production of fibrinogen, D-dimer and prothrombin time are verified;
- Myelogramin which the characteristics of the bone marrow are verified.
In addition to these tests, the hematologist may request mutation research using molecular techniques, such as NPM1, CEBPA or FLT3-ITD, in order to indicate the best form of treatment.
Read too: 13 blood tests that detect cancer
Causes of acute leukemia
Acute leukemia occurs as a consequence of changes in the bone marrow, which result in the release of immature cells into the bloodstream, which may be of lymphoid or myeloid lineage.
The changes in the bone marrow that result in leukemia are related to genetics, and changes in the FLT-3, NPM1, IDH and PML-RARA genes can be identified, in the case of acute myeloid leukemia, for example.
The genetic cause of acute lymphoblastic leukemia is not yet well understood, however it appears to be related to changes in DNA caused by exposure to radiation, previous chemotherapy treatment or genetic diseases.
Furthermore, mutations related to AML can also be favored by the use of immunosuppressive medications, genetic diseases, exposure to radiation and chemotherapy, for example.
Types of acute leukemia
Acute leukemia can be classified into two main types according to the type of cell that is affected:
- Aguda myeloid leukemia (AML), in which cells of the myeloid lineage, which is the lineage responsible for giving rise to leukocytes, among other blood cells. This type of leukemia can be classified into some subtypes according to the immature cells circulating in the blood and characteristics of the bone marrow;
- Acute lymphoid leukemia (ALL)in which cells of the lymphoid lineage are affected, resulting in the appearance of immature lymphocytes in the bloodstream.
It is important that the type of acute leukemia is identified so that the best treatment can be started immediately, preventing the development of complications and increasing the chances of a cure.
How the treatment is carried out
Treatment for acute leukemia is defined by the hematologist and/or oncologist according to the symptoms, test results, the person’s age, presence of infections, risk of metastasis and recurrence.
The treatment time may vary, with symptoms beginning to decrease after 1 to 2 months after starting polychemotherapy, for example, and treatment may last around 3 years.
Treatment for acute myeloid leukemia can be done through chemotherapy, which is a combination of medications, platelet transfusion and the use of antibiotics to reduce the risk of infections, as the immune system is compromised.
Read too: Chemotherapy: what it is, how it is done, side effects (and care)
Regarding the treatment for acute lymphoblastic leukemia, it can be done through polychemotherapy, which is done with high doses of medication to eliminate the possible risk of the disease reaching the central nervous system.
If the disease recurs, you can opt for a bone marrow transplant as, in this case, not everyone benefits from chemotherapy. Understand when bone marrow transplantation is indicated.
Is acute leukemia curable?
Cure in leukemia refers to the absence of signs and symptoms characteristic of leukemia within 10 years after the end of treatment, without relapses.
In relation to acute myeloid leukemia, cure is possible, due to several treatment options, however, as age advances, cure or control of the disease may be more difficult; The younger the person, the greater the chance of a cure.
In the case of acute lymphoblastic leukemia, the possibility of cure is greater in children, around 90%, and 50% of cure in adults up to 60 years of age, however, to increase the chances of cure and avoid recurrence of the disease, it is important that it is discovered as soon as possible and treatment started immediately afterwards.
Even after starting treatment, the person must undergo periodic tests to check whether or not there is a relapse and, if so, resume treatment immediately so that the chances of complete remission of the disease are greater.
Read too: Cancer remission: what it is and when it is achieved
