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Leukemias and Multiple Myeloma
Leukemias and multiple myelomas are hematologic cancers, meaning cancers of the blood or blood-forming tissues, such as bone marrow. These cancers develop as a result of genetic errors in immature blood cells, known as stem cells. The stem cells reproduce themselves over and over again, leading to an overabundance of abnormal blood cells that never mature, continue to multiply uncontrollably and enter the bloodstream.
Within the past decade, physicians have made enormous progress in the treatment of hematologic cancers with new drugs, resulting in saved and prolonged lives and significantly improved quality of life for patients.
Leukemias are marked by an abnormal proliferation of blood cells, usually leukocytes (white blood cells that fight infection). White blood cells usually grow and develop in an orderly manner in bone marrow. However, in leukemia patients, bone marrow produces large numbers of leukocytes that do not function properly.
There are acute and chronic forms of leukemia. Patients with acute leukemia have a rapid increase of immature white blood cells that prevent bone marrow from producing normal blood cells. Acute leukemia must be treated immediately because these rapidly accumulating cancer cells are quickly life-threatening.
Chronic leukemia is characterized by an excessive accumulation of abnormal leukocytes that are relatively mature, resulting in a high number of abnormal white blood cells in the blood. Chronic leukemia may take months or years to progress, and in chronic lymphoid leukemia your doctor may monitor your condition for some time before treating the disease.
Leukemias are further subdivided into the types of blood cells affected, including lymphoblastic (or lymphocytic) cells and myeloid (or myelogenous) cells. These are some of the main subtypes of lymphomas:
Acute lymphoblastic (or lymphocytic) leukemia (ALL) is a cancer arising in bone marrow. In people with ALL, abnormal stem cells develop into lymphoblasts or lymphocytes that are not able to fight infection well. As these cells increase in numbers in bone marrow and blood, they may cause anemia, infection and easy bleeding, and they may spread to the brain and spinal cord.
Chronic lymphocytic leukemia develops when the abnormal lymphocytes in bone marrow and lymph nodes multiply and replace normal lymphocytes over time. This type of leukemia develops slowly, and patients may have no symptoms in the early stages and little change in their health for many years. In time, such symptoms as fatigue, shortness of breath, swollen lymph nodes or spleen and repeated infections may occur.
Chronic myeloid leukemia is a slowly developing cancer of white blood cells characterized by uncontrolled growth of myeloid cells in bone marrow and the accumulation of these cells in blood. This disease may take years to progress, and most people are diagnosed during the first phase, which can last for months or years. As the number of myeloid cells gradually increases in blood, such symptoms as bleeding and bruising, unexplained weight loss, fever, fatigue, shortness of breath, pain in bones and excessive night sweats may develop.
Acute myeloid leukemia also arises in bone marrow, where abnormal stem cells develop into abnormal myoblasts (immature white blood cells) and sometimes into abnormal red blood cells or platelets (small blood cells). When they build up in bone marrow and blood, they cause the same symptoms as ALL and may also spread to the brain and spinal cord.
Hairy cell leukemia is a type of cancer in which abnormal lymphocytes are present in bone marrow, blood and the spleen. When these cells are looked at under a microscope, they appear to be covered with tiny hairs.
Multiple myeloma is cancer that arises in plasma cells (white blood cells that produce antibodies to fight bacteria and viruses). Plasma cells are also known as myeloma cells. Multiple myeloma and other plasma-cell cancers develop when abnormal plasma cells are overproduced in bone marrow, preventing bone marrow from producing enough healthy blood cells. In patients with multiple myeloma, the abnormal plasma cells form tumors in many bones of the body.
Multiple myeloma may not cause any symptoms at all, but the symptoms that can develop include bone pain (especially in the back or ribs), bones that break easily, fever, frequent infections, easy bruising or bleeding, difficulty breathing, weakness of the arms or legs and feeling very tired.
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