Leukemia is a blood cancer that occurs due to disruption of the production and function of white blood cells in the body. Leukemia begins with changes in the white blood cells produced in the bone marrow, which then develop into abnormal cells that grow uncontrollably.
In its early stages, leukemia often shows no obvious signs or symptoms. Complaints such as feeling tired or easily getting sick are often dismissed as normal problems. However, without realizing it, changes in the blood cells continue to develop and can affect the overall balance of bodily functions.
How Does Leukemia Occur in the Body?
Leukemia results from disorders in the bone marrow, which produces blood cells. Normally, bone marrow produces blood cells consisting of:
- Red blood cells (erythrocytes) function to carry oxygen.
- White blood cells (leukocytes) which function to fight infection.
- Platelets play a role in the blood clotting process.
These blood cells are produced in a balanced and controlled manner according to the body's needs. In leukemia, genetic changes occur in white blood cells, causing them to grow abnormally and uncontrolled. These abnormal cells not only lose their primary function of fighting infection, but also take up space in the bone marrow and inhibit blood cell production.
As a result, the body can experience anemia due to a lack of red blood cells, increased bleeding due to a low platelet count, and increased susceptibility to infection due to disruption of normal white blood cells. This imbalance triggers various symptoms and complications in leukemia patients, including damage to the lymph nodes, spleen, liver, and central nervous system.
Symptoms That Are Often Considered Trivial
Leukemia typically causes mild and vague symptoms at first, often overlooked. Many people assume that leukemia symptoms are simply caused by normal fatigue or a temporary decrease in immunity.
In fact, these symptoms may indicate a problem with the production and function of blood cells in the body. Here are some symptoms to watch out for:
- Prolonged fatigue , even when resting or not doing heavy activity.
- Bruising or bleeding easily , such as from nosebleeds, cuts, or bruises.
- Recurrent infections or fevers that often recur and are difficult to cure.
- Unexplained weight loss , without changes in diet or exercise.
- shortness of breath , especially if the disease has affected other organs
Types of Leukemia and Their Differences
Leukemia types are distinguished by the speed of disease progression and the type of blood cells affected. These two types determine the disease's characteristics, severity, and the required therapy and treatment. Here's an explanation:
1. Types of Leukemia Based on the Speed of Disease Progression
Based on the speed of development, leukemia is divided into:
- Acute leukemia
Acute leukemia progresses very quickly and is aggressive. In this condition, the bone marrow produces large numbers of very young white blood cells ( blasts ). These cells are immature and unable to function properly.
Characteristics of acute leukemia:
- Symptoms appear suddenly and worsen over a short period of time.
- It often causes serious complaints such as severe anemia, severe infections, and sudden bleeding.
- Generally requires intensive chemotherapy quickly after diagnosis.
Common examples of acute leukemia are Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML).
- Chronic leukemia
Chronic leukemia progresses more slowly than acute leukemia. The blood cells produced are more mature than those in acute leukemia. Because it progresses slowly, symptoms may not be noticeable for years.
Characteristics of chronic leukemia:
- Frequent bone or joint pain
- The development of the disease is gradual.
- In some cases, patients may be monitored before starting therapy.
- Discomfort in the stomach due to an enlarged spleen
Examples of chronic leukemia that are often found are Chronic Lymphocytic Leukemia (CLL) and Chronic Myeloid Leukemia (CML).
2. Types of Leukemia Based on Affected Cells
Apart from the speed of development, leukemia can also be differentiated based on the type of blood cells affected, namely:
- Lymphocytic Leukemia
Lymphocytic leukemia occurs when lymphocytes undergo abnormal changes and grow uncontrollably. Lymphocytes, consisting of B cells and T cells, play a vital role in fighting infection. This type of leukemia directly affects the body's ability to defend itself against disease.
Characteristics of lymphocytic leukemia:
- Disrupts the immune system directly.
- It can spread to other parts of the body, such as the lymph nodes, brain, liver, and spleen.
- Often found in children for the type of Acute Lymphoblastic Leukemia (ALL) and the elderly for the type of Chronic Lymphocytic Leukemia (CLL).
- Myeloid Leukemia (Myeloid Leukemia)
Myeloid leukemia attacks myeloid cells, the cells that eventually develop into red blood cells, platelets, and several types of white blood cells. Disorders of myeloid cells can simultaneously impact various bodily functions, from oxygen distribution to blood clotting mechanisms.
Characteristics of myeloid leukemia:
- More often it causes disturbances in the production of red blood cells and platelets.
- Symptoms such as anemia, easy bruising, and bleeding are usually more noticeable.
- It can occur in various age groups, both young and old.
The Importance of Early Detection and Treatment of Leukemia
Early detection is crucial for ensuring a faster diagnosis and determining the most appropriate therapy for the type of leukemia. The earlier detection, the greater the chance of effective treatment. The following are common tests and therapies:
- Routine blood test (Complete Blood Count/CBC) : Measures the levels of red blood cells, white blood cells, and platelets to detect abnormalities in the number or shape of cells.
- Bone marrow test (aspiration & biopsy) : Taking a sample of bone marrow to confirm the presence of cancer cells and determine the stage.
- Chemotherapy : Anticancer drug therapy through infusion or orally to kill or suppress the growth of cancer cells.
- Radiotherapy : Radiation therapy to destroy cancer cells or shrink the affected area.
- Immune therapy (immunotherapy) : Increases the immune system's response to more effectively recognize and attack cancer cells.
When Should You Consult a Doctor?
Recognizing subtle changes in your body is the first step to maintaining long-term health. Seek immediate medical attention if you experience persistent or persistent symptoms, unexplained fatigue, easy bruising, or frequent infections. If you experience these symptoms, consult a subspecialist in medical hemato-oncology.
Through further examinations, such as blood tests or bone marrow evaluations, doctors can help determine the cause of the symptoms and determine appropriate treatment and management. Early detection and treatment can increase the chances of successful therapy and maintain an optimal quality of life.
Article written by Dr. Ryan Ardian Saputra, Sp.PD, Subsp. H.Onk.M (K) (Internal Medicine Specialist - Medical Hemato Oncology Consultant at EMC Alam Sutera & Tangerang Hospital).