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Leukemia is a malignant disorder of blood-forming cells, usually originating in the bone marrow. Abnormal leukemic cells interfere with production of normal red cells, white cells and platelets. Patients may develop persistent fatigue, weakness or breathlessness because of anaemia. Frequent or prolonged infections can occur when normal white-cell production is impaired. Reduced platelet levels may cause easy bruising, nosebleeds, gum bleeding or prolonged bleeding. Fever, night sweats, unexplained weight loss, bone or joint discomfort and enlarged lymph nodes may also occur.
However, these symptoms are not specific to leukemia and may have several other causes. Leukemia is broadly classified into acute and chronic forms. Acute leukemias can progress rapidly and require prompt diagnosis and treatment, whereas chronic leukemias may occasionally be detected during routine blood testing. A complete blood count and peripheral blood smear are important initial investigations. If leukemia is suspected, bone marrow examination with flow cytometry, cytogenetic studies and molecular testing may be necessary to establish the precise diagnosis.
Persistent unexplained symptoms should not be ignored, but they should not lead to self-diagnosis either. Medical evaluation is the essential first step. Modern leukemia treatment is increasingly guided by disease biology, molecular abnormalities, patient fitness and treatment response. Accurate classification is therefore fundamental to selecting appropriate therapy and achieving optimal outcomes.
Dr. P. K. Das
Medical Oncologist