Leukemia

Leukemia is cancer of the blood cells. Usually, it starts in the bone marrow, the soft tissue inside most bones. Bone marrow is where blood cells are made.

The University of Vermont Cancer Center offers knowledgeable and respectful staff that take a comprehensive approach to care for leukemia.

Leukemia Care at UVM Medical Center

At the UVM Cancer Center, we deliver clinical excellence and specialized treatment that is centered around you and your family's needs.

• Comprehensive team approach - We know that a leukemia diagnosis impacts every facet of your life. Our team includes:
  • Board-certified Medical Oncologists and Hematologists
  • Physician's assistant
  • Patient Navigator
  • Dietician
  • Social worker
  • Clinical fellows
  • Registered nurses
  • Nurse practitioners
  • Pharmacists
  • Psychologists
  • Clinical research coordinators
  • Support staff
• Specialized expertise - Our physicians are board-certified medical oncologists and hematologists. They also have additional specialty training in adult and pediatric oncology. You can be confident in the care you receive at the UVM Cancer Center.
• Personalized care - We are committed to providing the best possible experience to our patients who have been diagnosed with cancer. Our Cancer Patient Support Program provides services like massage, yoga, and support groups to both patients and family members.

Leukemia: An Overview

Usually, leukemia starts in the white blood cells. Your white blood cells help your body fight infection. They normally grow and divide in an orderly way, as your body needs them. But in people with leukemia, the bone marrow makes abnormal white blood cells (called leukemia cells) that don't do the work of normal white blood cells. Leukemia cells grow faster than normal cells, and they don't stop growing when they should.

Many types of leukemia exist, but the four main types of leukemia include:

• Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in young children but also can happen in adults.
• Acute myelogenous leukemia (AML) is a common type of leukemia. It occurs in children and adults but is the most common type of acute leukemia in adults.
• Chronic lymphocytic leukemia (CLL) is the most common chronic adult leukemia. Sometimes CLL patients feel well for years without needing treatment.
• Chronic myelogenous leukemia (CML) mainly affects adults. A CML patient may have few or no symptoms for months or years before entering a time period in which the leukemia cells grow quickly.

There are less common types of leukemia, such as hairy cell leukemia. Additionally, there are subtypes of leukemia, such as acute promyelocytic leukemia (a subtype of AML).

Leukemia symptoms vary with the type of leukemia. Common leukemia symptoms include:

• Fever or chills
• Weakness and fatigue
• Frequent infections
• Weight loss without trying
• Swollen lymph nodes
• An enlarged liver or spleen
• Easy bleeding or bruising
• Very small red spots in your skin (called petechiae)
• Night sweats
• Bone or joint pain

Researchers don't know the exact causes of leukemia yet. It seems to develop from a combination of genetic and environmental factors. Several factors may increase your risk of developing some types of leukemia, including:

• Smoking or using other tobacco products - The UVM Medical Center offers a quit smoking program.
• Previous cancer treatments - Chemotherapy and radiation
• Genetic disorders - Certain genetic abnormalities such as Down syndrome
• Radiation exposure - Previous exposure to large doses of radiation, such as surviving a nuclear reactor accident, increases the risk of future leukemia.
• Chemical exposure - Previous exposure to certain chemicals such as benzene, found in gasoline and used in the chemical industry, or formaldehyde.
• Other blood diseases - Sometimes myelodysplastic syndrome is called preleukemia.
• Family history - In some cases, chronic lymphocytic leukemia (CLL) runs in families.

Leukemia Diagnosis

Since there are different types of leukemia, you'll need the guidance and expertise of doctors that specialize in leukemia diagnosis.

The University of Vermont Medical Center's specialist physicians may find leukemia cells in a routine blood test before symptoms begin. If this happens, or if you have symptoms that suggest leukemia, you may have other diagnostic tests, including:

• Medical history
• Physical exam
• Blood tests
• Bone marrow biopsy - removes a small amount of bone, fluid, and cells from inside the bone for testing
• Imaging, such as:
  • Chest X-rays - creates an image of the structures inside the chest, including the lymph nodes
  • Computed tomography (CT or CAT) scan - uses a detailed X-ray to create a 3D image of structures inside the body
  • Magnetic resonance imaging (MRI) of the head - uses magnets and radio waves to take an image of the inside of the head
• Biopsy: removing a lymph node or sample of other tissues for analysis in a laboratory
  • Needle biopsy
    • Fine-needle aspiration: the removal of tissue using a thin needle
    • Core biopsy: the removal of tissue using a wide needle
  • Surgical biopsy
    • Excisional biopsy: the removal of an entire lump of tissue
    • Incisional biopsy: the removal of part of a lump or sample of tissue
• Spinal tap (called lumbar puncture) - collects fluid from the lumbar area of the spine to look for leukemia cells

Treatments for Leukemia

Leukemia treatment can be complex, but we offer strategies and resources that can help to make your treatment successful. For example, hematology and oncology care is enhanced by the services provided by the Cancer Patient Support Program and the Victoria Buffum Endowment Fund. Patients and family members can receive psychological and nutrition services, massage, yoga, several support groups and other services through the Cancer Patient Support Program and grants provided by the Buffum Fund.

Leukemia treatments at The University of Vermont Medical Center are based on the type of cancer you have, its size and location, the extent (called stage) of cancer, your overall health and your preferences. Your team of doctors will take all of that into account with the treatments they recommend.

Leukemia treatments at The UVM Medical Center include:

• Chemotherapy - treats cancer by destroying cancer cells using different types of medication.
• Radiation Therapy - uses high-energy beams, such as X-rays and protons, to destroy cancer cells.
• Biological Therapy - uses special medicines that help your immune system recognize and attack cancer cells.