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Home > Cancer Information > Hematologic Malignancies > Leukemia

Leukemia

Leukemia is a cancer of the bone marrow and blood. It is characterized by the uncontrolled growth of blood cells. About 30,000 new cases of leukemia in the United States are reported each year. Most cases occur in older adults, though leukemia is the most common type of childhood cancer. Learn more about childhood leukemia.

On this page:

Types of Leukemia
Symptoms and Diagnosis
Treatment
Clinical Trials
Care Team
Support Groups

Types of Leukemia

Leukemia is either acute or chronic. In acute leukemia, the abnormal blood cells are blasts that remain very immature and cannot carry out their normal functions. The number of blasts increases rapidly, and the disease gets worse quickly. In chronic leukemia, some blast cells are present, but in general, these cells are more mature and can carry out some of their normal functions. Also, the number of blasts increases less rapidly than in acute leukemia. As a result, chronic leukemia gets worse gradually.

Leukemia can arise in either of the two main types of white blood cells—lymphoid cells or myeloid cells. When leukemia affects lymphoid cells, it is called lymphocytic leukemia. When myeloid cells are affected, the disease is called myeloid or myelogenous leukemia.

The four common types of leukemia are:

Acute lymphocytic leukemia (ALL): the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Learn more about childhood ALL.
Acute myeloid leukemia (AML): occurs in both adults and children. This type of leukemia is sometimes called acute nonlymphocytic leukemia (ANLL). Learn more about childhood AML.
Chronic lymphocytic leukemia (CLL): most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children.
Chronic myeloid leukemia (CML): occurs mainly in adults. A very small number of children also develop this disease.

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Symptoms and Diagnosis

Signs of acute leukemia may include:

easy bruising or bleeding (as a result of platelet deficiency)
paleness or easy fatigue (as a result of anemia)
recurrent minor infections or poor healing of minor cuts (as a result of impaired white cell function).

These symptoms and signs are not specific to leukemia and may be caused by other disorders. A proportion of people with chronic leukemia may not have major symptoms. The diagnosis of leukemia requires specific blood tests. A hematologist, oncologist, or pathologist examines a sample of bone marrow under a microscope. The doctor withdraws the sample by inserting a needle into a large bone (usually the hip) and removing a small amount of liquid bone marrow. This procedure is called bone marrow aspiration. A bone marrow biopsy is performed with a larger needle and removes a small piece of bone and bone marrow. Additional biochemical, immunologic and genetic tests on the bone marrow cells are often performed to insure a precise diagnosis of which type of leukemia is present.

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Treatment

The aim of treatment for acute leukemia is to bring about a complete remission and then add further treatment to prevent recurrence of the leukemia with possible cure. Complete remission means that there is no evidence of the disease. Relapse indicates a return of the leukemia cells and return of other signs and symptoms of the disease. For acute leukemia, a complete remission that lasts five years after treatment may indicate that the leukemia is cured. Chronic leukemias may require modest therapy or no treatment for long intervals. Usually, treatment results in control rather than cure.

The main treatment method for leukemia is chemotherapy, although some other methods such as radiation, bone marrow transplantation and immunotherapy may be used. Treatment for leukemia is complex. It varies with the type of leukemia and is not the same for all patients. The doctor plans the treatment to fit each patient's needs. The treatment depends not only on the type of leukemia, but also on certain features of the leukemia cells and whether the leukemia has been treated before. It also depends on the patient's age, symptoms, and general health.

The general treatment guidelines for each type of leukemia are available in the National Cancer Institute's PDQ database:

More information about childhood leukemia is available in the Pediatric Cancers section of this Web site:

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Clinical Trials

Clinical trials are studies that evaluate the effectiveness of new interventions for patients. There are different types of cancer clinical trials, such as prevention trials, early detection trials, and treatment trials. If you take part in a clinical trial, you may benefit from a new drug, procedure, or symptom-control method while helping scientists evaluate its effectiveness.

The hematologic malignancies multidisciplinary program is actively engaged in both national and regional clinical trials for hematologic malignant tumors.

If you have questions about clinical trials, contact Hematologic Malignancies Program Coordinator Jane Gau, R.N., gauxx003@umn.edu, 612-625-9125.

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Care Team

The links below go to physician profiles on the University of Minnesota Physicians Web site. To return to this site, either bookmark this page or use your browser's back button.