What Factors Increase Risk For Developing Leukemia
At this time, the causes of leukemia are not well understood. However, scientists agree that certain factors increase a person’s risk of developing this disease. These risk factors include:
- Genetics. People with Down syndrome and certain other genetic conditions get leukemia more frequently.
- Ionizing radiation. Exposure to high doses of ionizing radiation has been associated with the development of all types of leukemia except CLL.
- Medications. People treated with certain types of anti-cancer drugs are at greater risk for getting leukemia.
- Workplace exposures. Long-term exposure to chemicals such as benzene and ethylene oxide has been shown to increase risk for getting leukemia.
- Smoking. Researchers believe that up to 20% of acute myeloid leukemias may be caused by smoking.
- Blood disorders. People with certain disorders of blood cell formation, including polycythemia vera, essential thrombocytopenia and chronic myeloid leukemia are at higher risk of developing acute myeloid leukemia .
- Viruses. Certain unusual forms of leukemia are caused by a rare virus.
What Does A Complete Blood Count Measure
A CBC measures the amount of 3 types of cells in your blood:
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White blood cell count. A white blood cell count, also called a leukocyte count, measures the total number of white blood cells in a sample of blood. These cells protect the body from infection by attacking invading bacteria, viruses, and other foreign materials in the body. Some white blood cells can also attack cancer cells.
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White blood cell differential. A white blood cell differential measures the number of each type of white blood cell.There are 5 major types of white blood cells, andeach type plays a different role in protecting the body. Your doctor can learn valuable information about your health by measuring the levels of these cells:
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Red blood cell count. Red blood cells carry oxygen throughout your body. A red blood cell count, also called an erythrocyte count, measures the number of red blood cells in a sample of blood. There are several ways to measure red blood cells. Two of the most common are:
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Hematocrit , the percentage of your blood that is made up of red blood cells
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Hemoglobin , the amount of the protein in red blood cells that carries oxygen
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Platelet count. A platelet count measures the number of platelets in a sample of blood. Platelets help to stop bleeding by forming blood clots.
Prognostic Value Of Flt3
It has been shown that the amount of FLT3 signaling is associated with WBC count.1719 Patients who have lost both FLT3 alleles have higher WBC counts than patients with both wild-type FLT3 and FLT3 -ITD alleles.1719 We, therefore, wondered whether the gene dosage of wild-type FLT3 was different in patients with the genotypic combination NPMc+ with FLT3-ITD depending on whether they had a high or low WBC count. To address this question, we investigated the impact of the FLT3-ITD/FLT3 ratio on clinical outcomes within this particular subgroup of patients. The FLT3-ITD/FLT3 ratio was known for all 75 patients and was categorized as less than 1, 1, or more than 1. Interestingly, the FLT3-ITD/FLT3 ratio was significantly associated with event-free survival and overall survival within this subgroup of patients . In detail, patients with an FLT3-ITD/FLT3 ratio greater than 1 had a significantly shorter event-free survival as well as a significantly shorter overall survival . Thus, it appears that particularly patients with the genotypic combination NPMc+ with FLT3-ITD and an FLT3-ITD/FLT3 ratio greater than 1 had a poor outcome.
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Signs And Symptoms Of Chronic Lymphocytic Leukemia
Many people with chronic lymphocytic leukemia do not have any symptoms when it is diagnosed. The leukemia is often found when their doctor orders blood tests for some unrelated health problem or during a routine check-up and they are found to have a high number of lymphocytes.
Even when people with CLL have symptoms, they’re often vague and can be symptoms of other things. Symptoms can include the following:
- Swollen lymph nodes
- Pain or a sense of “fullness” in the belly , which is caused by an enlarged spleen and/or liver
Many of the signs and symptoms of advanced CLL occur because the leukemia cells replace the bone marrow’s normal blood-making cells. As a result, people don’t have enough red blood cells, properly functioning white blood cells, and blood platelets.
- Anemia is a shortage of red blood cells. It can cause tiredness, weakness, and shortness of breath.
- A shortage of normal white blood cells increases the risk of infections. You might hear the term neutropenia, which refers to low levels of neutrophils . People with CLL may have very high white blood cell counts because of excess numbers of lymphocytes , but the leukemia cells don’t fight infection the way normal white blood cells do.
- A shortage of blood platelets can lead to excess bruising, bleeding, frequent or severe nosebleeds, and bleeding gums.
Other Conditions That May Cause Low Wbc Counts
Having a low or high WBC is not always an indication of leukemia. Five percent of people will experience a high or low WBC in their lifetime. In fact, several noncancerous conditions can lead to an abnormal WBC count. For example, autoimmune diseases like rheumatoid arthritis , which can cause high WBCs, and excessive alcohol use can lead to a low WBC count. Certain racial and ethnic groups may naturally have a lower number of circulating WBCs.
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How Does Leukemia Affect Blood Counts
Leukemia mainly affects white blood cells called lymphocytes. These immune cells help your body fight off infections.
When someone has leukemia, their body makes larger, abnormal cells called leukemic cells instead of lymphocytes and other necessary cells like red blood cells and platelets . This is why leukemia can cause symptoms like fatigue or excessive bleeding and bruising.
A healthcare professional may order a complete blood count test as a part of your routine medical check-up. This is because blood counts can tell a lot about your health. For example, too many white blood cells and too few red blood cells or platelet cells may mean that you have leukemia or that your leukemia is not well-controlled.
How Is Leukemia Diagnosed
Leukemia staging is generally determined by blood cell counts and the accumulation of leukemia cells within organs. When diagnosing leukemia, the test most commonly performed is a complete blood count , which measures:
- White blood cell count
- Hemoglobin concentration
- Hematocrit concentration
If the results of a patients CBC are abnormal, additional testing will likely need to be performed. This might include:
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Leukemia White Blood Cell Count Ranges In Children
The Leukemia & Lymphoma Society says that children under 4 years old may have a higher percentage of lymphocytes in their blood than older children and adults. According to the University of Rochester Medical Center, the normal ranges of white blood cells per microliter of blood are:
- 9,000 to 30,000 for newborns
- 6,200 to 17,000 for children under 2
- 5,000 to 10,000 for children over 2
Leukemia is the most common cancer in children and teens, according to the of ALL occurs in children. Diagnosis includes the presence of 20 percent or more lymphoblasts, or immature lymphocytes, in the blood or bone marrow.
How Does Cml Affect Other Blood Cells
The Leukemia & Lymphoma Society notes that the increase in the number of immature WBCs prevents the bone marrow from making healthy red blood cells and platelets.
Therefore, in addition to increasing the WBC count, CML may cause a decrease in the RBC count. Depending on the phase of CML, the number of platelets may be higher or lower than normal.
The changes to other types of cells in the body may lead to additional symptoms in people with CML. For instance, if the RBC count becomes too low, a person may experience symptoms such as:
diagnostic tests for CML include:
Imaging tests, such as a CT scan or ultrasound, do not diagnose CML. However, these types of tests are helpful in identifying enlarged lymph nodes or an enlarged spleen, which may occur with CML.
After diagnosing CML, doctors may recommend that the person periodically undergo tests, such as a bone marrow exam, qPCR, and FISH. The reason for this is that these tests may help monitor how well someone responds to treatment.
Many other conditions can cause a high WBC count. Typically, WBC counts that are very high indicate a more serious condition or cause than levels that are just outside the normal range.
Possible causes of a high WBC count
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Acute Leukemia: The Most Rapidly Progressing Cancer We Know Of
Acute leukemias which are incredibly rare are the most rapidly progressing cancer we know of. The white cells in the blood grow very quickly, over a matter of days to weeks. Sometimes a patient with acute leukemia has no symptoms or has normal blood work even a few weeks or months before the diagnosis. The change can be quite dramatic.
Extreme fatigue is usually the first symptom that causes acute leukemia patients to seek medical care. Theyre tired for no apparent reason. They cant move and theyre not able to walk, and it comes on fairly quickly. When we check their blood count, their red blood cell count might be half of whats normal. Thats why theyre exhausted because theyre not getting enough oxygen.
Its also common for these patients to develop pneumonia or some sort of infection. They dont get better after taking antibiotics, so they take more and more, but they still dont get better. Then finally someone checks their blood count and discovers that theyre not responding because their immune system is very low because of the acute leukemia.
Early Detection And Treatment Can Improve Outlook
As with many types of cancer, early detection and treatment can help to improve outlook. Because of this, be sure to see your doctor if youre experiencing symptoms consistent with eosinophilic leukemia.
While your symptoms may not be due to eosinophilic leukemia, they could be caused by another condition that needs attention. If youre diagnosed with eosinophilic leukemia, your doctor will work to develop a treatment plan tailored to your condition.
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Symptoms Caused By High Numbers Of Leukemia Cells
The cancer cells in AML are bigger than normal white blood cells and have more trouble going through tiny blood vessels. If the blast count gets very high, these cells can clog up blood vessels and make it hard for normal red blood cells to get to tissues. This is called leukostasis. Leukostasis is rare, but it is a medical emergency that needs to be treated right away. Some of the symptoms are like those seen with a stroke, and include:
- Weakness in one side of the body
When blood vessels in the lungs are affected, people can have shortness of breath. Blood vessels in the eye can be affected as well, leading to blurry vision or even loss of vision.
Impact Of White Blood Cell Count On Complete Remission Rate Event
When considering all 525 patients, hyperleukocytosis was significantly associated with a lower complete remission rate , shorter event-free survival and shorter overall survival . Furthermore, within the subgroup of patients with cytogenetically intermediate-risk AML, hyperleukocytosis was significantly associated with a lower complete remission rate , shorter event-free survival and shorter overall survival . As expected, in the subgroup of patients with favorable cytogenetic risk, a WBC count below 20×109/L appeared to be significantly associated with a higher complete remission rate , improved event-free survival and improved overall survival . Finally, in the subgroup of patients with cytogenetically unfavorable risk AML, WBC count did not affect the complete remission rate , event-free survival or overall survival .
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If Additional Treatments Are Needed
Leukemia blood cell counts also help to show whether you need additional treatments. For example:
- If you have low red cell counts, you may have anemia, which causes low energy levels. Your doctor may recommend treatment for anemia, such as iron supplements or a blood transfusion.
- If you have low white cell counts and a fever, you may have an infection and need to take antibiotics.
- If your platelet counts are too low, you may have an increased chance of life-threatening bleeding. Your doctor may recommend platelet or blood infusions to lower this risk.
How Does Leukemia Develop
Leukemia begins in bone marrow, the soft spongy tissue in the inner cavity of your bones, where your bodys blood cells are made. Blood cells go through multiple stages before reaching their fully mature forms. Mature, normal blood cells include:
- Red blood cells: Cells that carry oxygen and other vital materials to all tissues and organs in your body.
- White blood cells: Cells that fight infection.
- Platelets: Cells that help your blood clot.
These blood cells start as hematopoietic stem cells. The stem cells develop into either myeloid cells or lymphoid cells. If blood cells were to continue to develop normally, the mature forms of these cells are as follows:
- Myeloid cells develop into red blood cells, platelets and certain types of white blood cells .
- Lymphoid cells develop into certain white blood cells .
However, if you have leukemia, one of the developing blood cells begins to multiply out of control. These abnormal cells called leukemia cells begin to take over the space inside of your bone marrow. They crowd out the cells trying to develop into healthy red blood cells, white blood cells and platelets.
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Prognostic Value Of White Blood Cell Count In The Context Of Additional Known Risk Factors For The Whole Group Of Patients With Acute Myeloid Leukemia
The impact of hyperleukocytosis on event-free and overall survival in all 525 patients with AML was confirmed in univariate analysis. Age at diagnosis, NPMc+, FLT3-ITD, mutated CEBPA and cytogenetic risk group also correlated with event-free and overall survival . When we subsequently considered these variables in a multivariable analysis, hyperleukocytosis maintained its independent prognostic value for both event-free survival and overall survival .
How Is Leukemia Treated
Treatments for leukemia depend on the type of leukemia you have, your age and overall health, and if the leukemia has spread to other organs or tissues.
Common treatments often include a combination of the following:
Clinical trials are also available to test new cancer treatments. Weigh the potential benefits and risks of enrolling in a clinical trial with your healthcare provider.
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How Blood Cancers Affect Blood Counts
Blood cancers can affect blood cell counts in a number of ways, either lowering or increasing measurements. If you’re currently receiving cancer treatment such as chemotherapy, drug therapy or radiation, your blood counts will be affected. Blood counts usually return to normal after treatment is complete.
Anxiety About Blood Test Results
Blood tests make many people with leukemia nervous. Results may show how well treatment is working or whether side effects from treatments are becoming more severe. Waiting is the WORST, one MyLeukemiaTeam member said.
Members have come up with a variety of ways to make the process easier. One member made sure they kept a copy of any results from their tests. I make sure I have copy of my blood work before I leave the doctor’s office. I keep files on all tests and results from any doctors I see.
Another MyLeukemiaTeam member advised others to make sure they ask about any blood test results they do not understand. If you are ever concerned about your numbers, you should discuss them with the doctor and ask him or her to explain it better to you.
When you join MyLeukemiaTeam, you gain a community of more than 7,000 people living with or caring for someone with leukemia. Blood count tests and results are a frequent topic of conversation.
Do you get anxious when waiting for blood count results? Do you have any tips for dealing with stress around blood tests? Comment below or start a conversation on MyLeukemiaTeam.
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Managing Your Mental Health Is Equally Important
In addition to the treatments discussed above, taking care of your mental health is also important after a diagnosis of eosinophilic leukemia. This can include things like:
- seeing a mental health professional that specializes in helping people with cancer
- joining a cancer support group
- trying out activities that can help to reduce feelings of stress or anxiety, such as yoga or meditation
The outlook for eosinophilic leukemia can depend on several factors. These include:
- the type of eosinophilic leukemia that you have
- the severity of your symptoms
- whether or not organ damage is present
- your age and overall health
Often, morbidity and mortality due to eosinophilic leukemia occurs due to organ damage that can happen because of high eosinophil levels. A couple examples of complications that can occur due to organ damage include heart failure and blood clots.
Additionally, CEL-NOS can sometimes progress into acute myelogenous leukemia . This type of leukemia can progress quickly without treatment.
Normal White Blood Cell Counts
The normal range of white blood cells found in every microliter of blood differs for adults and children. According to the Leukemia & Lymphoma Society, normal blood cell count falls within the following ranges:
- 5,000 to 10,000 WBCs per microliter of blood for men
- 4,500 to 11,000 WBCs per microliter of blood for women
- 5,000 to 10,000 WBCs per microliter of blood for children
Different types of WBCs are counted by a measure called white blood cell differential. The differential is the ratio of the various WBC types. In a normal blood count, the WBC differential comprises numbers within the following ranges:
- 55 percent to 70 percent neutrophils
- 20 percent to 40 percent lymphocytes
- 2 percent to 8 percent monocytes
Basophils and eosinophils comprise the rest of the blood.
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