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Leukemia

Leukemia is a type of blood cancer that begins in the bone marrow. Bone marrow is the soft tissue in the center of the bones, where blood cells are produced.

The term leukemia means white blood. White blood cells (leukocytes) fight infections and other foreign substances. Leukocytes are made in the bone marrow.

Leukemia leads to an uncontrolled increase in the number of white blood cells.

The cancerous cells prevent healthy red cells, platelets, and mature white cells (leukocytes) from being made. Life-threatening symptoms can then develop as normal blood cells decline.

The cancer cells can spread to the bloodstream and lymph nodes. They can also travel to the brain and spinal cord (the central nervous system) and other parts of the body.

Leukemia can affect children and adults.

Leukemias are divided into two major types:

  • Acute (which progresses quickly)
  • Chronic (which progresses more slowly)

The main types of leukemia are:

References

Appelbaum FR. Acute leukemias in adults. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 95.

Brown JR. Chronic lymphocytic leukemia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 169.

Hunger SP, Teachey DT, Grupp S, Aplenc R. Childhood leukemia. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 93.

Radich J. Chronic myeloid leukemia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 170.

Walter RB, Appelbaum FA. The acute leukemias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 168.

  • Bone marrow aspiration - illustration

    A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.

    Bone marrow aspiration

    illustration

  • Acute lymphocytic leukemia - photomicrograph - illustration

    This picture shows the darkly-stained lymph cells (lymphoblasts) seen in acute lymphocytic leukemia (ALL), the most common type of childhood leukemia.

    Acute lymphocytic leukemia - photomicrograph

    illustration

  • Auer rods - illustration

    Note multiple Auer rods which are found only in acute myeloid leukemias, either myeloblastic or monoblastic. These rods consist of clumps of azurophilic granule material.

    Auer rods

    illustration

  • Chronic lymphocytic leukemia - microscopic view - illustration

    This is a microscopic view of bone marrow from a person with chronic lymphocytic leukemia. It shows predominantly small, mature lymphocytes.

    Chronic lymphocytic leukemia - microscopic view

    illustration

  • Chronic myelocytic leukemia - microscopic view - illustration

    This high-power microscopic view of a blood smear from a person with classical CML shows predominantly normal-appearing cells with intermediate maturity.

    Chronic myelocytic leukemia - microscopic view

    illustration

  • Chronic myelocytic leukemia - illustration

    Oil immersion field demonstrating myeloid cells of all degrees of maturity.

    Chronic myelocytic leukemia

    illustration

  • Chronic myelocytic leukemia - illustration

    Low power view showing marked hypercellularity with a broad-spectrum of myeloid and erythroid cell types and marked myeloid hyperplasia.

    Chronic myelocytic leukemia

    illustration

  • Bone marrow aspiration - illustration

    A small amount of bone marrow is removed during a bone marrow aspiration. The procedure is uncomfortable, but can be tolerated by both children and adults. The marrow can be studied to determine the cause of anemia, the presence of leukemia or other malignancy, or the presence of some storage diseases, in which abnormal metabolic products are stored in certain bone marrow cells.

    Bone marrow aspiration

    illustration

  • Acute lymphocytic leukemia - photomicrograph - illustration

    This picture shows the darkly-stained lymph cells (lymphoblasts) seen in acute lymphocytic leukemia (ALL), the most common type of childhood leukemia.

    Acute lymphocytic leukemia - photomicrograph

    illustration

  • Auer rods - illustration

    Note multiple Auer rods which are found only in acute myeloid leukemias, either myeloblastic or monoblastic. These rods consist of clumps of azurophilic granule material.

    Auer rods

    illustration

  • Chronic lymphocytic leukemia - microscopic view - illustration

    This is a microscopic view of bone marrow from a person with chronic lymphocytic leukemia. It shows predominantly small, mature lymphocytes.

    Chronic lymphocytic leukemia - microscopic view

    illustration

  • Chronic myelocytic leukemia - microscopic view - illustration

    This high-power microscopic view of a blood smear from a person with classical CML shows predominantly normal-appearing cells with intermediate maturity.

    Chronic myelocytic leukemia - microscopic view

    illustration

  • Chronic myelocytic leukemia - illustration

    Oil immersion field demonstrating myeloid cells of all degrees of maturity.

    Chronic myelocytic leukemia

    illustration

  • Chronic myelocytic leukemia - illustration

    Low power view showing marked hypercellularity with a broad-spectrum of myeloid and erythroid cell types and marked myeloid hyperplasia.

    Chronic myelocytic leukemia

    illustration

A Closer Look

 

Tests for Leukemia

 

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Review Date: 3/31/2024

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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