Leukemia: Exploring Risks, Causes and Treatment

Sandy D. Kotiah, M.D., is a board certified medical oncologist, Director of The Neuroendocrine Tumor Center at Mercy, and a member of Medical Oncology and Hematology at Mercy. Dr. Kotiah recently addressed questions on leukemia's causes, risks and treatment.

What is leukemia and are there symptoms?

Leukemia is a type of blood cancer which begins in the blood marrow, where cells are produced. Symptoms may include fatigue, bleeding, bone pain, increased infections, night sweats, weight loss, or shortness of breath.

What are the most common types of leukemia?

There is acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML) and chronic myelomonocytic leukemia (CMML). The most common type is CLL and CML (more information is available at the Leukemia and Lymphoma Society website or via the American Cancer Society).

What's the difference between acute and chronic leukemia?

Acute leukemia is more deadly and requires chemotherapy right away, and is curable. Chronic leukemia can be monitored and treated if causing problems; it is not usually curable, but it is treatable.

How is leukemia diagnosed?

Specialized testing of the blood is required to confirm suspicions initially--flow cytometry or bcr-abl testing*. A bone marrow biopsy may follow to gain additional information in the patient's case.

Who is typically at risk for leukemia?

Patients who are older and have experienced physical exposures to certain chemicals, such as benzene, UV light, etc.

What are the treatment options for leukemia? Prognosis?

Treatment options depend upon the type of leukemia in question. Usually chemotherapy, targeted drugs, and possibly transplant for acute leukemia. For chronic leukemia, then observation, chemotherapy and targeted therapy as well as biologic therapy are all options. Regarding prognosis, this depends on chromosome/genetic testing of the cancer cells in general.

* Flow cytometry is a technique used to detect and measure physical and chemical characteristics of a population of cells or particle. A BCR-ABL genetic test looks for a genetic mutation (change) on a specific chromosome.

Dr. Sandy Kotiah works with patients to diagnose, evaluate and treat a variety of cancers and blood diseases including neuroendocrine tumors, blood cancers (such as multiple myeloma), breast cancer, colon and rectal cancer, lung cancer and lymphoma. In particular, Dr. Kotiah has specialized training and certification in performing bone marrow biopsies and administering intrathecal chemotherapy.