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To understand what happens to your blood when you have leukemia, it helps to know what makes up normal blood and bone marrow.
Red Blood Cells (RBCs), the major part of your blood, carry oxygen and carbon dioxide throughout your body. The percentage of RBCs in the blood is called hematocrit. The part of the RBC that carries oxygen is a protein called hemoglobin. All body tissues need oxygen to work properly. When the bone marrow is working normally, the RBC count remains stable. Anemia occurs when there are too few RBCs in the body. Leukemia, or the chemotherapy used to treat it, can cause anemia. Symptoms of anemia include shortness of breath, headache, weakness and fatigue.
White Blood Cells (WBCs) include several different types. Each has its own role in protecting the body from germs. The three major types are neutrophils, monocytes and lymphocytes:
- Neutrophils (also known as granulocytes or polys) destroy most bacteria.
- Monocytes destroy germs such as tuberculosis.
- Lymphocytes are responsible for destroying viruses and for overall management of the immune system. When lymphocytes see foreign material, they increase the body’s resistance to infection.
WBCs play a major role in fighting infection. Infections are more likely to occur when there are too few normal WBCs in the body.
Absolute Neutrophil Count (ANC) is a measure of the number of WBCs you have to fight infections. You can figure out your ANC by multiplying the total number of WBCs by the percentage of neutrophils (“neuts”). The K in the report means thousands. For example:
WBC = 1000 = 1.0K
Neuts = 50% (0.5)
1000 X 0.5 = 500 neutrophils
While anyone can catch a cold or other infections, this is more likely to occur if your ANC falls below 500. Your WBC count generally will fall within the first week you start chemotherapy, but it should be back to normal between 21 and 28 days after starting chemotherapy.
Platelets are the cells that help control bleeding. When you cut yourself, the platelets collect at the site of the injury and form a plug to stop the bleeding.
Bone marrow is the soft tissue within the bones where blood cells are made. All blood cells begin in the bone marrow as stem cells.
The bone marrow is made up of blood cells at different stages of maturity. As each cell fully matures, it is released from the bone marrow to circulate in the bloodstream. The blood circulating outside of the bone marrow in the heart, veins and arteries is called peripheral blood.
Stem cells are very immature cells. When there is a need, the stem cells are signaled to develop into mature RBCs, WBCs or platelets. This signaling is done with “growth factors.”
In leukemia, the normal production of blood cells changes. The bone marrow starts making too many abnormal, immature cells, called blasts or lymphoblasts, which crowd out other blood cells in the blood marrow, blood stream and lymph system. They can travel to other places in the body, including lymph glands and the spleen.
Types of Leukemia
According to the American Cancer Society, some 43,000 people in the United States are diagnosed with leukemia each year. This includes about:
- 15,000 cases of chronic lymphocytic leukemia (CLL), most in older adults
- 13,500 cases of acute myeloid leukemia (AML), most in adults
- 6,000 cases of acute lymphoblastic leukemia (ALL), about one in three in adults
- 5,000 cases of chronic myeloid leukemia (CML), most in older adults
Types of leukemia are grouped by the type of cell affected and by the rate of cell growth. Leukemia can be either acute or chronic.
Acute leukemia involves an overgrowth of very immature blood cells. This condition is life threatening because there are not enough mature blood cells to prevent anemia, infection and bleeding. A diagnosis of acute leukemia is made when there are 20% or more blasts or immature cells in the bone marrow.
There are two main types of acute leukemia:
Acute lymphoblastic leukemia (ALL) is most prevalent during childhood and early adulthood, but it also is found in adults.
Acute myeloid (or myelogenous) leukemia (AML) occurs more often in adults.
Myelodysplastic Syndrome (MDS) is a condition in which the bone marrow does not produce enough normal blood cells. Some cases of MDS may, over time, progress to acute leukemia. Learn more at about myelodysplastic syndrome.
Myeloproliferative Disorder (MPD), also known as myeloproliferative neoplasia (MPN), is a condition in which the bone marrow makes too many blood cells. Sometimes the disease progresses slowly and requires little treatment; other times it develops into acute myeloid leukemia (AML). Learn more abut myeloproliferative disorder.
Chronic leukemia involves an overgrowth of mature blood cells. Usually, people with chronic leukemia have enough mature blood cells to prevent serious bleeding and infection. Chronic leukemia is found more often in people between ages 40 and 70. The main types of chronic leukemia are:
- Chronic lymphocytic leukemia (CLL)
- Chronic myeloid leukemia (or chronic myelogenous leukemia) (CML)
To look for specific types of leukemia, your doctor will examine features on the bone marrow cell surface and the appearance of the bone marrow cells under a microscope, as well as analyze chromosome number and appearance.
Learn more about leukemia
Why choose MD Anderson for your leukemia treatment?
With 25 world-renowned and highly experienced physicians dedicated to leukemia treatment, MD Anderson's Leukemia Center is proud to be the largest practice of leukemia experts in the world.
Using a comprehensive team approach, we work together to give you customized care that includes the most advanced diagnostic methods and treatments.
As a foremost program for leukemia treatment, we offer access to numerous innovative new therapies and investigational agents that may help increase your chances for successful treatment. Many of these are not found in other centers. We have the full range of services needed to ensure comprehensive, yet specialized care.
Care Designed Specifically for You
Successful leukemia treatment begins with
Our approach to leukemia is customized especially for you; we do not take a one-size-fits-all approach. Our first step is to carefully evaluate your risk factors to determine if treatment is necessary. If it is, we recommend the most advanced therapy with the least impact on your body.
Whether you are treated as an inpatient or outpatient, our comprehensive program offers all the services needed to care for leukemia and its impact on your
Researching the Future
MD Anderson is known internationally for developments in the leukemia treatment. In fact, we have helped pioneer many treatments, including decitabine (Dacogen®), dasatinib (Sprycel®), nilotinib (Tasigna®), imatinib mesylate (Gleevec) and clofarabine (Clolar®).
And we are constantly striving to find new and better ways to fight leukemia. We are one of the few cancer centers in the nation to house a prestigious federally funded SPORE (Specialized Program of Research Excellence) program. This means we are able to offer a wide range of clinical trials for leukemia treatment.
MD Anderson is my hope. I know that without it, I wouldn’t be alive today.
Lea White is a survivor in every sense of the word. The U.S. Marines veteran left home at age 16 and developed a stubborn determination to overcome adversity along the way.
She’d just gotten a divorce, moved to California, suffered the loss of two pets and was drowning in work when life dealt her another blow: an acute myelogenous leukemia (AML) diagnosis in April 2004.
“I’ve always been a survivor, and so this was just another one of those things,” she says. “My philosophy was to take it one test at a time, and not to read up on it and let the statistics scare me.”
Lea underwent several rounds of chemotherapy before receiving an autologous stem cell transplant using her own healthy stem cells that September.
That briefly put her AML into remission.
An AML recurrence
But in 2005, a month after Lea had moved to Beeville, Texas, a repeat bone marrow biopsy showed atypical myeoid blast cells. This made her doctors suspicious that she had what they called “minimal residual disease.” They said it was still too early to treat with chemotherapy.
But that changed five months later. In March 2006, Lea went to get a blood test after experiencing what she thought was a stomach flu. “Before I even got back to my office, the hospital called for me to come back for a retest,” she recalls. The doctors said her platelet counts were off.
“I immediately contacted MD Anderson, and they told me I needed to be in their emergency room that day,” Lea says.
She checked into the hospital that night.
Lea’s AML treatment at MD Anderson
Lea’s doctor recommended she undergo a second stem cell transplant. He also suggested she enroll in a clinical trial in which she’d receive more chemotherapy, even if her second stem cell transplant was successful. The decision was an easy one for Lea.
“‘If I gotta go out, I may as well go out helping someone else,’” she recalls telling her brother, who’d accompanied her to the doctor’s appointment.
In July 2006, Lea received a second stem cell transplant, this time using stem cells from an anonymous donor. Afterwards, she underwent chemotherapy.
Her AML has been in remission ever since then.
A reason to celebrate
Lea just celebrated her 10-year anniversary of showing no evidence of disease. To mark the occasion, she went skydiving in Belen, New Mexico. Now, she’s preparing to crew a hot air balloon for the fourth time.
For anyone who knows her, that’s a huge deal.
“Before leukemia, I was debilitatingly afraid of heights -- so much so that I was driving down Interstate 5 in California and found out that I had to cross the Coronado Bridge, and I had to pull my car over and let my passenger drive us over the bridge,” she says. “I got over my fear of heights after cancer. I went up in a hot air balloon the first time and I said, ‘Wow, I’d rather croak falling out of this hot air balloon than I would have leukemia.’”
Nothing is impossible
Lea thinks her healthy lifestyle played a part in her successful AML treatment, but she credits MD Anderson with saving her life.
“If you want to live, find your way to MD Anderson,” she says. “If you want half a chance, especially if it’s something complex, MD Anderson is the only place to be.”
As she tells others facing cancer, it’s important to celebrate every milestone – and to look for the positive in your situation.
“Take it one test at a time,” she says. “You can get through this. You can do it. Nothing is impossible.”
Moon Shots Program
MD Anderson’s MDS/AML Moon Shot™ and CLL Moon Shot™ aim to rapidly and dramatically improve treatment outcomes for leukemia patients through powerful new treatment approaches and research.Learn more about the Moon Shots Program