Leukemias, lymphomas and myeloma: what they are and how to fight them

Leukemias, lymphomas and myeloma: what they are and how to fight them. International day against leukemias, lymphomas and myeloma, observed on June 21. The goal of AIL, the Italian Association against Leukemias, Lymphomas and Myeloma, is to raise awareness among patients and their families. Founded in 1969, the association now has 83 sections across Italy.

What leukemias, lymphomas and myeloma are: the different types of leukemia

Leukemias are a group of diseases of the blood and bone marrow. They affect leukocytes, that is, the white blood cells found in our body. There are several types of leukemia: acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia and chronic myeloid leukemia. Leukemias are also classified by how fast the disease progresses. Acute leukemias progress rapidly, while chronic ones progress more slowly.

Acute lymphoblastic leukemia (ALL) 

This is a type of blood cancer that develops in the precursor cells of lymphocytes, which are a type of white blood cell that fights infections. ALL is the most common form of leukemia in children, but it can also affect adults. In acute lymphoblastic leukemia, immature lymphoid cells multiply abnormally. This multiplication prevents the production of normal white blood cells and reduces the body’s immunity. The disease can spread rapidly to other parts of the body, such as the bone marrow, lymph nodes, liver and spleen.

Symptoms and treatment of acute lymphoblastic leukemia (ALL) 

The symptoms of ALL can vary depending on the patient and how advanced the disease is. They include tiredness, fever, night sweats, weight loss, joint and bone pain, pallor, easy bleeding and bruising, and frequent infections. Treatment of acute lymphoblastic leukemia depends on how advanced the disease is and on the patient’s age and general condition. Treatment options include chemotherapy, radiation therapy, targeted therapy and bone marrow transplant. In many cases, ALL can be successfully cured, especially in children. 

Details of acute myeloid leukemia (AML)

Acute myeloid leukemia (AML) is a type of blood cancer that develops from the precursor cells of myelocytes. AML is the most common type of leukemia in adults, but it can also affect children. In acute myeloid leukemia, immature myeloid cells multiply abnormally and prevent the production of normal white blood cells, red blood cells and platelets. This can cause reduced immunity, anemia and a greater tendency to bleeding and bruising. Compared with ALL, it also causes frequent infections, while the other symptoms are the same. Treatment is similar to that of other leukemias.

What is chronic lymphocytic leukemia (CLL)

It develops in mature lymphocytes, a type of white blood cell that fights infections. CLL is more common in older people, but it can also affect young people. In chronic lymphocytic leukemia as well, mature lymphoid cells multiply abnormally. As a result, they prevent the production of normal white blood cells, reducing the body’s immunity. Like other leukemias, the disease can spread to other parts of the body and, compared with the others, it also causes excessive night sweats and pallor. Treatments are similar to those of other leukemias.

Chronic myeloid leukemia (CML) 

Here, too, the disease develops in the precursor cells of myelocytes, a type of white blood cell that fights infections and produces red blood cells and platelets. CML is more common in middle-aged adults, but it can also affect children. In CML, immature myeloid cells multiply abnormally and prevent the production of normal white blood cells, red blood cells and platelets. This can cause reduced immunity, anemia and a greater tendency to bleeding and bruising. The symptoms are the same as those of other leukemias. Treatment options include drug therapy with medications called tyrosine kinase inhibitors, chemotherapy, radiation therapy and bone marrow transplant. In many cases, CML can be successfully kept under control with drug therapy, but sometimes a bone marrow transplant may be needed. 

The characteristics of lymphomas

Lymphomas are a group of blood diseases that affect the cells of the lymphatic system, that is, the body tissue that helps fight infections and diseases. Lymphomas fall into two main categories: Hodgkin lymphomas and non-Hodgkin lymphomas. Hodgkin lymphomas affect a specific type of white blood cell called Reed-Sternberg lymphocytes, while non-Hodgkin lymphomas can affect different types of lymphocytes. It is established that non-Hodgkin lymphomas are more common than Hodgkin lymphomas. The symptoms of lymphomas can vary depending on the type of lymphoma and how far it has spread, but they generally include swollen lymph nodes, fever, night sweats, weight loss, itching and fatigue. Treatment options include chemotherapy, radiation therapy, targeted therapy and bone marrow transplant. In many cases, especially for Hodgkin lymphomas, the disease can be successfully cured. 

Myeloma

Multiple myeloma, simply called myeloma, is a type of blood cancer. It develops in the plasma cells of the bone marrow. These cells produce antibodies that help fight infections. In multiple myeloma, these cells grow abnormally and produce an excessive amount of abnormal proteins, called monoclonal proteins. Multiple myeloma can damage the surrounding bone tissue, causing bone pain and fractures. Other symptoms may include anemia, frequent infections, tiredness, weight loss and kidney failure. It is treated with chemotherapy, radiation therapy, targeted therapy, bone marrow transplant and therapy with immunomodulators. In many cases, multiple myeloma can be kept under control, but it cannot always be completely cured. However, thanks to advances in research and treatment, patients can live for many years with a good quality of life.

Tests

Diagnosing leukemia requires a series of tests to confirm the presence of the disease and determine its type and stage. Blood tests can be done at the NefroCenter clinical laboratories in Napoli and at the Rome American Hospital in Roma. Bone marrow biopsy is done at the RAH pathology laboratory. Bone marrow aspiration: a small amount of bone marrow is drawn with a special needle and examined under a microscope to detect the presence of abnormal cells. Cytogenetic tests, and imaging studies, that is, X-rays, computed tomography (CT) and magnetic resonance imaging (MRI). And finally, immunophenotyping tests.