The Adult Hematology Oncology Program offers diagnosis and treatment for those with blood cancers.  To make an appointment or for more information:

Healthcare professionals, please contact our M-LINE service: 800-962-3555.

Patients, please call 734-647-8902.

There are several different types of leukemia. In general, leukemia is grouped by the type of cell that becomes cancerous.

It may be acute or chronic.

• Acute leukemias are cancers of early blood making cells called stem cells or blasts.

• Chronic leukemia are cancers that lead to the overproduction and accumulation of mature white blood cells.

It may be lymphocytic or myeloid.

• Lymphocytic (or lymphoblastic) leukemias affect white blood cells called lymphocytes.

• Myeloid leukemias affect the production of several types of white blood cells including granulocytes and monocytes, red blood cells, and platelet-making cells.

The four most common types of leukemia are:

• Acute lymphoblastic leukemia (ALL)

• Acute myeloid leukemia (AML)

• Chronic lymphocytic leukemia (CLL)

• Chronic myeloid leukemia (CML)

There are less common leukemias, such as hairy cell leukemia, chronic myelomonocytic leukemia, chronic neutrophilic leukemia, etc.

There are also often subtypes of leukemias, such as acute promyelocytic leukemia (a subtype of AML), and in many cases, these subtypes are defined by genetic changes seen inside of the leukemia cells. The genetic changes often can influence the prognosis of the leukemia and help your doctor determine the proper treatment for the leukemia.

Symptoms of acute leukemia depend on how much the cancer has grown. They may include:

• Fatigue, shortness of breath, or lightheadedness due to a lowering of the red blood cell count (anemia).

• Frequent nosebleeds, bleeding from the gums or rectum, more frequent bruising, or heavy menstrual bleeding due to a lowering of the platelet count (thrombocytopenia).

• Recurrent infections due to a lowering of the white blood cell count.

• Frequent fevers.

• Night sweats.

• Bone pain.

• Unexplained appetite loss or recent weight loss.

• Swelling and pain on the left side of the belly (due to an enlarged spleen).

• Swollen lymph nodes in your neck, under your arm, or in your groin.

If your blood work points to possible leukemia, your doctor will want to find out what kind you might have. Your treatment plan will depend on the specific kind of leukemia that you have.

Tests that look closely at the leukemia cells may include the following:

• Assessment of proteins expressed on the surface or inside of the cells (flow cytometry and immunohistochemistry).

• Genetic tests that look at the chromosomes (cytogenetics and cytogenomic array testing) or individual genes within the chromosomes (next generation sequencing).

• During therapy, your doctor may recommend testing to look for leftover leukemia cells (measure residual disease – MRD) at certain points in your therapy.

These tests can help guide treatment. Sometimes they can help your doctor and you know whether your leukemia is likely to go into remission or come back. In some cases, the tests can predict survival rates.

Your doctor may also order other tests, including:

• Chemistry testing of your kidney function and liver function.

• Blood testing of your blood clotting system.

• Lumbar puncture, to find out if leukemia cells are in your cerebrospinal fluid (CSF).

• Positron emission tomography (PET) scans in some forms of leukemia to determine if the leukemia has involved the lymph nodes.

• A biopsy of a lymph node or other tissues, to look for leukemia cells.

• Echocardiogram to assess your heart function to make sure it is safe to receive certain types of chemotherapies.

Treatment for leukemia is based on the type of leukemia and other factors such as your overall health. Treatment options may include:

• Chemotherapy: Chemotherapy medicines kill fast-growing cells, including cancer cells and some normal cells.

• Other medicines may be given to help chemotherapy work better and prevent infections or complications from chemotherapy. Examples include antiviral medications, antibiotics, antifungal medications, and antinausea medications.

• Radiation therapy: This uses high-dose X-rays to destroy cancer cells.

• Stem cell transplant: A procedure that replaces a patient’s bone marrow with a matched donor’s stem cells with the intent to create an immune response against the leukemia.

• Immunotherapy: This treatment helps your immune system fight cancer. It may be given in several ways.

• Sometimes a clinical trial may be a good choice.

Your doctor will talk with you about your options and then make a treatment plan.