Leukemia is often considered a childhood cancer, but 92% of cases in the U.S. are diagnosed in adults 20 and older. This type of blood cancer causes very high or very low white blood cell counts, as well as vague — yet disruptive — symptoms such as fatigue, fever and easy bruising.

There are generally two types of leukemia:

• Acute leukemia – cancer that develops over a few weeks and can be cured if caught early
• Chronic leukemia – a long-term condition that can be managed for decades with treatment and specialized care

Dr. Shilpan Shah, an oncologist at Houston Methodist who specializes in treating blood cancers, says that we have more — and more effective — leukemia treatment options now than ever before.

"Oncology — including leukemia, specifically — is one of the fastest growing fields in medicine," Dr. Shah explains. "The immunotherapy and targeted therapy options available today can significantly improve patients' outcomes."

When identified and treated early, leukemia can have excellent outcomes — potentially even be cured. Finding an expert provider who can determine and provide the right combination of therapies is key to successful treatment.

Spot symptoms of leukemia for a timely diagnosis

Leukemia can develop in childhood or adulthood, and is most common in men. People with a family history of leukemia may have a slightly higher risk. But in most cases, leukemia is not hereditary.

"Many patients ask me if their kids are genetically at risk of getting leukemia," Dr. Shah says. "My general answer is no — passing on leukemia is not something patients should worry about."

Though a person may seem healthy, leukemia symptoms such as these can progress over a just few weeks or months:

• Abnormally high or low white blood cell or platelet counts
• Anemia
• Coughing and trouble breathing
• Easy bruising
• Extreme fatigue
• Fever and infections, such as a persistent sore throat
• Headache
• Joint or bone pain
• Swollen lymph nodes (more common in children)
• Unexplained weight loss

These vague symptoms could be chalked up to a busy life or aging. But if symptoms persist and worsen, talk with a doctor right away.

In most cases, a complete blood count (CBC) test can show whether white blood cell counts are normal. For a healthy adult, the count should be 4,500 to 11,000 white blood cells per microliter of blood. However, leukemia can cause very high or very low counts of white blood cells.

• A high count could mean the body is fighting a disease, infection or inflammation
• A low count could mean the body is producing too few white blood cells or that they are being destroyed

Aggressive forms of acute leukemia can cause low platelets, which prevents healthy clotting. A normal platelet count for a healthy adult is 150,000 to 400,000 platelets per microliter of blood.

If the CBC suggests leukemia, a bone marrow biopsy is used to test blood cells from a bone. This procedure helps determine which of the four main types of leukemia a person has:

• Acute myeloid leukemia (AML)
• Acute lymphoblastic leukemia (ALL)
• Chronic myeloid leukemia (CML)
• Chronic lymphocytic leukemia (CLL)

How is leukemia treated?

How leukemia is treated depends on whether the disease is acute or chronic.

Acute leukemia treatment

Chemotherapy is the standard treatment for AML and ALL, and it is typically given in the hospital. Over the past five years oncologists also have been using immunotherapy, which enlists the immune system to kill cancer, with goal of reducing and even eliminating the need for chemotherapy. Immunotherapy for leukemia is targeted cancer killing, which results in higher efficacy with fewer side effects.

"We typically admit patients with acute leukemia to the hospital for testing and to monitor their overall wellbeing while treatment is started," explains Dr. Shah.

Some patients may need a bone marrow transplant to replace their blood-forming cells with healthy cells from a donor.

In academic medical centers such as Houston Methodist, patients can join clinical trials. In a trial, patients get the best standard of care and the chance to try a new leukemia treatment before it is widely available.

When detected and treated early, acute leukemia is curable in many cases.

"Even when there are a lot of factors, such as advanced age and other medical conditions, we estimate that half of acute leukemia cases can be cured, which is high for such an aggressive cancer," says Dr. Shah.

Chronic leukemia

CML and CLL are generally less aggressive, so most patients don't have to stay in the hospital for treatment. Immunotherapy and targeted monoclonal antibody medications can be effective long term, without the side effects of chemotherapy such as nausea, vomiting and hair loss.

"Targeted therapies recognize the cancer cells based on specific proteins on the cell surface," Dr. Shah explains. "The medication eliminates the cells that have those proteins without damaging the healthy, normal cells."

Most patients will have a similar longevity compared with their peers, says Dr. Shah. "Similar to managing high blood pressure or diabetes, as long as you take your pills regularly, most people have good outcomes with targeted therapies."

Whole-patient support for adult leukemia

"Patients with leukemia are going through a difficult time in their life, and they need empathy and support," says Dr. Shah. "In addition to giving the best possible care, we work hard to show patients they aren't just a number here — their care and comfort is our top priority."

For most families facing leukemia, it can feel like the diagnosis came out of the blue. Working with a provider team that is understanding and supportive through the ups and downs is key to successful leukemia treatment. Support groups for patients and families adds another layer of community and hope during a difficult time.

"The most important thing I hear from patients is that we offer one-on-one connections and personalized care," says Dr. Shah. "When a patient says they feel really comfortable and happy with the nurses, doctors and support staff, it adds to the quality of their care."