Leukemia is a type of cancer in which the body produces large numbers of abnormal (usually white) blood cells. Approximately 28,500 new cases of leukemia are diagnosed each year. There are several types of leukemia, grouped as either acute (the diseases progresses rapidly) or chronic (the diseases progresses slowly). The most common leukemias are:

• Acute lymphocytic leukemia (ALL), which comprises 90 percent of all leukemias in children (although it also occurs in adults)
• Acute myelocytic leukemia (AML), which mostly occurs in adults
• Chronic lymphocytic leukemia (CLL), which mostly strikes adults over age 55
• Chronic myelocytic leukemia (CML), which mostly occurs in adults

Leukemia is often accompanied by the following signs and symptoms.

• Fatigue
• Fever
• Abnormal paleness
• Weight loss
• Shortness of breath
• Easily bruising
• Bleeding
• Repeated infections
• Bone pain
• Abdominal pain

Most causes of leukemia are not known. However, the disease has been linked to exposure to large amounts of high-energy radiation (from nuclear bombs), occupational exposure to the chemical benzene, viral infections, and chemicals from cigarettes.

Leukemia is linked to the following risk factors.

• Increasing age
• Genetic diseases, such as Fanconi's anemia or Down syndrome
• Acquired diseases, such as Hodgkin's disease
• First-degree relative with leukemia
• Excessive exposure to ionizing radiation
• Chemical exposure (benzene)
• Certain drugs
• Chromosomal abnormalities
• Cigarette smoking

If you or your child is experiencing symptoms associated with leukemia, see your health care provider. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies will work best.

Your provider will do a physical examination, checking for swelling in the liver, the spleen, and the lymph nodes, and will order certain laboratory tests. The bone marrow is examined to check for leukemia cells or to determine the type of leukemia. A lumbar puncture ("spinal tap") checks for leukemia cells in the fluid around the brain and spinal cord, and chest X rays can reveal signs of the disease in the chest.

Some leukemias can be prevented by avoiding exposure to benzene, nicotine, or radiation.

Leukemia is an extremely complex disease. Treatment depends on the type of leukemia, certain features of the leukemic cells, the extent of the disease, and whether the leukemia has been treated before. Whenever possible, a patient with leukemia should be treated at a medical center that specializes in this disease.

Some of the drug therapies used to treat leukemia include the following.

• Radiation therapy— the use of high energy rays to kill cancer cells and prevent them from growing
• Chemotherapy—the use of drugs to kill cancer cells
• Bone marrow transplantation—a procedure in which cancerous bone marrow is destroyed with high doses of anticancer drugs or radiation, and is then replaced with healthy bone marrow.
• Biological therapy—stimulates or restores ability of the body's immune system to fight infection and disease; may also be used to lessen side effects caused by other treatments

Surgeries may include the following.

• Lumbar puncture
• Bone marrow transplant
• Splenectomy (removal of the spleen)

A comprehensive treatment plan for leukemia may include a range of complementary and alternative therapies.

Eating the following nutrient-dense foods that are high in antioxidants may help protect against cancer: dark berries, orange and yellow vegetables, dark leafy greens, fresh vegetable juices containing wheatgrass, beets, romaine lettuce, parsley, and cucumber.

Potentially beneficial nutrient supplements include those listed below.

• Vitamin A (25,000 IU a day), vitamin E (800 IU a day), vitamin C (3 to 6 g a day), and selenium (200 to 400 mcg a day) have antioxidant activity and may decrease side effects of chemotherapy and radiation
• Vitamin D (400 to 800 IU a day) may help promote differentiation of cells
• B-complex (50 to 100 mg a day) with additional B₁₂ (1,200 mcg a day) and folic acid (800 mcg a day) for anemia

The use of certain herbal remedies may support the lymphatic system, spleen, bone marrow, and liver. Take a combination of the following herbs in equal parts, 30 to 60 drops three times a day.

• Red clover (Trifolium pratense)
• Blue flag (Iris versicolor)
• Yellowdock (Rumex crispus); for late-stage disease, substitute greater celandine (Chelidonium majus) for yellowdock
• Poke root (Phytolacca americana)
• Tree of life (Thuja occidentalis)
• Cleavers (Galium aparine)
• Coneflower (Echinacea purpurea)
• Turmeric (Curcuma longa) (250 to 500 mg two to three times a day)
• Periwinkle (Vinca rosea) and autumn primrose (Colchicum officinale). Note: these are potentially toxic herbs to consider for use only under a supervising physician.

Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp./cup water steeped for 10 minutes (roots need 20 minutes).

An experienced homeopath can prescribe a regimen for treating leukemia that is designed especially for you. Acute remedies may be useful for relief of symptoms associated with complications.

Chinese herbs and acupuncture may be a powerful adjunct to conventional therapy.

Repeated infections complicate most cases of leukemia. Kidney failure or impaired function and a decreasing number of neutrophils (a type of white blood cell) are also common complications. Treatments for leukemia can have serious side effects.

The prognosis for people with leukemia varies by the type of leukemia. ALL patients have the best prognosis, with a 35- to 45-percent five-year survival rate and a 40-percent long-term survival rate.

Patients with leukemia undergo extensive follow-up care, including daily exams to check for infections and bleeding, weekly bone marrow biopsies after chemotherapy has begun, post-remission chemotherapy, treatment for central nervous system conditions, and monitoring of urinary function.

Cunningham FG, et al. Williams Obstetrics. 19th ed. Norwalk, Conn: Appleton & Lange; 1993:1270-1272.

DeVita VT Jr, et al. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, Pa: Lippincott-Raven; 1997:2293-2338.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:685-694.

Holleb AI, et al. American Cancer Society Textbook of Clinical Oncology. Atlanta, Ga. American Cancer Society; 1991: 410-432.

Kelly WN. Textbook of Internal Medicine. Vol 1. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1997: 1370-1381.

Wittes RE. Manual of Oncologic Therapeutics. Philadelphia, Pa: Lippincott; 1990: 345-366.

Woodley M. Manual of Medical Therapeutics. 27th ed. Boston, Mass: Little, Brown; 1992:360-361.