 What is leukemia? Leukemia is a cancer of the blood-forming organ called the bone marrow. And also it's a cancer sometimes of the lymphoid tissue, which also is part of the immune system. It's estimated that in the U.S. we're going to have 60,000 cases of cancer leukemia this year. And it's one of the leading cause of mortality, being the sixth cause of mortality related to cancer in the U.S. Leukemia is a cancer of the blood-forming organ system called the bone marrow. And it also involves this immune system called the lymphoid tissue. It is suspected that we're going to have 60,000 cases of leukemia diagnosed this year. And it's expected to be the sixth leading cause of mortality in the U.S. Can you explain the different types of leukemias? We have classified the leukemias according to the time and according to the cell of origin. In terms of the time we have acute leukemias and we have chronic leukemias. And in terms of the cell of origin we have the myeloid and the lymphoid. Therefore, we have four types of leukemia in the broad spectrum. Acute myeloleukemia, chronic myeloleukemia, acute lymphocytic leukemia, and chronic lymphocytic leukemia. What are the symptoms of leukemia? The symptoms of leukemia vary according to the type of leukemia we have. For acute leukemia, the symptoms seem to be very fast. For chronic leukemias, the symptoms develop over years or many months. In general, the symptoms for leukemia are related to the side effects in the immune system of the rest of the Balmar reserve. For the immune system, you can have fevers, chills, night sweats, or even multiple infections. For the Balmar compromise, you can have anemia, low platelets, bleeding. There's also some mention of out-immune diseases related to leukemia. There can be enlarged liver, enlarged spleen, an invasion of the leukemic cells into the other organs. How is leukemia diagnosed? The diagnosis of leukemia depends again on what type of leukemia you have. In general, we looked at the physical examination. We looked for enlarged lymph nodes, enlarged liver, over spleen, any signs of infiltration of the leukemia into any part of your body. We will look at your bone marrow, and we'll also look at your floating cells, looking for mutations and determine if the leukemia is present or not, and what type of leukemia there is. What are the risk factors of leukemia? That's a great question and is asked very often in my consultations. The risk factors for leukemia are really vary according to the type of leukemia. In general, we know that we need a genetic predisposition and an environmental factor to produce a leukemia. Some of the risk factors that are already known, for example, are genetic predispositions like Down syndrome, dyskeratosis congenital, these kind of symptoms that change your immune system or make you have more mutations. Other things like exposure to chemicals like benzines or like oil derivatives. Other risk factors include exposure to radiation, prior chemotherapy, and in general, you also will need an environmental factor added to this. How is leukemia treated? Treatment for leukemia depends on how the disease is manifested, either acute leukemia or a chronic leukemia. In general terms for acute leukemia, we tend to use chemotherapy plus, minus other targeted therapies or therapies that are directed to the cancer cells per se. For chronic leukemias, there are some ones that you don't really need to treat unless they become symptomatic or you have complications like chronic lymphocytic leukemia. And for chronic myeloid leukemia, we have special targeted therapies that are taking away the directed chemotherapy per se. The other part of the treatment for leukemias is the coming up with the immune system modulators and the immune system regulators helping us balance in the immune system to help us fight the disease. And the last part of this is the bone marrow transplantation, which we have the autologous bone marrow transplantation and the allogeneic bone marrow transplantation. What can I do to prevent from getting leukemia? The prevention therapies and prevention strategies for leukemia has not been very well developed. We don't really know how to 100% prevent leukemia from happening because, as we said, it's environmental factors plus genetic predisposition. But maybe we can change the environmental factors, exposure to chemicals, radiation therapy before patients that have had also family history of leukemia. These patients should be evaluated by their primary care physicians every year looking for changes in their blood counts or their physical exam that might prompt an evaluation by a hematologist and oncologist. In terms of the general health, it's always encouraged to have a good balanced diet and exercise. At least, it might help modulating the immune system and help us might be preventive for some of these cancers. What is the role of stem cell transplantation in leukemia? Stem cell transplantation is a process in which we give you a new bone marrow to treat the diseased bone marrow. This bone marrow will have the stem cells that will help you produce new cells. This process is usually given to patients with acute high-risk leukemias like acute lymphocytic leukemia or acute myelo leukemia. In this process, we hope to maintain the leukemia at bay by the effect of the graft versus the leukemia effect and also achieving control of the leukemia by the initial chemotherapy that is given to the patient. In general terms, these stem cell transplantations are given to patients with acute leukemias. Can you describe the hematologic malignancies program at NYU Winthrop? We have developed a comprehensive hematological malignancy program that has all of the resources that we need to take care of our patients with the standard of care and above the standard of care. We have a nurse navigator dedicated to help our patients go through all of the layers of care. We have social worker that help us in our patient needs in terms from economical needs to social support. We also have a nurse that is dedicated to us in terms of research and research coordinators and we have developed this team that it's able to provide for our patients in the most comprehensive manner and with the latest scientific advances to take care of our patients the best we can. What is your sense about the future treatment of leukemia? I believe that the leukemia treatment is evolving and every year we get new therapies being approved. The time for personalized treatment of leukemia is here. That is something that we do right now at NYU Winthrop. We look into specific mutations and look for targets that we can use to treat your leukemia. I believe that the leukemia treatment will go to be more specialized, more into targeted therapies, more into immune modulator therapies with the hope of cure. For more information about the NYU Winthrop Malignant Hematology Program call us at 866 Winthrop or visit us at NYUWinthrop.org.