Angelique Nyiramutarutwa, 30, suffered a severe headache and went for a check-up at King Faisal Hospital, Kigali, where she was diagnosed with leukemia. Like Nyiramutarutwa, many people out there continue to face the challenges that come with this terrible illness. But what exactly is leukemia?

Dr Yvan Butera of Muhima Hospital says leukemia is a cancer of blood cells and is therefore sometimes referred to as blood cancer. In leukemia, abnormal blood cells are produced in the bone marrow. Usually leukemia involves the production of abnormal white blood cells - the cells responsible for fighting infection. However, the abnormal cells in leukemia don’t function in the same way as the normal white blood cells. Leukemia cells continue to grow, eventually crowding out the normal blood cells, the end result being that it becomes difficult for the body to fight infections, control bleeding and transport oxygen.

Dr Butera explains that there are mainly four types of leukemia, namely; acute lymphocytic leukemia which is caused by abnormal proliferation of white blood cells that get packed up in the bone marrow; acute myeloid leukemia that is caused by abnormal proliferation of blasts in the bone marrow (blasts are immature cells); chronic lymphocytic leukemia caused by abnormal maturation of lymphocytes that start in the bone marrow and eventually spread to the blood, lymph nodes and other organs like the liver; and chronic myeloid leukemia caused by deregulated production and uncontrolled proliferation of mature and immature granulocytes.

He says that the chronic types of leukemia develop slower than the acute ones.

Causes

Dr Vincent Mutabazi from Rwanda Biomedical Centre says how one gets leukemia is not well understood, but says studies point to a combination of environmental and genetic predisposition of a person.

"The exact causes of this cancer are not known, but risk factors have been identified,” he says.

Dr Emile Musoni of University Teaching Hospital of Kigali says risk factors for leukemia involve exposure to cigarette smoking, certain cancer drugs, radiation or certain chemicals.

He adds that most cases of leukemia are not believed to be hereditary but certain genetic mutations and conditions can be passed on to offsprings which increases the chances of developing leukemia.

"Having risk factors does not mean that a person will definitely get leukemia and most people with risk factors will not develop the disease. Likewise, not everyone who develops leukemia has an identifiable risk factor,” says Butera

Symptoms 

Dr Mutabazi says that the symptoms of leukemia depend on the type of cells affected, but there are general symptoms. These include, fatigue, weight loss, petechiae(red spots on the skin), easy bleeds, fevers, swollen lymph nodes that usually don’t hurt and night sweats, among others.

"Also, if the leukemia cells have infiltrated the brain, symptoms such as headaches, seizures, confusion, loss of muscle control and vomiting can occur,” he adds.

Treatment

Dr Mutabazi adds that like all cancers, leukemia is best treated when diagnosed early. 

The treatment is dictated by the type and stage of the leukemia.

He says during diagnosis, a number of tests on the blood cells and tissue biopsies are conducted.

"Other diagnostic tools include magnetic resonance imaging (MRI) and X-ray computed tomography (CT scans),” he says.

Treatment may involve radiation therapy, chemotherapy and stem cell transplantation (bone marrow transplantation).

"Chemotherapy is the administration of drugs that kill rapidly developing cells such as leukemia or other cancer cells. It may be taken orally in pill or tablet form or it may be delivered via a catheter or intravenous line directly into the bloodstream. The drugs are given in cycles with rest periods in between,” Dr Mutabazi explains.

He adds that radiation therapy uses high energy radiation to target cancer cells and may be used in treatment of leukemia that has spread to the brain.

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