Leukemia is a disease of the blood

Blood is a vital liquid that carries oxygen, food, hormones, and other necessary chemicals to all of the body's cells. It also removes toxins and other waste products from the cells. Blood helps the lymph system fight infection and carries the cells necessary for repairing injuries. Blood also contains important clotting factors.

Whole blood is made up of plasma, which is a clear fluid, and many other components, each with a specific task. All three types of blood cells are affected by leukemia: red blood cells, platelets, and white blood cells.

Red blood cells (erythrocytes or RBCs) contain hemoglobin, a protein that picks up oxygen in the lungs and transports it throughout the body. RBCs that contain oxygen give blood its red color. When leukemia cells in the bone marrow slow down the production of red cells, the child develops anemia. Anemia can cause tiredness, weakness, irritability, pale skin, and headache: all due to decreased oxygen being carried to the body tissues.

Platelets (thrombocytes) are tiny, disc-shaped cells that help form clots to stop bleeding. Leukemia can dramatically slow down the production of platelets, causing children to bleed excessively from cuts or from the nose or gums. Children with leukemia can develop large bruises (ecchymoses) or small red dots (petechiae) on their skin.

White blood cells (leukocytes or WBCs) destroy foreign substances in the body such as viruses, bacteria, and fungi. WBCs are produced and stored in the bone marrow and lymph nodes. They are released when needed by the body. If an infection is present, the body produces extra WBCs. There are three main types of WBCs:

• Lymphocytes. Two types of lymphocytes interact to prevent infection, fight viruses and fungi, and provide immunity to disease:

- T cells attack infected cells, foreign tissue, and cancer cells.

- B cells produce antibodies that destroy foreign substances.

• Granulocytes. There are three types of granulocytes:

- Neutrophils attack foreign bacteria.

- Eosinophils respond to allergic reactions as well as foreign bacteria and parasites.

- Basophils are the rarest of the white cells and play a special role in allergic reactions.

• Monocytes. Monocytes are cells that scavenge (clean up) waste material that is left over from battles between the body's defenses and infectious or cancerous invaders. They also contain enzymes that kill foreign bacteria.

The different types of leukemia are cancers of a specific white blood cell type. For instance, acute lymphoblastic leukemia affects only lymphocytes. The specific types of leukemia are explained later in the chapter.

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