Leukemia Discharge Information

What is leukemia?

Leukemia is a cancer of the blood and bone marrow. Marrow is the soft, fatty tissue inside the hard, outer part of the bones. Bone marrow makes blood stem cells, which become the different types of blood cells, including white blood cells, red blood cells, and platelets. Normally, white blood cells help your body fight infection and other diseases. Leukemia occurs when the body produces many abnormal white blood cells. When this happens, the abnormal cells crowd out the normal blood cells needed by the body. The abnormal white blood cells cannot fight infections like normal white blood cells. Your red blood cell count and the number of platelets decrease, which causes you to have blood clotting problems and bleed easily.

There are many different types of leukemia. The type is determined by two things:

• Whether the leukemia symptoms come on quickly (acute) or the disease develops slowly (chronic)
• What type of white blood cell is affected (lymphocytes or myelocytes)

Some of the most common types of leukemia include Acute Myelogenous Leukemia (AML), Chronic Myelogenous Leukemia (CML), Acute Lymphocytic Leukemia (ALL), and Chronic Lymphocytic Leukemia (CLL).

It is important to diagnose and treat leukemia as soon as possible. The main goals of treatment are to kill the cancer cells and prevent the cancer from spreading.

The cause of leukemia is not well known. However, there are things that increase your risk. These include:

• Being exposed to radiation
• Smoking
• Being exposed to certain chemicals, such as benzene
• Having certain inherited diseases, such as Down syndrome
• Having certain blood disorders, such as myelodysplastic syndrome
• Being infected with Human T-cell leukemia virus type I (HTLV-I)
• Family history of leukemia

How can I take care of myself when I go home?

Many people with leukemia live normal lives for many years. However, the cancer may return in weeks, months, or years. How long you will live after diagnosis depends on the type and stage of the disease when it was diagnosed, how fast the cancerous cells are growing, and how well you respond to treatment. Certain types of leukemia may be cured, while some may slowly get worse over many years. If the cancer comes back after remission, it is called a recurrence. Recurrences can be treated.

Management

• Your provider will give you a list of your medicines when you leave the hospital.
  • Know your medicines. Know what they look like, how much you should take each time, how often you should take them, and why you take each one.
  • Take your medicines exactly as your provider tells you to.
  • Carry a list of your medicines in your wallet or purse. Include any nonprescription medicines and supplements on the list.
  • Talk to your provider before you use any other medicines, including nonprescription medicines.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent low blood counts caused by the cancer or its treatment
  • Treat or prevent side effects, such as nausea, from the other treatments
  • Help your immune system fight cancer
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• You may be more at risk for serious infections during and after your treatment. Try to stay away from people who may be sick. Avoid crowded places, like shopping malls, when you can. Ask your provider if you should wear a surgical mask when you are out in public so that you are less likely to breathe in germs. Practice good hand washing.
• Ask your healthcare provider if there are any foods or medicines you should avoid.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.
• You may need other treatments for your cancer after you leave the hospital. Treatments may include:
  • Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells. Different types of chemotherapy may be given in the hospital, outpatient clinic, or at home.
  • Radiation therapy, which uses high-energy X-rays to kill cancer cells. Radiation treatment may be done in the hospital or an outpatient clinic.
  • Biological therapy, which uses medicine designed to help your immune system fight the cancer or block the growth of cancer cells
• In some cases, you may continue to have treatment during remission to try to keep the cancer in remission.

Appointments

• Follow your provider's instructions for follow-up appointments.
• Keep appointments for any testing you may need. Testing may include:
  • Blood tests to check the level of certain hormones, proteins, or chemicals that may be high if you have cancer, or to check for cancer cells in the blood
  • Bone X-rays: Pictures of your bones to check for cancer
  • Bone marrow biopsy: A biopsy is the removal of a small sample of bone marrow for testing.
  • Bone scan: A series of detailed pictures is taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
  • Computed tomography (CT) scan: A series of X-rays is taken from different angles and arranged by a computer to show thin cross sections of the chest, abdomen, and pelvis.
  • Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the chest, abdomen, and pelvis.
  • Lumbar puncture: A test that uses a needle to get a sample of fluid from the area around your spinal cord to check for spread of cancer to the brain and spinal cord
  • Ultrasound scan: Sound waves are used to show pictures inside your abdomen to look for spread to the abdominal organs or lymph nodes in the abdomen.
  • Positron emission tomography (PET) scan: A series of detailed pictures is taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.
  • Genetic analysis: Blood or bone marrow tests to look at your genes to see if your leukemia may be linked to a condition you may have inherited and to look at changes in your leukemia cells to see how aggressive they are

Talk with your provider about any questions or concerns you have.

Call your healthcare provider if you have new or worsening:

• Tiredness
• Fever higher than 100.5 degrees F (38.1 degrees C)
• Easy bruising or bleeding
• Loss of appetite
• Weight loss more than your healthcare provider tells you to expect in any month
• Full feeling below the ribs, especially on the left
• Swollen lymph nodes in the neck, underarms, and groin
• Night sweats
• Infection that does not go away or frequent infections
• Deep bone pain

For more information:

Contact national and local organizations such as:

• American Cancer Society, Inc.
  Phone: 1-800-ACS-2345 (800-227-2345)
  Web site: http://www.cancer.org
• National Cancer Institute’s Cancer Information Service
  Phone: 1-800-4-CANCER (800-422-6237)
  Web site: https://www.cancer.gov/