When to Seek Medical Care

See a health care provider promptly if any of the following symptoms appear:

• Unexplained fevers
• Night sweats
• Unexplained weight loss
• Bleeding or bruising easily
• Swelling in your neck, under your arm, or in your groin
• Persistent pain in your abdomen, back, or bony areas
• Persistent headache, confusion, balance problems, or difficulty concentrating
• Sores or minor infections that fail to heal
• Persistent blurred vision

Follow-up

After completion of treatment, the diagnostic studies are repeated to see how the treatment has affected the leukemia. Many people have a reduction or even a disappearance of leukemia cells in their blood and bone marrow. This is called remission.

• If the patient is in remission, his or her medical team watches the patient carefully over time for signs that the leukemia is coming back. In certain very high risk patients, who are likely to relapse despite a seeming remission, stem cell transplantation may follow induction therapy.
• If the initial treatment does not cause remission, the doctor discusses alternate treatment plans, perhaps with new agents undergoing testing.

Another factor to be addressed may be impaired organ function secondary to therapy. Careful follow-up on any patient who has received extensive therapy, such as stem cell transplantation, should receive careful systemic evaluations in order to initiate corrective measures should any organ impairment be detected.

Prevention

No known way exists to prevent leukemia. Avoiding risk factors such as smoking, exposure to toxic chemicals, and exposure to radiation may help prevent some cases of leukemia.

Outlook

The leukemias vary in their response to treatment.

• Some types of acute leukemia respond very well to treatment and can be cured. Others do not have such a positive outlook.
• Chronic leukemias usually cannot be cured, but they can be controlled for long periods. Some people with chronic leukemias respond well at first, but, over time, their remissions last for shorter and shorter intervals.

Specific factors are associated with outcomes in each type of leukemia. General factors associated with outcomes include the following:

• Age
• Percentages of leukemia cells in the blood and bone marrow
• Degree to which specific systems of the body are affected by leukemia
• Chromosome abnormalities in leukemia cells

Like other cancers, leukemia outlook is measured in terms of survival rates. The number of people who are still alive 5 years after treatment varies by type of leukemia. After 5 years, greater than 80% of patients without detectable disease will likely maintain a lifelong remission. Patients in remission longer than 15 years are considered unequivocal cures.

One problem that requires concerted efforts by advocate groups is the need to address the reluctance on the part of the health care industry to offer health insurance for former pediatric leukemia patients whose disease-free survivals are considered "cures" by all available evidence.