What is Leukemia?
Leukemia is a cancer that starts in the bone marrow, where blood cells are produced. It occurs when abnormal white blood cells form and multiply uncontrollably.
Patients may face additional costs beyond conventional medical bills, such as:
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Caregiver loss of earnings;
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Traveling for treatment;
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Out-of-pocket expenses related to medications and insurance premiums.
The 5-year survival rate for all types of leukemia is 67%.
(Comparison of normal blood cells vs. leukemia. Source - BD Biosciences)
The National Cancer Institute (NCI) recognizes leukemia as a type of cancer that requires specialized treatment and care. The treatment strategy is complex and depends on multiple factors. Yet, it’s possible to ease the disease progress with a personalized treatment plan.
What Causes Leukemia?
Leukemia begins when a genetic mutation occurs in the DNA of bone marrow cells. These mutations cause the cells to grow and divide rapidly, forming abnormal white blood cells. These abnormal cells crowd out the healthy blood cells, leading to the symptoms of leukemia.
The risk factors that can increase the likelihood of developing leukemia are:
🧬 Genetic factors, such as inherited conditions or family history of leukemia.
☢️ Exposure to radiation or certain chemicals, such as benzene.
🚬 Smoking, which increases the risk of some types of leukemia.
💉 Previous cancer treatments, including chemotherapy or radiation therapy.
What are the Types of Leukemia?
Leukemia is classified into four main types based on the speed of progression and the type of blood cells affected:
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Acute Lymphoblastic Leukemia (ALL) progresses rapidly and affects immature lymphocytes, a type of white blood cell.
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Acute Myeloid Leukemia (AML) affects myeloid cells, which form white blood cells, red blood cells, and platelets.
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Chronic Lymphocytic Leukemia (CLL). A slower-growing leukemia affects mature lymphocytes.
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Chronic Myeloid Leukemia (CML) develops slowly and affects mature myeloid cells.
Multiple myeloma, another type of blood cancer, also has significant financial implications, often involving high costs for various stages of care.
The doctors classify leukemia by:
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How advanced the disease is;
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How many abnormal cells are in the blood;
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Whether the cancer has metastasized.
| Type of Leukemia | Age when diagnosed | Projected new cases in the next year |
| ALL | 2-5 y.o. | 6,550 |
| AML | 65 years and older | 20,800 |
| CLL | 60-70 y.o. | 20,700 |
| CML | ~64 y.o. | 9,280 |
What are the Early Signs of Leukemia?
Leukemia can present with a variety of symptoms, which may include:
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Fatigue and weakness;
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Frequent infections due to a weakened immune system;
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Easy bruising or bleeding, such as frequent nosebleeds or bleeding gums;
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Petechiae (flat, pinpoint spots under the skin caused by bleeding);
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Painless swellings in the neck, armpit, belly, or groin;
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Bone or joint pain;
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Shortness of breath;
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Frequent infections;
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The feeling of fullness below the ribs;
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Unexplained weight loss;
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Fever or night sweats.
As these symptoms often sound like flu or other common disease, the doctors perform lab and instrumental tests to detect the presence of cancer.
How to Confirm a Patient Has Leukemia?
Along with asking about personal and family health history and doing a physical exam, the doctor may do some tests, including:
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Complete blood count (CBC) to check for abnormal white cells or low red blood cell counts;
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In a blood chemistry study, doctors check the levels of different substances in blood, such as glucose, fats, and proteins);
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For a peripheral blood smear, doctors examine a blood sample under a microscope to see if there are any abnormal cells. They look at the types and numbers of white blood cells, platelets, and changes in the shape of the blood cells;
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Imaging tests, like CT scans or MRIs, to check for bone metastasis;
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During a bone marrow aspiration and biopsy, the doctor removes a small sample of bone marrow, blood, and bone from the hip or chest bone using a needle. A pathologist examines the sample under a microscope to spot any abnormal cells.
(Bone Marrow Aspiration and Biopsy, Source - National Cancer Institute)
What is Cytogenetic Testing for Leukemia?
Cytogenetic testing determines whether there are missing or broken chromosomes and abnormal genes in a cell’s genome. Usually, doctors apply it to detect CML or Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL).
The most commonly used is the BCR-ABL1 method, which looks for a pathological gene called BCR-ABL1. It is an acquired genetic change, meaning patients do not take it from their parents and cannot pass it on to their children.
What is the Treatment of Acute Lymphoblastic Leukemia in Childhood?
The treatment of childhood acute lymphoblastic leukemia (ALL) happens in three main stages:
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Remission induction. This is the first stage, where the aim is to destroy leukemia cells in the blood so the leukemia becomes remission (meaning there are no signs of cancer).
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Consolidation/intensification. Once the leukemia is in remission, the goal is to get rid of any remaining cancer cells to prevent recurrence.
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Maintenance. In this final stage, the goal is to kill any leftover leukemia cells. The treatment doses are usually lower during this phase compared to the earlier stages. This is also called the continuation phase.
What are the Treatment Options for Children in Different Risk Groups?
The leukemia treatment centers offer different approaches for children with ALL. In addition to standard medical treatments, patients may face financial burdens from other therapies, such as travel, lodging, and alternative treatments.
| Risk Level | Main Procedure |
| Standard risk | -Intrathecal chemotherapy: -Stem cell transplant during the first remission. |
| High risk | -Intrathecal and systemic chemotherapy -Radiation therapy. |
| Very high risk | -Intrathecal and systemic chemotherapy -Radiation therapy; -Stem cell transplant not during the first remission. |
What is the Role of Clinical Trials in Cancer Treatment?
When it comes to cancer treatment, there is no one-size-fits-all approach. The best leukemia treatment centers in the world offer various options tailored to the type and stage of cancer, as well as the patient’s overall health.
Clinical trials play a pivotal role in advancing cancer treatment. These trials provide patients access to new and innovative therapies that are not yet widely available. Participating in a clinical trial can be valuable for those who have not responded to standard treatments or are seeking alternative options.
Standard treatment methods include:
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✔️Surgery;
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✔️Chemotherapy;
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✔️Radiation therapy;
Stem cell transplantation, for instance, is a cutting-edge treatment that has shown promise in treating blood cancer. This procedure involves replacing damaged or destroyed bone marrow with healthy stem cells, which can help restore average blood cell production.
Is Stem Cell Transplant Effective in Treating Leukemia?
Stem cell transplants rarely serve as the first treatment for children and teens with ALL. Doctors typically use them if the leukemia returns after initial treatment.
In a stem cell transplant, doctors collect stem cells from a donor’s blood or bone marrow, freeze them for later use, and store them. After the patient finishes chemotherapy and radiation, doctors infuse the stem cells into the patient’s body. Transplants for leukemia patients grow into red and white particles, restoring the regular bloodstream.
What are the Top Leukemia Treatment Centers in the World?
Bookimed has ranked the best hospitals for treating blood cancers. Based on our Smart Ranking System, the top facilities are in Spain, Israel, and Turkey.
The top leukemia treatment centers are:
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SJD Barcelona Children’s Hospital (Spain). The hospital belongs to the ITCC (Innovative Therapies for Children with Cancer) consortium. It is the only hospital in Spain and among several in Europe treating lymphoblastic leukemia insensitive to traditional therapy with innovative CART-T therapy.
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Sourasky Medical Center (Ichilov) (Israel). According to Newsweek magazine, the hospital is one of the best in Europe for treating blood cancer. The oncologists have over 20 years of experience, with
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Anadolu Medical Center (Turkey). The hospital has ESMO (European Society for Medical Oncology) certification, which proves its compliance with strict blood cancer treatment standards. Anadolu Medical Center also partners with Johns Hopkins Hospital in the USA, using the latest equipment for precise diagnosis and treatment.
What Is the Cost of Treating Blood Cancers Worldwide?
The type and treatment cost depends on leukemia's stage and severity. Here's a short overview of the most-demanded blood cancer destinations and their treatment costs.
| Country | Turkey | Spain | Israel |
| CAR-T cell therapy cost | From $60,000 to $95,500 | From $133,607 | From $90,000 to $120,000 |
| Chemotherapy cost | From $5,200 to $13,480 | From $15,200 to $28,200 | From $6525 |
What Is the Insurance Coverage for Leukemia?
Health insurance plans help cover expensive drugs and procedures. Many people have insurance through their jobs or by purchasing a plan themselves. However, some treatments or costs may not be fully covered.
The are several types of plans:
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Health Maintenance Organizations (HMOs). Lower costs with a specific network of doctors and hospitals. A primary care doctor (PCP) is chosen, and specialists need referrals.
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Preferred Provider Organizations (PPOs). More flexibility in choosing doctors, both in-network and out-of-network, but out-of-network care costs more. No referrals are needed for specialists.
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Point-of-Service (POS). This health insurance plan is a mix of HMO and PPO. Members choose between in-network or out-of-network providers but usually need a referral to see a specialist.
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Fee-for-Service (FFS). Most flexible but with higher costs. Members pay upfront for care, submit claims for reimbursement, and often handle more paperwork.
The patients who struggle to find healthcare professionals can fill a request on Bookimed, and the medical coordinator will contact an individual treatment plan.
How to Choose the Blood Cancer Treatment Center?
Seeking a lower cost of childhood leukemia treatment should not be the sole factor influencing the hospital choice. Here's what else is essential:
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Hospital's Accreditation. The more evaluations the center has from international organizations, the higher its success rate will be. The most popular communities are National Cancer Institute and Joint Commission International. They provide the ranking of accredited centers with proven treatment and diagnostic standards.
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Level of Doctor's Expertise. Leukemia is a multimodal disease requiring the same approach. It demands high qualification in terms of modern treatment tools. Plus, patients can check the doctor's experience by looking at the number of successful procedures (or surgeries) they performed so far.
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Patients Safety. For example, if the hospital has HEPA-filtered wards, ensuring 100% sterilization. HEPA filters usually contain glass or plastic fibers. It doesn't allow airborne pathogens into the environment and works excellently with UV light air filtration systems.
For patients with less time to choose a center, Bookimed can find the best treatment facility and develop an individual treatment plan. Just submit a free request on our website to contact the medical coordinator and find a solution to your problem.
How Much Does Chemotherapy for Leukemia Cost?
The average price range for chemotherapy is $1,000-$5,000. This depends on a disease's complexity and medication response. According to recent data, about 2 out of 3 people with AML who get standard induction chemotherapy (chemo) go into remission.
The average cost for leukemia treatment is:
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Vincristine, used for ALL, costs around $25 for a supply of 2 milliliters;
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Mitoxantrone, used for AML, is about $186 for a supply of 10 milliliters;
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Imbruvica (enzyme inhibitor), used for CLL, will cost around $616 per tablet.
What is the New Treatment for Leukemia?
In 2024, the FDA approved blinatumomab for adult and pediatric patients one month and older with a specific type of B-cell precursor ALL. This treatment is applicable when cancer signs disappear after initial therapy.
References
Childhood Acute Lymphoblastic Leukemia. Comprehensive Cancer Information - NCI. URL: https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq#_62 (date of access: 10.09.2024).
Key Statistics for Acute Lymphocytic Leukemia (ALL). Information and Resources about Cancer: Breast, Colon, Lung, Prostate, Skin | American Cancer Society. URL: https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/about/key-statistics.html (date of access: 10.09.2024).
Leukemia & Lymphoma Society | Blood Cancer Leaders | LLS. URL: https://www.lls.org/managing-your-cancer/finances-and-insurance-coverage/insurance-coverage (date of access: 11.09.2024).
Survival Rate of Leukemia: Stats by Type, Age, and More. Healthline. URL: https://www.healthline.com/health/leukemia/survival-rate-of-leukemia (date of access: 10.09.2024).
Treatment Response Rates for Acute Myeloid Leukemia (AML). Information and Resources about Cancer: Breast, Colon, Lung, Prostate, Skin | American Cancer Society. URL: https://www.cancer.org/cancer/types/acute-myeloid-leukemia/treating/response-rates.html (date of access: 10.09.2024).