Leukemia is a type of cancer that affects the blood and bone marrow. It occurs when the bone marrow produces abnormal white blood cells that crowd out the healthy cells. This can lead to a variety of symptoms, including potential hair loss. In this article, we’ll explore the link between leukemia and hair loss, the types of hair loss that can occur, and treatment options that may help.
What is leukemia?
Leukemia is a cancer of the body’s blood-forming tissues, including the bone marrow and lymphatic system. In most types of leukemia, abnormal white blood cells proliferate rapidly, resulting in high numbers of abnormal white blood cells in the blood and bone marrow. These abnormal cells interfere with the production of normal blood cells.
There are several different types of leukemia, which are classified based on the type of blood cell affected and how quickly the disease progresses:
Acute leukemia:
– Acute lymphocytic leukemia (ALL): Cancer of the lymphocytes, a type of white blood cell. This is the most common type of leukemia in children.
– Acute myelogenous leukemia (AML): Cancer of the myeloid cells, another type of white blood cell. This type occurs in both adults and children.
Chronic leukemia:
– Chronic lymphocytic leukemia (CLL): Cancer of the lymphocytes that gets worse slowly. It is the most common type of leukemia in adults.
– Chronic myelogenous leukemia (CML): Cancer of the myeloid cells that gets worse slowly. It occurs mainly in adults.
In acute leukemia, the abnormal blood cells grow quickly and crowd out the healthy cells, leading to symptoms that can develop rapidly. Chronic leukemia progresses more slowly.
What causes leukemia?
The exact cause of leukemia is unknown. However, doctors have identified several risk factors that may increase a person’s chances of developing the disease:
– Genetic abnormalities: Certain genetic syndromes, such as Down syndrome, are associated with a higher risk.
– Prior cancer treatment: Chemotherapy and radiation therapy for other types of cancer may increase leukemia risk.
– Exposure to chemicals: Long-term exposure to high levels of benzene or formaldehyde is linked to a higher risk.
– Smoking: Smoking is associated with increased risk, especially for AML.
– Family history: Having a sibling or parent with leukemia may raise risk.
– Radiation exposure: High levels of radiation, such as from nuclear accidents, raises risk.
– Certain viruses: Exposure to the human T-cell leukemia virus-1 (HTLV-1) or Epstein-Barr virus increases risk for certain types of leukemia.
In most cases, it is unclear exactly why one person develops leukemia and another doesn’t. Research continues on determining causes.
What are the symptoms of leukemia?
Symptoms of leukemia result from having too many abnormal white blood cells and not enough normal blood cells. Common symptoms may include:
– Fatigue and weakness: Occurs from anemia, or not having enough healthy red blood cells.
– Frequent infections: With not enough normal white blood cells, the immune system is impaired.
– Bruising or bleeding easily: Platelet counts are low.
– Bone pain: From the buildup of leukemia cells in bones.
– Swollen lymph nodes: Leukemia cells may collect in lymph nodes causing swelling.
– Fever and chills: Can result from infection due to the lack of normal white blood cells.
– Unintended weight loss and loss of appetite.
– Night sweats.
– Shortness of breath.
– Frequent nosebleeds and bleeding gums.
– Petechia, or tiny red spots under the skin.
– Pain or feeling of fullness below ribs or in the abdomen due to an enlarged spleen.
The symptoms may be acute and severe with rapidly progressing types of leukemia. In slower progressing chronic leukemia, symptoms may be milder at first.
Can leukemia cause hair loss?
Hair loss, or alopecia, is a potential side effect of leukemia itself and its treatments. There are a few reasons this may occur:
– The leukemia disrupts the normal hair growth cycle. The abnormal cells and immune system activity affect the hair follicles and growth pattern.
– Chemotherapy medications damage hair follicles, leading to dramatic hair thinning approximately 1-3 weeks after starting treatment. This hair loss is most often temporary.
– Radiation therapy to the head or specific areas may cause hair thinning or loss in those areas.
– Bone marrow transplantation can lead to hair loss due to the high-dose chemotherapy given prior to the transplant.
– Graft-versus-host disease, a complication of bone marrow transplants when the donor cells attack the body’s tissues, can sometimes lead to hair loss.
– Secondary conditions like anemia, hypothyroidism, or infections may contribute as well.
The pattern and extent of hair loss depends on the type of leukemia, the treatment regimen, and other individual factors. Let’s look specifically at how the main types of leukemia may influence hair.
Acute lymphocytic leukemia (ALL)
Of childhood leukemia cases, about 80% are ALL. It may lead to hair loss through:
– Chemotherapy used to treat ALL often causes temporary total baldness approximately 3-4 weeks after starting treatment.
– Radiation to the brain or skull can lead to localized hair loss.
– Children over 10 years old have a higher risk of chemotherapy-induced hair loss with ALL. Younger children’s hair follicles may be more resilient to chemotherapy drugs.
Acute myelogenous leukemia (AML)
– Up to 70% of AML patients report noticeable hair thinning or complete baldness, especially with chemotherapy regimens containing anthracyclines like daunorubicin or cytosine arabinoside. This hair loss is reversible in most patients.
– About 20-25% of children with AML experience hair loss.
Chronic lymphocytic leukemia (CLL)
– CLL usually does not directly cause dramatic hair loss. Mild thinning can occur as the disease progresses due to the malignant blood cells inhibiting hair growth.
– Treatments like chemotherapy drugs, radiation, or stem cell transplants may lead to temporary or permanent patchy hair loss.
Chronic myelogenous leukemia (CML)
– Most patients with CML do not experience direct hair loss from the disease itself.
– However, tyrosine kinase inhibitor drugs like imatinib used for treatment may cause mild hair thinning. Up to 10% of patients report hair loss with long-term imatinib treatment.
So in summary, while leukemia itself does not always directly cause severe alopecia, the treatments used for acute leukemias often result in dramatic but reversible hair loss. Hair loss may be less with chronic leukemias. Discuss hair loss risks and prevention steps with your health care team.
Types of hair loss
There are different patterns of hair loss that may be seen with leukemia:
Diffuse hair loss (telogen effluvium):
Your scalp hair grows in cycles. Chemotherapy damages the hair follicles, causing them to prematurely enter the resting phase (telogen). This results in shedding of large amounts of hair within 1-3 months of starting treatment. It can involve the entire scalp rather than specific areas. It is the most common type of chemotherapy-induced hair loss. It is temporary in most cases, with regrowth starting after treatment ends.
Anagen effluvium:
This is acute hair loss occurring within days of starting chemotherapy. It happens when chemotherapy rapidly pushes large numbers of anagen (actively growing) hairs into the resting phase. This can cause up to 90% of scalp hairs to shed. Permanent baldness is rare. However, the large amount of shedding can be emotionally difficult.
Localized hair loss:
Radiation therapy to treat cancer only affects the hair follicles in the treatment area. Patients may experience well-defined areas of total hair loss limited to the radiated field. For example, scalp irradiation may result in a bald patch. The hair loss may be permanent if radiation severely damages the follicles.
Patchy hair loss (alopecia areata):
This causes patchy bald spots, often on the scalp. It occurs when the immune system attacks the hair follicles. Leukemia itself or graft-versus-host disease post-transplant may trigger this type of hair loss. The hair often regrows on its own.
When does hair start to fall out with leukemia?
If hair loss occurs, it often follows this general timeline:
– Within 1-2 weeks of starting cytotoxic chemotherapy: Patients may notice increased hair shedding.
– 2-3 weeks after starting chemotherapy: Shedding increases further, becoming very noticeable.
– 4-6 weeks after chemotherapy: Most patients experience maximal hair loss now. This varies based on chemotherapy regimen.
– Regrowth often starts about 1-3 months after finishing chemotherapy. It may take 6 months or longer for full regrowth.
With radiation therapy, the hair shedding is limited to the treatment area and occurs over 2-3 weeks. Hair loss from graft-versus-host disease can begin within weeks to several months after a bone marrow transplant.
Hair regrowth after leukemia treatment
The good news is that most hair loss from leukemia treatment is temporary, and hair regrowth occurs once treatments are completed. However, there are factors that affect regrowth:
– Age: Younger children tend to regrow hair more quickly and completely after chemotherapy. Puberty may prolong regrowth.
– Chemotherapy drugs: Certain chemo agents like busulfan are more likely to cause permanent baldness. Others like cyclophosphamide commonly allow full regrowth.
– Duration and dosage of chemo: More cycles of intensive chemotherapy can increase the time it takes for hair to re-grow or prevent full regrowth.
– Prior radiation therapy: This may damage follicles enough to prevent hair from regrowing normally in those areas.
– Condition of hair before treatment: Having healthier, thicker hair beforehand helps the regrowth process.
It is difficult to predict who will regrow hair fully and who will experience permanent thinning or patchiness. Work with your oncology team to maximize regrowth potential.
Speeding up hair regrowth
While you cannot rush the normal hair growth cycle too much, some tips to help optimize regrowth include:
– Taking vitamins and supplements your doctor recommends to support hair growth.
– Eating a well-balanced, nutritious diet. Stay hydrated and get adequate protein.
– Avoiding tightly pulled hairstyles that stress the follicles.
– Using gentle hair products formulated for post-chemotherapy regrowth.
– Gently massaging the scalp to increase circulation.
– Staying active and reducing stress may aid regrowth.
– Avoiding damaging hot tools and processing during regrowth.
– Using cooling caps during chemo may help minimize hair loss in the first place.
– Seeing a dermatologist if patchy loss like alopecia areata occurs.
Coping with leukemia-related hair loss
Hair loss from leukemia treatment is often extremely difficult emotionally. Patients describe feeling a loss of privacy, lack of control, and reduced self-image. Fortunately, there are ways to help make the process easier:
Work with a compassionate health care team
Ensure your doctors and nurses understand the anxiety you feel about losing your hair. They can provide support resources and help you prepare.
Consider hair alternatives
Many patients feel more comfortable using wigs, hats, scarves or other head coverings when hair loss occurs. Your insurer may cover the cost of a wig. Donating your hair to make wigs for cancer patients before chemo can also be meaningful.
Anticipate grief over your changing appearance
Expect to go through an emotional grieving process as your physical appearance changes temporarily. Counseling provides many patients relief during this time.
Enjoy periods without hair hassle
Focus on the bonuses, like no need to style your hair or wash it daily. Appreciate your wig-free time as well.
Emphasize your natural beauty
You are so much more than your hair. Refocus your self-image on your inner strengths and spirit.
Join a support community
Speaking with others experiencing cancer-related hair loss makes a huge difference in feeling less alone. In-person and online groups provide real comfort.
Summary & conclusion
In summary, hair loss is a common side effect of leukemia itself and its treatments like chemotherapy and radiation therapy. Both child and adult leukemia patients may be impacted. Diffuse shedding and complete baldness is most often seen with acute leukemias treated with chemo. Hair loss is more mild and localized with chronic leukemia types.
The good news is that most cases of dramatic hair loss related to chemotherapy are temporary, with the hair regrowing once treatment is completed. However, some people may experience patchy or incomplete regrowth depending on individual factors.
Working closely with your health care team can help minimize hair loss upfront and optimize regrowth. Coping strategies, use of hair alternatives, and joining support communities helps many patients through this difficult side effect of leukemia treatment. While hair loss presents an emotional challenge for leukemia patients, the priority is working to achieve remission and improved wellbeing.