Leukaemia is a form of blood cancer in which the bone marrow produces abnormal blood cells.
These are usually white blood cells that do not work properly. The abnormal cells may multiply too rapidly, fail to mature into properly functioning blood cells, or overcrowd and prevent normal blood-cell production (including red cells and platelets) in the bone marrow.
Bone marrow is a spongy tissue found inside the bones, where blood cells are made.
Leukaemia affects the blood and bone marrow rather than forming a solid tumour, therefore it has particular features compared to many other cancers.
The rate at which leukaemia progresses depends on the type:
- ‘Acute’ leukaemias are fast-growing and often require urgent treatment.
- ‘Chronic’ leukaemias are slower-growing and in some cases may be monitored without immediate treatment.
The time from the first abnormal cell growth to the appearance of symptoms can vary greatly depending on the type of leukaemia and individual factors.
Symptoms also differ by leukaemia type and disease stage. In chronic leukaemias, which develop slowly, early symptoms may be mild or even absent, and the condition is sometimes discovered during routine blood tests.
Common symptoms of leukaemia can include:
- persistent tiredness / fatigue that doesn’t go away with rest
- unexplained weight loss or night sweats
- frequent or repeated infections and high temperature (fever)
- easy unexplained bruising or bleeding more than usual
- swollen lymph nodes in the neck, underarms or groin
- shortness if breath (breathlessness)
- bone or joint pain
- headaches or visual disturbances
There are four main types of leukaemia, and these include:
- Acute Lymphoblastic Leukaemia (ALL) – a fast-growing leukaemia arising from early (immature) lymphoid cells
- Acute Myeloid Leukaemia (AML) – a fast-growing leukaemia affecting myeloid lineage (granulocytes/monocytes) in bone marrow
- Chronic Lymphocytic Leukaemia (CLL) – a slower-growing leukaemia from lymphoid cells, often in older adults
- Chronic Myeloid Leukaemia (CML) – a slower-growing leukaemia affecting myeloid white blood cells; many people live for years with treatment
Other, less common leukaemia types include:
- Hairy Cell Leukaemia (HCL)
- Acute Promyelocytic Leukaemia (APL)
- Large Granular Lymphocytic Leukaemia (LGLL)
- Chronic myelomonocytic leukaemia (CMML)
Treatment for leukaemia at CUH
The treatment you have depends on several factors, which include:
- the specific type of leukaemia
- the stage and progression of the disease
- the genetic and molecular features of the leukaemia cells
- your age and general health
A team of specialists at CUH will meet to discuss your condition and to make a recommendation about the best possible treatment for you.
You, along with your clinician, will then discuss your treatment recommendations at the clinic appointment and decide on the right treatment plan for you. Your clinician will explain different treatment options and possible side effects.
The treatment for leukaemia can include:
- chemotherapy
- targeted therapy
- immunotherapy / biological therapies
- stem cell / bone marrow transplant
- CAR-T cell therapies (for acute lymphoblastic leukaemia)
- radiotherapy
- active monitoring (“watch and wait”)
At times, you may require more than one treatment or a combination of different treatments to give the best chance of long-term cure.