Leukaemia

What is leukaemia?

Leukaemia is a type of cancer where the bone marrow of your bones produces too many white blood cells, because of problems in the process that regulates your stem cells dividing.

Stem cells are special cells that are able to divide and create any type of blood cell, like platelets, red or white cells (the cells responsible for fighting infection). If you have leukaemia, your stem cells lose the ability to stop themselves growing and replicating, and so the bone marrow fills with too many white blood cells.

Because these stem cells are occupied creating white blood cells, they aren’t able to create the other cells that are needed in your blood.

What are the symptoms of leukaemia?

Usually, leukaemia presents with symptoms that are very general, such as:

• Tiredness

• Pale skin

• Difficulty growing in children

• Rashes

• Bruising

• Fever and infections

• Swollen glands

• Pain in arms and legs

• An enlarged liver and spleen

• Weight loss

How common is leukaemia?

Leukaemia is the 12th most common cancer in the UK. There are about 9,907 cases of leukaemia in the UK, and every day, about 27 people are diagnosed. Most of these cases are in people aged 85-89, but it can also appear in younger people.

What are the types of leukaemia?

The different types of leukaemia are classified depending on their characteristics. They can be acute, where the disease appears quickly and can be very aggressive from the start, or chronic, where it may take several years to show any symptoms.

The main types of leukaemia include:

• Acute myeloid leukaemia (AML) – this is the most common progressive leukaemia in adults and tends to show after the age of 75, when myeloid cells are produced

• Acute lymphoblastic leukaemia (ALL) – this happens because lymphocytes replicate quickly. ALL is the most common cancer in children aged 2-4, but can also appear in adults over the age of 45

• Chronic myeloid leukaemia (CML) – this is a slower progression of a leukaemia that may take 5 years to show any symptoms. It’s most common in people over 65

• Chronic lymphocytic leukaemia (CLL) – this is the long-term fast growth of lymphocytes in people over the age of 55. It may not present symptoms for the first few years, and then suddenly transform into a very aggressive form of leukaemia.

There are also other less common types of leukaemia, like hairy cell leukaemia, myelodysplastic syndromes and myeloproliferative disorders.

What causes leukaemia?

Scientists don’t yet know the exact causes of leukaemia but there are several genetic and environmental risks that can increase your risk:

• Exposure to high levels of radiation

• Previous chemotherapy

• Previous blood cancers

• Specific viral infections like the human T-cell leukaemia virus

• Some genetic syndromes can also increase your risk of developing leukaemia, like Down’s syndrome

How is leukaemia diagnosed?

All the symptoms of leukaemia could also suggest many other diseases, but still shouldn’t be missed. This is why seeing a doctor is so important early on, especially if you notice any abnormal bruising or rashes.

• The doctor will first ask you a few questions and have a closer look at your tummy for any bruising or rashes

• They will take a blood test called a full blood count. They may refer you for further tests at the hospital

• At the hospital, medical professionals will carry out other blood tests, like a blood film to look for any abnormal cells or to look for a parameter called lactate dehydrogenase.

• A bone marrow biopsy may also be needed to see if your cells are cancerous. This is the best test for leukaemia

• Other tests can also be done to see how far the cancer has spread. These may include a chest x-ray, lumbar puncture, a biopsy of the lymph nodes and other scans like CT, MRI and PET.

How to treat leukaemia

To best treat leukaemia you’ll have a multidisciplinary team, which is a team of different professionals that work together. Depending on the type of leukaemia and its severity, different treatments can be given:

• Chemotherapy – anti-cancer drugs that destroy cells by stopping them from growing and dividing

• Stem cell transplant – because a high dose of chemotherapy can kill the stem cells in the bone marrow, it may be necessary to do a bone marrow transplant to replace these lost cells

• Radiotherapy – uses radiation to kill cancer cells that have spread to other parts of the body.

Once leukaemia has been treated, your doctor will organise checkups to make sure the cancer doesn’t come back in the future.

When should I speak to a doctor?

If you have any suspicious rashes or bruising that would not usually be there, talk to a GP as soon as possible.

If you’ve had leukaemia, treatment can make you feel tired and you may find it difficult to sleep. If you have these issues, talk to your consultant or nurse specialist as they may be able to help and support your recovery.