Leukaemia is a cancer of the body’s blood-forming tissues, where your body produces damaged blood cells. While there are many types of leukaemia, most usually involve white blood cells and its precursors.
The disease usually starts in the bone marrow, which is responsible for making blood cells. The cancerous cells divide and eventually crowd out healthy blood cells.
Leukaemia can be classified into acute or chronic leukaemia. In acute leukaemia, abnormal blood cells multiply quickly, causing the disease and symptoms to worsen rapidly. In general, acute leukaemias develop and produce symptoms within weeks or months. In contrast, abnormal cells in chronic leukaemia replicate more slowly, so the disease and its symptoms may go unnoticed.
There are several types of leukaemia:
Acute myelogenous leukaemia (AML)
This is the most common type of leukaemia in adults and originates from the part of the marrow responsible for producing most of the white and red blood cells.
Acute lymphocytic leukaemia (ALL)
This is the commonest cancer affecting children, but can occur in adults as well. It originates from the part of the bone marrow giving rise to white blood cells called lymphocytes.
Chronic lymphocytic leukaemia (CLL)
Usually affecting the elderly, CLL can sometimes occur in young adults. This condition often has no symptoms, and it is often picked up during routine blood tests which show increased lymphocyte levels.
Chronic myelogenous leukaemia (CML). This type of leukaemia usually affects adults. Those with CML may not show any symptoms, before they enter a phase where the leukaemia cell growth accelerates.
Symptoms of Leukaemia
Those with chronic leukaemia may not experience any symptoms, and it is usually picked up from routine blood tests. Some patients have vague symptoms like weight loss, night sweats or fatigue which develops slowly over months. However, people with acute leukaemia, or those with worsening chronic leukaemia may experience the following symptoms:
- Fever or chills
- Persistent fatigue, weakness
- Frequent or severe infections
- Losing weight without trying
- Swollen lymph nodes, enlarged liver or spleen
- Bleeding or bruising easily
- Recurrent nosebleeds
- Tiny red spots in your skin (petechiae)
- Excessive sweating, especially at night
- Bone pain or tenderness
These symptoms can also be caused by problems other than cancer. Send us an enquiry if you experience such symptoms, and are concerned about them.
Your doctor will ask for your medical history and conduct a physical examination. He or she may run several tests, including:
- Blood tests. Your doctor will check your blood count by taking a sample of your blood. A high white blood cell count, together with a low platelet and red blood cell count may suggest that leukaemia is present.
- Bone marrow test. A sample of your bone marrow will be removed. The sample is sent to a laboratory to check for leukaemia cells. This procedure is also used to determine the type of leukaemia you may have. In additional, specialised diagnostic and molecular tests may be ordered, depending on the clinical suspicion, to confirm the diagnosis, classify it and determine the prognosis.
Treatment for Leukaemia
Your treatment depends on the type of leukaemia, as well as your age and overall health. Common treatments include:
- Targeted therapy
- Radiation therapy
- Bone marrow transplant
Chemotherapy involves giving you anti-cancer drugs. They are either injected into your vein (intravenously), under the skin (subcutaneously) or taken orally. These drugs enter your bloodstream and target growing and rapidly dividing cells.
Doctors give chemotherapy treatments in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Chemotherapy cycles generally last two to four weeks, and treatment typically involves four to six cycles.
Targeted drugs work differently from standard chemotherapy drugs. Unlike chemotherapy drugs, which target both normal and cancer cells that grow and divide rapidly, targeted drugs control the leukaemia by preferentially blocking the growth and spread of cancer cells. Some types of leukaemia have specific mutations that may respond to targeted drugs.
Depending on your drug, you may experience different (and less severe) side effects.
Radiation therapy uses high-energy x-rays to kill leukaemia cells, while minimising damage to normal cells. It is seldom used as the main treatment for leukaemia, as cancer cells circulate throughout the whole body, whereas radiation usually focuses on a specific region. It may be used to treat specific areas like the brain in some types of leukaemia. This treatment may also be done to prepare your body for bone marrow transplants.
Bone Marrow Transplant
A bone transplant replaces your bone marrow with a healthy one from a donor. It involves harvesting healthy stem cells from a donor’s blood or bone marrow, or from a newborn’s umbilical cord. The transplanted blood stem cells will produce healthy blood cells, which replaces the abnormal ones in your body.
Immunotherapy uses drugs and the body’s own immune system to control the leukaemia. While immunotherapy is generally well tolerated by most patients, some may experience serious side effects.
Talk to us to understand more about the different treatment options, and find out which treatments are most suitable for you.
Post-treatment Care for Leukaemia
After your treatment is over, it is important to keep all follow-up appointments. This is needed to check for leukaemia recurrence, as well as monitor for the side effects of certain treatments. You can also discuss any questions or concerns you may have with your healthcare team.