Medical Overview
Leukaemia, a Greek word meaning white blood, was identified in 1845.
Leukaemia represents just over 5% of all cancers.
The first drugs that were effective for the treatment of leukaemia did not appear until the 1950's.
TYPES OF LEUKAEMIA
Leukaemia comes in two forms acute and chronic.
- Acute means that the disease has a speedy onset and must be treated quickly.
- Chronic means that the disease has a slow onset and may run a prolonged course.
The disease is divided into four main categories, which have different age and gender distribution.
- Acute myeloid leukaemia (AML) in younger people is equally common in either sex, but in the over 50's there is an increase in the proportion of males.
- Chronic myeloid leukaemia (CML) is very rare in younger people, but gets more common in old age.
- Acute lymphoblastic leukaemia (ALL) is very rare in older patients, but accounts for 85% of leukaemias in children.
- Chronic lymphocytic leukaemia (CLL) hardly ever occurs in childhood. CLL is most commonly found in people over 50 years of age.
SYMPTOMS
The patient may have noticed a lack of energy, tiredness, fever and loss of appetite. Persistent and recurrent infections, nose bleeds and excessive bruising with no obvious cause.
Swellings may develop when leukaemia cells accumulate in the lymph glands around the neck, under the arm or in the groin. Pain in the bones or joints is common.
DIAGNOSIS
In most cases a blood test would show the presence of leukaemic cells.
Examination of the bone marrow will confirm the diagnosis.
TREATMENT
Forms of treatment vary depending on the type of leukaemia.
Chemotherapy
Treatment using anticancer drugs. Chemotherapy acts on all the body's cells and is carried round the body by the blood stream. It is sometimes known as cytotoxic therapy because it is poisonous to all the cells whether or not they are cancerous. Medical staff should explain exactly what the side effects might be. Chemotherapy can cause hair loss but this is usually temporary.
Radiotherapy
Radiotherapy is localised treatment. It kills cancer cells in the area of the body being treated and is therefore effective treatment for localised disease, particularly in lymphoma and multiple myeloma. Side effects will vary according to the type of treatment.
Bone marrow and Stem Cell transplantation
Bone marrow transplantation is the replacement of a patient's own bone marrow with that provided by a suitable donor. Bone marrow / stem cell transplantation has an important role to play in the treatment of some leukaemias since it allows the use of intensive chemotherapy and radiotherapy that would otherwise leave the marrow permanently damaged. Every year thousands of people with leukaemia reach a stage when only a bone marrow/stem cell transplant can save them.
Until recently bone marrow had been the only source of stem cells for transplantation. New techniques include obtaining stem cells from the peripheral blood and the use of stem cells from the umbilical cord of a new born baby.
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