What is Leukaemia?
Leukaemia is often referred to as cancer of the blood. In leukaemia normal control mechanisms break down and the bone marrow starts to produce large numbers of abnormal white blood cells of an identical type. This disrupts the normal production of blood c ells leading to anaemia, a low platelet count and often enlargement of the liver and spleen which may cause abdominal discomfort.
The large numbers of white cells produced in leukaemia are all abnormal, which means that patients may have frequent, severe infections because normal infection-fighting white cells are not being produced.
Leukaemia can be classified as acute or chronic. This refers to the speed at which the disease progresses if it is left untreated, not the severity of the disease.
Acute leukaemia comes on quickly and if not effectively treated will rapidly progress.
It can be classified as lymphoid or myeloid referring to the type of white cell affected.
Leukaemia arises as a result of changes in or damage to the genes which control cell growth, development and division.
In most cases no specific cause can be identified.
In general the risk of developing leukaemia increases with age.
The symptoms which are seen most often in acute leukaemia are:
- Fatigue and limited capacity for exercise
- Breathlessness on exertion
- Excessive bruising, often spontaneous
- Bleeding from gums
- Persistent infections
- Night sweats
- Abdominal discomfort
Chronic lymphocytic leukaemia
Chronic lymphocytic leukaemia is the most common leukaemia in the western world.
- Average age of onset 65-70 years
- More common in males
- Up to 10% of cases are familia
Most new cases are discovered incidentally at a routine GP check up as a result of:
- Enlarged lymph nodes
- Abnormal blood results
Indications for referral
- High White cell count with excessive numbers of lymphocytes
- Presence of enlarged lymph nodes or liver/spleen
- Weight loss of >10% in 6 months
- Persistent fever >38 degrees Celsius
- Extreme fatigue
- Night sweats
If diagnosed early treatment is often not required immediately.
Patients who have no symptoms and whose laboratory results indicate early stage disease are likely to be offered check-ups but no treatment – this is often termed a ‘watch and wait’ approach.
The mainstay of treatment is with chemotherapy drugs often taken in low doses by mouth.
Targeted anti-cancer drugs such as Rituximab may also be used.
Most patients are able to enjoy a good quality of life for many years with little or no treatment.
For the minority of patients with more rapidly progressing disease more intensive therapy may be required.
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