Leukaemia

What is Leukaemia?

Leukaemia is a cancer of the white blood cells. White blood cells are involved in fighting infections and are produced in the bone marrow. This cancer first develops in the bone marrow and can spread into the bloodstream. Leukaemia cells have undergone a cancerous change, and develop abnormally, multiplying in an uncontrolled way. The leukaemia cells lose their normal function to fight infection and can take over the bone marrow and squash normal blood cells at the same time.

Leukaemia is the second most common blood cancer in Aotearoa New Zealand and can be categorised into two broad groups:

• Acute leukaemia is less common, but comes on quickly, and is rapidly growing. There are two main types of acute leukaemia:

  • Acute lymphoblastic leukaemia (ALL) which is more common in children
  • Acute myeloid leukaemia (AML) which is more common in older people

• Chronic leukaemia is more common but comes on slowly over months or years. There are several types of chronic leukaemia including:

  • Chronic lymphocytic leukaemia (CLL) which accounts for around two-thirds of all leukaemia, tends to come on slowly and affects older adults
  • Chronic myeloid leukaemia (CML) which generally starts slowly but can transform into a fast-growing leukaemia. It can be found in people of any age but is more common in older adults.

Who can be affected by leukaemia?

Leukaemia can affect any age group. But certain leukaemia are more common in specific age groups:

• In children the most common leukaemia is acute lymphoblastic leukaemia
• In adults over 50 years, acute myeloid leukaemia is the most common acute leukaemia

Can I pass leukaemia on to my children?

Most people who have leukaemia have no history of leukaemia in the family. In general, this is not something that is inherited or passed on to other family members. Very occasionally genetic defects that run in the family can increase the risk of family members developing leukaemia, however in most patients this is not the case.

Risk factors

• Radiation – very high levels of radiation exposure (e.g. after a nuclear accident)
• Rarely exposure to benzene in the workplace can increase risk of leukaemia
• Smoking
• Rarely previous treatment with certain chemotherapy or radiotherapy can cause leukaemia years after the treatment. This is called treatment-related acute myeloid leukaemia (AML)
• Blood disorders – certain blood disorders can sometimes progress to AML. These include myeloproliferative neoplasms or myelodysplasia (MDS)
• Certain genetic conditions carry a risk of developing leukaemia including Downs Syndrome

Personal factors

• Gender – slightly more common in males
• Family history – people with relatives that have acute myeloid or chronic lymphocytic leukaemia have a slightly increased risk of developing leukaemia themselves

What are the signs and symptoms of Leukaemia?

Some people may have no symptoms at all, and leukaemia may be picked up on routine blood tests. However possible symptoms could include:

• Fatigue
• Shortness of breath
• Recurrent infections or slow recovery from infections
• Sore throat or mouth
• Bleeding or easy bruising
• Aching bones and joints
• Fever or night sweats
• Gum swelling and bleeding
• Unexplained weight loss
• Swollen lymph nodes (glands)

It is important that if you have any of these symptoms lasting for two weeks or more, or if the symptoms are new, unusual or getting worse, then you should get them checked by your doctor as soon as possible.

Diagnosis

Leukaemia is diagnosed with a blood test and a bone marrow test.

Treatment

The treatment for leukaemia depends on whether it is chronic or acute.

All acute leukaemia require treatment immediately. The aim of treatment will depend on your age, other medical conditions an preference. These will be discussed with your haematologist (doctor who treats blood diseases). Acute leukaemia requires intensive treatment to cure it. Your treatment may include chemotherapy (medicines to destroy cancer cells). You may require a blood stem cell transplant (or bone marrow transplant) as part of your treatment plan.

Chronic leukaemia can be very slow growing and may not require treatment for the first few months or years, but treatment will eventually be required.

Treatments for chronic leukaemia may include:

• Chemotherapy (medicines to destroy cancer cells). There are many different types of chemotherapeutic drugs and what is recommended for you will depend on your age, your health status, and the stage of your leukaemia.
• Targeted therapies, that specifically act to block the proliferative effect of an abnormal gene or genes driving the growth of the leukaemia cells.
• Blood stem cell transplant (often referred to as bone marrow transplant). That involves getting rid of the person’s diseased blood factory in their bone marrow and replacing it with healthy blood or bone marrow stem cells from another person. This treatment is very intensive and not right for everyone but it can cure leukaemia and stop it from coming back.

Helpful Website:

Leukaemia & Blood Cancer New Zealand