Leukaemia: Everything you need to know

What is leukaemia?

Leukaemia is a type of cancer of the blood and bone marrow. It occurs when the bone marrow makes too many white blood cells (lymphocytes), which are part of the body’s immune system to fight infections. Leukaemia cells do not function properly as white blood cells, and they do not fight infections very well. They can also crowd the bone marrow, meaning less room for healthy blood cells.

There are 4 most common types of leukaemia:

The names refer to whether they are acute or chronic (develop over a short, or long period of time), and whether they begin in the lymphoid or myeloid cells. Lymphoid cells develop into lymphocytes, a type of white blood cell. Myeloid cells develop into other blood cells.

What are the first signs of having leukaemia?

The first signs are most commonly:

  • Tiredness, weakness, shortness of breath and a pale complexion – caused by a lack of red blood cells and anaemia
  • Fever and infections that don’t go away– caused by a lack of white blood cells
  • Bruising, bleeding easily and heavy periods in women – caused by a lack of platelets

Other symptoms include:

  • Weight loss
  • Night sweats
  • Loss of appetite
  • Swelling or discomfort in the abdomen – caused by a build‑up of leukaemia cells in the liver and spleen
  • Enlarged lymph nodes in the neck, underarms or groin
  • Pain in the bones or joints

 Although these symptoms vary depending on the type of leukaemia.

What is the main cause of leukaemia? What puts you at risk for leukaemia?

There are different risk factors associated with developing different types of leukaemia. 

Some common factors include:

  • Exposure to high levels of radiation
  • Certain genetic syndromes such as down syndrome
  • Genetic abnormalities
  • Age (with people aged over 50 being more at risk of most leukaemias and children more at risk of acute leukaemias)

Can a blood test detect leukaemia?

Blood tests can be used to diagnose leukaemia by checking blood cell counts, related infections, enzymes associated with leukaemia and genetic tests. Some chronic leukaemias do not show symptoms so diagnosis can be accidental when having a blood test for another reason.  

Other tests that are used to diagnose leukaemia include: 

  • Medical history and physical examination 
  • Removal of a small piece of bone marrow to be examined
  • Chromosome testing – leukaemia often causes chromosome changes that can be seen under a microscope or using laboratory tests 
  • Fluid from the spinal cord
  • Scans to see cancer cells or visualise symptoms 

Can leukaemia be cured? Can leukaemia be cured if caught early?

Leukaemia can be cured when caught early and treatment depends on: 

  • The stage of the disease 
  • The location of the cancer 
  • The severity of symptoms 
  • Your general health and choices. 

The most common treatment for acute leukaemia is chemotherapy. Chemotherapy involves the use of medicines to remove cancer cells, although it can also affect healthy cells. Chemotherapy is administered in different ways, depending on the type of acute leukaemia. Chronic leukaemia commonly involves chemotherapy although often combined with targeted therapy. Targeted therapy involves specific medicines that remove cancer cells or inhibit their growth.

Other medications are used to avoid some side effects of chemotherapy or increase its effectiveness. Steroids, hormones naturally found in the body, can be administered to increase the effect of chemotherapy, help destroy leukaemia cells, or to reduce allergic reactions to some chemotherapy drugs. 

If chemotherapy is given in a high dose, a stem cell transplant may be necessary to restore the bone marrow that has been destroyed by the chemotherapy treatment. The transplanted cells can come from a donor or from the patient’s own body.

Commonly asked questions:

How long can you have leukaemia without knowing?

Chronic leukaemia can have no symptoms, or vague symptoms such as an ongoing cold, so an individual can go years without knowing. Whereas symptoms of acute leukaemia often occur quickly over a few weeks.

Where does leukaemia start?

Leukaemia starts in blood cells in the bone marrow. The type of blood cell where it begins, depends on the type of leukaemia.

What age does leukaemia usually occur?

Leukaemia is one of the 10 most common cancers in both men and women in Australia. Most types of leukaemia are mostly common in adults over 50, but leukaemia is also the most common cancer in children and teenagers, making up around one-third of cancers in these young people. Most of these cases are acute forms of leukaemia. 

Does leukaemia start suddenly? How quickly does leukaemia start?

Depending on the type of leukaemia it can develop slowly over several years, even decades or in just a few weeks.  

Who is most at risk of leukaemia?

  • Individuals who have been exposed to high amounts of radiation. 
  • Individuals infected with certain viruses- Epstein–Barr virus or human T-cell lymphoma
  • Individuals with certain genetic syndromes, including Down syndrome, Klinefelter syndrome, Fanconi anaemia, Bloom syndrome, ataxia-telangiectasia, neurofibromatosis, Li-Fraumeni syndrome, trisomy 8, Diamond–Blackfan anaemia, and severe congenital neutropenianeutropaenia. 
  • Males – several leukemias are more common in males than in females 
  • Individuals aged 50 and over and children – several leukemias are more likely to occur in adults over 50 years old, and acute leukaemias are also more likely to occur in children 
  • Individuals with an identical twin or family member with leukaemia 
  • Individuals with certain blood disorders 
  • Individuals who are exposed to certain pesticides 
  • Individuals from certain racial backgroundsbackground – CLL is more common in Russian or eastern European Jews
  • Individuals who smoke and/or are obese can also increase risk of AML. 

What is the survival rate of leukaemia?

In Australia, between 2014 and 2018 the chance of surviving at least 5 years post diagnosis of leukaemia was 64%. 

ACRF awarded a $2.5M grant to the South Australian Health and Medical Research Institute (SAHMRI) and the University of Adelaide’s adjacent Adelaide Health and Medical Sciences building to help establish the ACRF Centre for Integrated Cancer Systems Biology. The state-of-the-art facility will bring together next generation technologies to transform patient outcomes through the delivery of targeted and personalised cancer therapy. It will target five critically important cancer streams – chronic myeloid leukaemia, acute lymphoblastic leukaemia, multiple myeloma, prostate cancer and colorectal cancer.

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