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Leukaemia - a general overview

Published by Bupa's health information team, February 2008.

This factsheet is for people who have leukaemia, or who would like information about it.

Leukaemia is a type of cancer that affects the white blood cells. In leukaemia, white blood cells become abnormal, and divide and grow in an uncontrolled way. Leukaemia affects three times as many adults as children. It's the most common form of childhood cancer, but this is because childhood cancers are rare.

About leukaemia

In the UK, almost 7,000 people are diagnosed with leukaemia every year.

The term leukaemia refers to a group of cancers of the blood cells. In leukaemia, white blood cells become abnormal, and divide and grow in an uncontrolled way. For more information on specific types of leukaemia, please see Related topics.

White blood cells and leukaemia

White blood cells are made in your bone marrow, which is the soft spongy centre of your bones. Your bone marrow makes the most basic type of cells (called stem cells), and they can develop further into three types of cells:

  • white blood cells - protect your body from infection
  • red blood cells - carry oxygen around your body
  • platelets - important for normal blood clotting

Once these cells are made, they enter your bloodstream.

White blood cells are involved in your body's immune system, a defence system that protects you from infections. There are two main types of white blood cells: myeloid cells and lymphocytes.

In leukaemia, some of the white blood cells don't grow properly. They stay in the bone marrow and keep reproducing in an uncontrolled way. These abnormal white blood cells fill up the bone marrow and prevent it from making healthy white blood cells. This means the body is less able to fight off infections.

The abnormal white blood cells also prevent bone marrow from making enough red blood cells and platelets. A lack of red blood cells leads to less oxygen being delivered to the organs and tissues of your body. This is called anaemia, and it can make you feel tired and breathless. A lack of platelets can lead to problems with the blood-clotting system, and results in bleeding and bruising much more easily than usual.

Types of leukaemia

There are several types of leukaemia. They are named according to the type of white blood cells (myeloid cells or lymphocytes) that are affected and how quickly the disease develops. Only the common types are discussed here. The two main types of leukaemia are acute and chronic.

Acute leukaemia

In acute leukaemia, symptoms develop rapidly and the leukaemia can quickly become life-threatening if it's not treated. The most common form of acute leukaemia affects lymphocytes. This is called acute lymphocytic leukaemia (ALL). Another type of acute leukaemia is acute myeloid leukaeumia (AML).

Chronic leukaemia

In chronic leukaemia, symptoms develop slowly and the white blood cells are almost fully grown and normal when they leave the bone marrow and enter the bloodstream. They can function, but not as well as they should do.

One type of leukaemia, called chronic myeloid leukaemia (CML), affects a particular type of white blood cells called myeloid cells. It has two phases, a chronic phase that can last for several years, during which symptoms develop slowly, followed by a more aggressive phase (accelerated phase), where symptoms quickly get worse.

Symptoms

The symptoms of leukaemia vary, depending on the exact type of disease and how advanced it is. There may be no symptoms in the early stages, especially in people with chronic leukaemia. Many symptoms are vague, such as fever, headaches, weight loss and night sweats.

Symptoms of leukaemia include:

  • tiredness, breathlessness and pale skin (due to anaemia, a reduction in number of red cells in the blood)
  • frequent infections that do not get better
  • increased bruising
  • abnormal bleeding from gums and cuts
  • heavier periods in women
  • nosebleeds
  • bone pain (due to the pressure of a build-up of cells in the bone marrow)
  • swollen lymph glands (glands in the neck, groin and under the arms)
  • abdominal pain (due to an enlarged spleen or liver)
  • swollen gums, and occasionally, swollen testicles
  • headaches and vision problems

Causes

The exact cause of leukaemia isn't known, although there are some factors that increase the chance of developing it. These include:

  • a weakened immune system - this may be a result of medicines that suppress the immune system (eg medicines to prevent rejection of organ transplants), high doses of radiation (eg radiotherapy or chemotherapy for another cancer), or diseases that affect the immune system (eg HIV)
  • age - chronic leukaemias are more common in people who are over 40
  • gender - slightly more men than women are affected by leukaemia
  • smoking
  • certain genetic conditions, such as Down's syndrome
  • other blood disorders, such as aplastic anaemia, a rare condition where the bone marrow fails to produce blood cells correctly
  • contact with a chemical called benzene, one of the chemicals in petrol and a solvent used in the rubber and plastics industry

Diagnosis

Leukaemia can be diagnosed from a blood test to measure the number of blood cells and look for any abnormal cells. People with suspected leukaemia are referred to a specialist doctor, usually a haematologist (an expert in the treatment of blood disorders).

Other tests are often carried out to investigate the type of leukaemia and how far it has spread. These include:

  • chest X-ray - to check your general health, and also for lumps of cells in the chest, which can occur in some types of leukaemia
  • bone marrow sample - a small sample of bone marrow is taken examined for abnormal white blood cells
  • genetic analysis of the abnormal cells

These tests are all very important because they help guide the treatment.

Sometimes doctors carry out further tests, such as:

  • CT (computerised tomography) scans - these can show enlarged lymph nodes
  • MRI (magnetic resonance imaging) scans - to locate the position of tumours
  • ultrasound - can be done to see if your spleen has been affected by anaemia
  • tissue typing - if your doctor has advised you to have a bone marrow transplant

Diagnosis, investigation, treatment and follow-up for people with leukaemia usually takes place at specialist centres in hospitals.

Treatment

The effectiveness of treatment for leukaemia depends on the type and stage of the disease. Acute leukaemia often goes into remission (the symptoms go away; the disease is under control but not necessarily cured). But many people with acute leukaemia have a relapse (the disease returns). Treatment includes:

  • chemotherapy
  • radiotherapy
  • bone marrow or stem cell transplant
  • monoclonal antibodies
  • biological therapy (which may be in the form of tablets)
  • steroids

Living with leukaemia

Most people feel confused and overwhelmed when they are told they have leukaemia. It's a very distressing time both for them and their families. An important part of cancer treatment is learning how to talk about how you are feeling, and getting support with the physical and emotional symptoms you are experiencing.

For more advanced cancer, you can receive extra support, known as palliative care. Doctors and nurses based in hospitals, hospices and pain clinics specialise in providing the support you need, and can also visit you at home.

Further information

Related topics

Sources

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: February 2008

 

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