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Acute leukaemiaPublished by BUPA's health information team, healthinfo@bupa.com, February 2008. This factsheet is for people who have acute leukaemia, or who would like information about it. Acute leukaemia is a cancer of the blood that can spread very rapidly. There are two types of acute leukaemia, depending on the type of cells affected: acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML).
About acute leukaemiaThe 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. There are two main types of leukaemia: acute leukaemia and chronic leukaemia. For more information about leukaemia in general, please see Related topics. According to Cancer Research UK, 2,800 people are diagnosed with acute leukaemia each year. This accounts for less than one percent of newly diagnosed cancers in the UK. Acute leukaemia tends to affect very young children or older adults. The symptoms develop rapidly, and it can quickly become life-threatening if not treated. Types of acute leukaemiaThere are two types of acute leukaemia, depending on the type of white blood cells affected. The bone marrow produces two main types of white blood cells - lymphocytes and myelocytes - which work together to fight off infections. These two main types of acute leukaemia are as follows. Acute lymphoblastic leukaemia (ALL)This type is when too many immature lymphocytes (sometimes called lymphoblasts) are produced. These fill up the bone marrow so that not enough normal blood cells can be made. ALL is most common in children aged around four or five and in adults aged around 50. Acute myeloid leukaemia (AML)This type is when too many immature myeloid cells are produced. These fill up the bone marrow so that not enough normal blood cells can be made. SymptomsThe symptoms of acute leukaemia are due to a lack of healthy white blood cells, red blood cells and platelets. Many of the symptoms of acute leukaemia may be vague and seem like those of the flu. If you have any of these symptoms you should see your doctor, but it's important to remember that they may indicate other illnesses apart from acute leukaemia. Symptoms of acute leukaemia may include:
CausesSome of the risk factors for developing acute leukaemia are as follows.
DiagnosisDiagnosis, investigation, treatment and follow-up for people with leukaemia usually take place at specialist centres in hospitals. People with suspected leukaemia are referred to a specialist doctor, usually a haematologist - a doctor that specialises in the treatment of blood disorders. Tests that are often carried out to investigate the type of leukaemia and how far it has progressed include:
Other tests that your doctor may carry out include:
These tests are all very important because they help determine which treatment is best for you. TreatmentChemotherapyChemotherapy is the first and main treatment used to destroy the abnormal white blood cells in acute leukaemia. If you are having chemotherapy for acute leukaemia, you will probably need to stay in hospital. This is because it's a very demanding treatment - larger doses of chemotherapy drugs are needed for acute leukaemia than for other types of cancer. For acute leukaemia, you will need to have a mixture of chemotherapy drugs, as this has been shown to work better than just one drug on its own. You will normally have these different drugs in cycles, with a rest period in between. There are over 50 chemotherapy drugs, all with slightly different side-effects. Your doctor will give you advice about the side-effects of your specific chemotherapy drugs, and may prescribe medicines to help reduce any side-effects. Hair may fall out during treatment but it re-grows once the chemotherapy has stopped. Central lineThe chemotherapy drugs are usually fed into a vein and they travel through your bloodstream to nearly all parts of your body. Because people with leukaemia need to have so much treatment, sometimes a central line can be used to deliver the chemotherapy drugs to the bloodstream. A central line is a long plastic tube that leads to a large blood vessel near the heart. The only part of the tube you can see is where it runs out through a small hole in your chest. A central line can be useful because it means you don't have to have a new drip every time you need a dose of chemotherapy. RadiotherapyThe only parts of the body chemotherapy drugs don't reach so well are the brain, spinal cord and, in men, the testes. Radiotherapy may be used to get to the places that the chemotherapy can't reach. Remission and relapseThe 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). However, many people with acute leukaemia have a relapse (the disease returns). If the leukaemia returns (relapses), you may need more intensive treatment. This involves a bone marrow or a stem cell transplant. Bone marrow or stem cell transplants allow much higher doses of chemotherapy to be given. Bone marrow or peripheral stem cell transplantA bone marrow transplant is where healthy bone marrow - either from another person (normally a close relative) or from your own bones - is fed into your bloodstream through a drip. High doses of chemotherapy and sometimes radiotherapy are given before the transplant to destroy all the existing bone marrow, both abnormal and normal. This improves the chance of completely curing the leukaemia. Peripheral blood stem cell transplantPeripheral blood stem cell transplant involves transplanting stem cells (the most basic type of cell, from which all types of blood cells develop), rather than bone marrow cells. Stem cells can be collected (harvested) from your own blood or from another person. New treatmentsThere are some new treatments available, some of which are currently still being tested in clinical trials. Many people with leukaemia take part in clinical trials as new treatments are constantly changing. Your doctor can give you more information about these trials. Further information
Sources
Related topics
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. Expected review date: February 2010.
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