Leukaemia

Leukaemia is the name given to a collection of diseases in which immature white blood cells fill up the bone marrow, preventing normal blood cells from being made. The bone marrow becomes crowded with white cells, which also affects the normal growth of red blood cells and platelets. These changes mean that people with leukaemia often feel abnormally tired, are more prone to infection, and may experience bruising and bleeding.

Leukaemia is classified as either acute or chronic and either lymphoid or myeloid.

Acute Leukaemia

Acute leukaemia is characterised by rapid onset and proliferation of abnormal white cells over a short period of time. Regardless of the type of acute leukaemia, the cells affected are immature and do not function well. These immature cells are sometimes referred to as ‘blast cells’. The two main types of acute leukaemia are acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL).

Acute Myeloid Leukaemia (AML)

Acute myeloid leukaemia (AML) & acute promyelocytic leukaemia (APL, which is a specific form of AML) are rare forms of blood cancer. They account for approximately 6.8% of all haematological malignancies with an estimated 2300 patients newly diagnosed in the UK each year. Whilst these diseases can affect people of any age, they tend to be more common after the age of 60.

Acute Lymphoblastic Leukaemia (ALL)

Acute lymphoblastic leukaemia (ALL) is a rare form of blood cancer. It accounts for approximately 2.2% of all haematological malignancies with an estimated 730 patients newly diagnosed in the UK each year. Whilst this disease can affect people of any age, it tends to be more common in children. ALL can be further categorized according to the type of white blood cell affected (B-cell or T-cell). In addition, some patients with ALL have a particular genetic abnormality known as a Philadelphia chromosome which can be identified through further blood and bone marrow tests.

Treatment of Acute Leukaemia

Various combinations of chemotherapy, radiotherapy and possibly stem cell transplantation are used. The combination of treatment an individual patient receives depends on the type of leukaemia they have, their age, general health and stem cell availability.

Chronic Leukaemia

Chronic leukaemia is characterized by an accumulation of abnormal white cells over a long period of time. In contrast to acute leukaemia, the white blood cells appear mature, but do not function as well as normal white cells. The two main types of chronic leukaemia are chronic myeloid leukaemia (CML), and chronic lymphocytic leukaemia (CLL).

Chronic Myeloid Leukaemia (CML)

Chronic myeloid leukaemia (CML) is a rare form of blood cancer, that is sometimes referred to as chronic myelogenous leukaemia. CML accounts for approximately 1.7% of all haematological malignancies with an estimated 570 cases newly diagnosed in the UK each year. Whilst this is a disease which can affect people of any age it tends to be more common in older people, developing slowly over a long period of time.

80-90% of patients with CML have a particular genetic abnormality known as a Philadelphia chromosome, which is identified through further blood and bone marrow tests. CML usually progresses through three distinct phases known as chronic, accelerated and blast transformation (blast crisis). The phases are defined by how severe a person’s symptoms are and the number of abnormal cells in their blood and bone marrow. Most people are diagnosed in the chronic phase which is characterized by very few symptoms and stable disease.

Treatment of Chronic Myeloid Leukaemia (CML)

Treatment depends on the stage of your disease and includes Imatinib and Alpha Interferon. Allogenic stem cell transplantation may be recommended for some patients.

Chronic Lymphocytic Leukaemia (CLL)

Chronic lymphocytic leukaemia (CLL) accounts for approximately 10% of all haematological malignancies, with an estimated 3300 cases newly diagnosed in the UK each year. Whilst this is a disease which can affect people at any age it tends to be more common in older people. CLL develops slowly over many years and treatment is not always required as many individuals with CLL have few or no symptoms.

Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) are a varied group of haematological disorders which carry the risk of transforming to acute leukaemia; their underlying similarity being the impaired production of mature blood cells.

MDS accounts for approximately 6.1% of all haematological malignancies with an estimated 2000 cases newly diagnosed in the UK each year. Whilst these diseases can affect people of any age, they tend to be more common after the age of 60.

The individual disorders making up this diagnostic group include refractory anaemia with ringed sideroblasts, refractory anaemia with excess blasts, and refractory cytopenia with multilineage dysplasia.

Treatment of Myelodysplastic Syndromes (MDS)

No treatment may be needed, and some patients may only need to be monitored by their doctor. Because of the wide variety of MDS types, monitoring and/or treatment varies with the type, severity and stage of disease. MDS stage is determined by the number of abnormal blood cells in the bone marrow, any genetic abnormalities present, and the levels of red cells, white cells and platelets. Once the stage of of disease has been determined, other factors such as general health and age are used to inform the best treatment approach for an individual patient.