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Reviewed by Dr Rachel Green, consultant haematologist
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What is leukaemia?
Leukaemia, or blood cancer, is a disease of unknown cause where
the bone marrow produces large numbers of abnormal cells. This means that the
normal marrow is pushed into smaller and smaller areas, which results in fewer
cells being produced and leads to some of the symptoms listed
below.
There are many types of leukaemia and each of them is classified
according to the exact cell type affected by the disease.
Chronic leukaemia is
a slowly progressive form of leukaemia and tends to involve more mature cell
types.
Acute leukaemia is rapidly progressive if not treated and
involves more immature cells. It develops rapidly from the earliest forms of
cells in the immature bone marrow cells (blasts). It requires urgent medical
treatment but is generally responsive to chemotherapy.
Acute leukaemia is a rare disease that is more common in
children and young people. However, their survival rate is better than in older
people.
What are the symptoms of acute leukaemia?
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Sudden appearance of symptoms.
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An unnaturally pale complexion (anaemia).
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Fatigue.
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Pain in the joints. When children are affected, this is
sometimes mistaken for growing pains.
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Repeated infections, such as
sore
throats.
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Acute leukaemia is also usually accompanied by
nosebleeds and
bruising easily, often without any kind of blow or fall.
If any of the above symptoms develop, it is advisable to consult
a doctor. Parents are understandably afraid of leukaemia, but fortunately, the
diagnosis often turns out to be something else entirely, as many other diseases
have similar symptoms.
How is acute leukaemia diagnosed?
Many forms of leukaemia can be diagnosed by
blood tests.
Commonly, the acute leukaemia cell (blasts) can be seen circulating in the
blood.
A bone marrow test will also be performed to diagnose the type
of cells involved, as this can help doctors decide on the best choice of
treatment.
Acute leukaemia is usually easy to diagnose.
How is acute leukaemia treated?
Most patients with acute leukaemia will be referred to
specialist units for investigation and treatment.
These days, medical treatments are extremely effective and an
ever-increasing number of
children and young
people recover completely.
Treatment is usually with
chemotherapy
given through the veins. In most cases, chemotherapy is given in courses over
four to six months. Each course lasts four to five days. Chemotherapy kills all
fast dividing cells and this includes normal body cells as well as cancer
cells.
The normal bone marrow is sensitive to chemotherapy and the
blood counts may drop, making the patient vulnerable to infection and bleeding.
This generally means that the patient has to remain in hospital for weeks
following chemotherapy. However the blood counts will recover over time. Blood
transfusions are likely to be given during this vulnerable period.
Chemotherapy can lead to hair loss, nausea, vomiting and
diarrhoea. Doctors will give medicine to prevent or reduce the vomiting and
diarrhoea. Hair loss is not permanent and hair re-grows after three to four
months.
Sometimes a bone marrow transplant will also be recommended by
the doctor. This is a way of giving larger doses of treatment. It is a very
aggressive form of treatment and so is only recommended for young, fit
patients. The cells used for this sort of treatment may be the patient's
own, donated by a brother or sister or by an unrelated donor.
The medical treatment can be unpleasant. Recognising this,
specialised hospital staff are trained to give as much help and support to
patients as possible.
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Based on a text by Dr Per Grinsted
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Last updated 01.05.2005
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