Comprehensive Guide to Leukaemia: Types, Symptoms, and Treatment Options

Leukaemia is a type of cancer that affects the blood and bone marrow, which are responsible for producing blood cells. Unlike other cancers that form solid tumours, leukaemia causes an overproduction of abnormal white blood cells. These cells do not function properly and crowd out healthy cells, impairing the body's ability to fight infections and produce red blood cells and platelets. This disease can develop suddenly (acute) or progress slowly over time (chronic), depending on the type of leukaemia.

Importance of Understanding Leukaemia for Early Diagnosis and Treatment

Globally, leukaemia affects millions of people each year, and while it can occur at any age, certain types are more common in specific age groups. According to the World Cancer Research Fund, leukaemia accounts for about 474,000 new cases annually, making it a prevalent form of cancer worldwide.

Leukaemia often goes undiagnosed in its early stages due to vague symptoms such as fatigue, frequent infections, or bruising. By being aware of the signs and understanding the different types of leukaemia, individuals and healthcare professionals can recognise the disease sooner. And it may lead to more successful treatment outcomes. Early diagnosis can make a significant difference, especially for acute forms of leukaemia, which can progress rapidly.

Types of Leukaemia

1. Acute Lymphocytic Leukaemia (ALL)

• Characteristics - Acute Lymphocytic Leukaemia is a fast-growing cancer that affects the lymphoid cells, a type of white blood cell responsible for immune function. In ALL, the bone marrow produces too many immature lymphocytes (a type of white blood cell), which crowd out healthy blood cells.
• Who It Affects - ALL is most common in children, accounting for about 75% of all childhood leukaemia cases. However, it can also occur in adults, although it is less frequent.
• Prognosis - Thanks to advancements in paediatric cancer treatment, the prognosis for children with ALL has improved significantly, with cure rates approaching 90% in children. The prognosis for adults is generally less favourable but varies depending on age, health, and how well the disease responds to treatment.

2. Chronic Lymphocytic Leukaemia (CLL)

• Characteristics- Chronic Lymphocytic Leukaemia progresses more slowly than ALL and primarily affects older adults. In CLL, abnormal lymphocytes build up over time and can cause symptoms like swollen lymph nodes, fatigue, and frequent infections. Many patients with CLL may not experience symptoms for years, as the disease can remain dormant in its early stages.
• Who It Affects - CLL primarily affects adults over the age of 60 and is more common in men than women. It is the most common type of leukaemia in adults, particularly in Western countries.
• Prognosis - The prognosis for CLL varies widely depending on the stage of the disease at diagnosis. For early-stage CLL, the outlook is generally good, with many patients living for many years without needing treatment. However, advanced-stage CLL can be more challenging to manage, though new targeted therapies have improved outcomes.

3. Acute Myeloid Leukaemia (AML)

• Characteristics - Acute Myeloid Leukaemia is an aggressive cancer that affects the myeloid cells, which develop into red blood cells, white blood cells, and platelets. In AML, immature myeloid cells accumulate in the bone marrow, interfering with the production of normal blood cells. The rapid progression of AML requires prompt treatment to prevent serious complications.
• Who It Affects - AML can occur at any age but is most common in older adults, particularly those over 65. Exposure to certain chemicals, previous chemotherapy, and genetic factors can increase the risk of developing AML.
• Prognosis- AML has a lower overall survival rate compared to other forms of leukaemia, particularly in older adults. The prognosis depends on factors such as the patient’s age, overall health, and the specific genetic mutations involved. Treatment for AML is often intensive, involving chemotherapy and sometimes bone marrow transplants.

4. Chronic Myeloid Leukaemia (CML)

• Characteristics - Chronic Myeloid Leukaemia is a slow-growing cancer that affects the myeloid cells. CML is unique in that it is associated with a specific genetic mutation called the Philadelphia chromosome. This mutation leads to the production of an abnormal enzyme that causes the overproduction of white blood cells.
• Who It Affects - CML primarily affects adults and is rare in children. Most people diagnosed with CML are over the age of 50. The development of targeted therapies, specifically drugs known as tyrosine kinase inhibitors, has revolutionised the treatment of CML, turning what was once a fatal disease into a manageable condition for many patients.
• Prognosis- The prognosis for CML has improved dramatically with the advent of TKIs, allowing many patients to live near-normal lives with long-term remission. In fact, patients who respond well to these treatments can have a life expectancy close to that of the general population.

Symptoms of Leukaemia

The symptoms of leukaemia can vary depending on the type and progression of the disease. Common symptoms include

• Fatigue and weakness
• Frequent infections
• Unexplained bruising or bleeding
• Swollen lymph nodes
• Fever and night sweats
• Bone or joint pain
• Weight loss

These symptoms can often be mistaken for other illnesses, making early diagnosis challenging. However, if any of these symptoms persist, it is crucial to seek medical advice for further testing.

Treatment Options for Leukaemia

1. Chemotherapy- Chemotherapy is one of the most common treatments for leukaemia. It involves using drugs to kill cancerous cells or stop their growth. Chemotherapy can be administered orally or intravenously, depending on the type and stage of the disease.

2. Targeted Therapy- Targeted therapies, like TKIs used in CML treatment, focus on specific genetic mutations that cause leukaemia cells to grow uncontrollably. These therapies are less likely to harm healthy cells and have transformed the prognosis for many patients.

3. Radiation Therapy- Radiation therapy uses high-energy rays to destroy cancer cells. It may be used in combination with other treatments or when leukaemia has spread to other parts of the body.

4. Bone Marrow Transplant- In some cases, patients may require a bone marrow transplant (also known as a stem cell transplant) to replace diseased bone marrow with healthy donor cells. This treatment is often used for patients with high-risk or relapsed leukaemia.

5. Immunotherapy- Immunotherapy helps the body's immune system recognise and destroy cancer cells. This emerging treatment option is showing promise, particularly in patients with difficult-to-treat forms of leukaemia.

Leukaemia is a complex and varied disease, with different types affecting individuals based on age, genetics, and other risk factors. While the prognosis can vary depending on the type and stage of leukaemia, advancements in treatment are offering new hope to patients worldwide.