Leukaemia is a cancer that affects the blood and bone marrow.

Every day billions of cells are produced in the bone marrow. In people with leukaemia, the body starts producing an excess of white blood cells, many of which do not mature properly but live beyond their normal lifespan.

Despite their excess numbers, these immature leukaemic cells are not able to fight infection the way normal white cells would. As they accumulate, they interfere with organ function, including the production of healthy blood cells. They ‘crowd’ the bone marrow resulting in less production of red cells and platelets, which affects the transport of oxygen, the clotting process and the production of enough healthy white cells to fight infection.

With regards to leukemia’s causes, experts are not entirely sure about them, but risk factors include:

  • Radiation exposure
  • Smoking
  • Exposure to certain chemicals, such as benzene and formaldehyde
  • Genetics
  • Children with Down’s syndrome are also at greater risk of developing leukaemia.

Leukaemia is the most common cancer in children.

What are its symptoms?

In its early stages, leukemia’s symptoms may not always be that obvious and will depend on whether the leukaemia is acute (cells continue to develop aggressively) or chronic (cells develop progressively).

Symptoms include:

  • Anaemia and its related symptoms, including fatigue, paleness
  • Poor blood clotting, which causes bruising or bleeding from the nose or gums
  • Swollen lymph nodes, especially in the throat, groin or armpit
  • Loss of appetite and/or weight
  • Increased susceptibility to infections
  • Discomfort in the area below the left rib cage (caused by an enlarged spleen)
  • Headache
  • In advanced stages, symptoms may include high temperature, confusion, seizures, inability to move limbs or talk, altered state of consciousness.

How is it diagnosed?

Leukaemia is diagnosed by examining the blood and bone marrow under a microscope. Tests include:

  • Blood tests: Leukaemia may be suspected if the blood shows large numbers of abnormal white blood cells, and low numbers of normal white blood cells, red blood cells and platelets.
  • Bone marrow biopsy: A small amount of fluid is collected from the bone marrow and a small core of bone marrow is also taken.
  • Lymph node biopsy: If the lymph nodes are enlarged, tissue may be taken from the affected lymph node.
  • Lumbar puncture: A fine needle is placed in between the bones in the lower back and fluid is removed from around the spine.

What are your treatment options?

The aim of leukemia treatment is to destroy the leukemia cells in order for normal cells to form in the bone marrow.

Treatment options will depend on the type of leukemia, its stage, your general health and age.

Treatment of leukemia generally involves:

  • Chemotherapy
  • Radiation therapy
  • Immunotherapy: a treatment that uses your body’s own immune system to help fight cancer
  • Bone marrow transplant (The cells in the bone marrow that make new cells are known as stem cells.)

Acute leukemia should be treated as soon as it is diagnosed, the goal being to induce remission as soon as possible. Maintenance therapy follows.

The prognosis for chronic leukemia is different, with treatment aimed at controlling the cancer and managing the symptoms. Chronic leukemia sufferers may be candidates for bone marrow stem cell transplant, which does offer a better chance for a cure.

Can it be prevented?

There is no known way to prevent most types of leukemia, but some may be prevented by avoiding high doses of radiation, certain types of chemotherapy, preventing chemical benzene exposure, and avoiding smoking.

For more info
Cancer Association of South Africa 
Childhood Cancer Foundation South Africa – CHOC

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2015
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