Leukaemia: Types, Symptoms, Diagnosis, Treatment

Leukaemia is a form of blood cancer that develops when immature white blood cells in the bone marrow multiply uncontrollably. These abnormal cells swarm the healthy cells that are trying to develop into healthy red blood cells, white blood cells and platelets. As a result, the body may not receive enough oxygen for its organs and tissues to operate effectively, and it may also be unable to fight off infections or create blood clots when needed.

In 2020, leukaemia accounted for 4% of all newly diagnosed cancer cases in Malaysia, making it the ninth most common cancer in the country.

What are the types of leukaemia?

There are four primary forms of leukaemia:

• Acute lymphocytic leukaemia (ALL)
• Acute myeloid leukaemia (AML)
• Chronic lymphocytic leukaemia (CLL)
• Chronic myeloid leukaemia (CML)

Acute leukaemia vs. chronic leukaemia

Leukaemia can be classified as acute or chronic based on how mature the majority of the cells are.

Acute leukaemia develops when bone marrow cells do not mature properly but continue to multiply and accumulate. Without treatment, most patients would not live more than a few months. However, some forms of acute leukaemia that respond well to treatment can be cured.

Chronic leukaemia cells mature partly and live longer than normal cells, eventually accumulating and crowding out normal bone marrow cells. Although chronic leukaemia symptoms may not appear for years, it is typically more challenging to treat than acute leukaemia.

Lymphocytic leukaemia vs. myeloid leukaemia

Leukaemia is also classified according to the bone marrow cells that the cancer started in.

Myeloid leukaemia begins in early myeloid cells, which are precursors to white blood cells (except lymphocytes), red blood cells or platelet-making cells. Myeloid leukaemia is also referred to as myelogenous, myelocytic or non-lymphocytic leukaemia.

Lymphocytic leukaemia begins in cells that develop into lymphocytes. It is also referred to as lymphoid or lymphoblastic leukaemia. While both lymphocytic leukaemia and lymphomas begin in the same cells, leukaemia is mostly concentrated in the bone marrow and blood, whereas lymphoma typically affects the lymph nodes and other tissues.

What are the risk factors for developing leukaemia?

Risk factors of the main types of leukaemia include:

• Exposure to radiation
• Exposure to industrial chemicals
• Family history of leukaemia
• Certain genetic disorders

What are the signs and symptoms of leukaemia?

Leukaemia causes deficiencies in healthy blood cells because leukaemia cells crowd out normal blood-producing cells in the bone marrow. This could then cause symptoms such as:

• Pale skin
• Bruises (or small purple or red spots) on the skin
• Fatigue, weakness, or light-headedness
• Shortness of breath
• Persistent or recurring infections
• Bleeding (observed as bleeding gums, severe or frequent nosebleeds or heavy menstrual bleeding)

Other typical leukaemia symptoms include:

• Fever
• Chills
• Night sweats
• Weight loss
• Feeling full after consuming a small amount of food
• Swelling of the lymph nodes (felt as lumps under the skin)

While these symptoms may not necessarily be caused by leukaemia, it is important to consult a doctor if any pain or discomfort persists or worsens.

How do doctors diagnose leukaemia?

Doctors would typically assess that patient’s medical history and perform a physical assessment to check for any enlarged lymph nodes, bruising, areas of bleeding or signs of an infection. A blood test may also be required to examine the levels of blood cells.

Other diagnostic tests include:

• Blood cell examination to check for leukaemia cell markers.
• Blood marrow aspiration to confirm a leukaemia diagnosis by drawing liquid bone marrow to be tested.
• Bone marrow biopsy to confirm a leukaemia diagnosis by using a needle to collect a small sample of bone marrow to be tested.
• Imaging tests to determine the spread of leukaemia to other parts of the body.
• Lumbar puncture (spinal tap) to check if leukaemia has spread to the brain or spinal cord by collecting a sample of cerebrospinal fluid from the lower back over the spine.

Learn more about the different types of screening and diagnostic procedures performed to diagnose leukaemia.

How is leukaemia treated?

The course of treatment for leukaemia is determined by the type and extent of cancer, as well as the age and general health of the patient.

Treatments typically include:

• Chemotherapy, which uses drugs to kill leukaemia cells or slow their growth.
• Immunotherapy, which uses certain drugs immune system’s ability to fight leukaemia.
• Targeted therapy, which uses drugs that target and attack specific parts of a leukaemia cell to kill the cells or prevent them from multiplying.
• Radiation therapy, which employs high-energy radiation to kill leukaemia cells or restrict their growth.
• Haematopoietic cell transplant (stem cell or bone marrow transplant), which provides new, to replace the cancerous blood-forming cells killed by chemotherapy or radiation therapy. These new, healthy new cells can proliferate and develop more bone marrow and blood cells.
• Chimeric antigen receptor (CAR), T-cell therapy, which involves collecting T-cells (infection-fighting cells) from the body, modifying them to combat leukaemia cells and reintroducing them into the body.

Learn more about the different types of treatment technologies to treat leukaemia.

What can I do to reduce the risk of developing leukaemia?

While leukaemia cannot be prevented, leading a healthy lifestyle may be helpful.

As doctors learn to treat tumours without increasing the risk of secondary leukaemia, the obvious advantages of treating life-threatening tumours with chemotherapy and radiation therapy should be assessed against the small possibility of developing secondary leukaemia.

On the other hand, staying away from industrial chemicals like benzene may reduce your risk of developing leukaemia. However, experts agree that only a small amount of leukaemia is possibly linked to industrial exposure to these chemicals.

Do I need to get screened for leukaemia?

There are currently no available routine screening tests for leukaemia. The disease is occasionally discovered from abnormal blood test results. Nonetheless, the best strategy to detect leukaemia early is to notify the doctor of any potential symptoms as soon as possible.

Make an appointment at Pantai Hospitals

Early detection of leukaemia makes it easier to treat the disease with effective and appropriate treatment. A dedicated multidisciplinary team of specialists and oncologists at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through screening, diagnosis, and treatment.

Get in touch with us to book an appointment today if you have any concerns or questions about leukaemia treatment options.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.