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Leukemia

Leukemia accounts for only 2% of newly diagnosed cancers in the UK and is more common in men than women. Each year, there are over 6,600 new cases in the UK. Although leukemia is the most common form of childhood cancer, it affects three times as many adults as children. This section is about acute leukemia in adults.
Leukaemia is a cancer of some of the cells that make up the blood. It affects white blood cells, which are part of the body’s defenses against infection. There are two main types of leukemia, acute leukemia and chronic leukemia. Chronic leukemia usually develops slowly. You can read about chronic leukemia in a separate section of this website. The incidence of acute and chronic leukemia is approximately equal.
Acute leukemia can progress very rapidly. Immature white blood cells accumulate in the body and can disrupt the function of many tissues and organs. Depending on what type of white blood cell is affected, acute leukemia is called either acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML).
Risk factors
Gender
slightly more men than women develop acute leukemia.
Radiation exposure
Exposure to high levels of radiation, for example through radiotherapy for another cancer, slightly increases the risk of developing acute leukemia many years later.
Chemical exposure
Exposure to the chemical benzene for a long time increases the risk of AML.
Smoking
Researchers estimate that smoking causes more than 1 in 4 cases of AML.
Previous history of cancer
Treatment for certain other cancers, such as Hodgkin's disease, non- Hodgkin's lymphoma, or childhood acute lymphoblastic leukemia (ALL), increases the risk of developing acute leukemia many years later.
Previous cancer treatment
certain chemotherapy drugs given to treat cancer may increase the risk of developing leukemia later on. However, this is very rare and the benefit of treating a cancer will outweigh the very small risk of leukemia occurring.
Previous blood disorder
Diseases that damage the bone marrow, such as aplastic anemia or myelodysplastic syndrome, may increase the risk of leukemia.
Signs and symptoms
Many symptoms will be vague and non-specific and may appear like flu. Symptoms include:
generalised weakness and fatigue (this may be due to anaemia)
fever
weight loss
frequent infections
excessive bruising
bleeding (of the gums or nose)
blood in the urine or stools
pain in the bones and joints
breathlessness (can be due to anaemia)
Enlarged lymph glands, liver and/or spleen.
Mostly, these signs and symptoms will indicate problems other than cancer. However, people who notice any symptoms should see their doctor. Treatment of leukemia will be more effective the earlier it begins.
Detection
Initially the doctor will ask questions about previous medical problems, and carry out a physical examination. After referral, a hematologist (a doctor who specialists in diseases of the blood) may carry out specific tests. Some cases of leukemia are diagnosed quite by chance when a person has a routine blood test for some other reason.
Tests may include:
Blood test
this will check the number and appearance of the different types of cells in the blood. Any abnormalities may indicate leukemia, but doctors will have to examine the bone marrow to be sure.
Bone marrow test
Lumbar puncture
X-rays
X-rays of the chest can help doctors to find any abnormalities.
Genetic analysis
this can help to find out the exact type of leukemia.
Occasionally, doctors may suggest the following tests, which are not routine:
Bone scan
CT or MRI scans
Tissue typing
Ultrasound scan
In some cases, a bone marrow transplant may be needed. This test will help doctors to find a prospective bone marrow donor whose tissue matches that of the patient as closely as possible.
Treatment
Treatment for acute leukemia can include:
Chemotherapy
Doctors will usually give a combination of several drugs to treat acute leukemia. Generally, chemotherapy for acute leukemia is given in higher doses than for other cancers.
Steroids
Radiotherapy
Doctors may apply radiotherapy to the area of the body where leukemia cells have accumulated. They might also use it in preparation for a bone marrow transplant.
Intensive treatments
Doctors may use high-dose chemotherapy or radiotherapy in combination with a bone marrow or stem cell transplant.
Growth factors

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