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Leukaemia



about this glossary tool

Leukaemias (or leukemias - U.S. spelling) are cancers of the white blood cells, which begin in the bone marrow. This information refers to four types of leukaemia; acute lymphocytic leukaemia, chronic lymphocytic leukaemia, acute myeloid leukaemia and chronic myeloid leukaemia.

Leukaemias are grouped in two ways: the type of white blood cell affected – lymphoid or myeloid; and how quickly the disease develops and gets worse – acute leukaemia appears suddenly and grows quickly while chronic leukaemia appears gradually and develops slowly over months to years.


Incidence and mortality

In 2012, 2812 people in Australia were diagnosed with leukaemia. Chronic lymphocytic leukaemia is the most common type of leukaemia in Australia, in 2012 1161 people were diagnosed. There were 955 people diagnosed with acute myeloid leukaemia, 341 with chronic myeloid leukaemia and 355 with acute lymphocytic leukaemia.

In 2013, there were 1367 deaths due to these four cancer types. Acute myeloid leukaemia caused the most deaths, with 843 deaths. Chronic lymphocytic leukaemia caused 319 deaths, chronic myeloid leukaemia caused 104 deaths and acute lymphocytic leukaemia caused 101 deaths.


Screening

There is no routine screening test for leukaemia.


Symptoms and diagnosis

Many people with leukaemia have no symptoms. Symptoms tend to be mild at first and worsen slowly.

The main symptoms include:

  • tiredness and/or anaemia (pale complexion, weakness and breathlessness)
  • repeated infections (mouth sores, sore throat, fevers, sweats, coughing, frequent passing of urine with irritation, infected cuts and scratches, and boils)
  • increased bruising and bleeding.

Other less common symptoms include:

  • bone pain
  • swollen tender gums
  • skin rashes
  • headaches
  • vision problems
  • vomiting
  • enlarged lymph glands
  • enlarged spleen that may cause pain or discomfort
  • chest pains.

An initial blood test will show if blast cells are present. A bone marrow biopsy, chest x-ray and lumbar puncture are done to confirm diagnosis and the type of leukaemia.


Staging

Chest x-ray, CT scan and lumbar puncture determine if the leukaemia has spread. Cytogenetic analysis also may be used, to look for chromosomal changes.

For acute myeloid leukaemia and acute lymphoblastic leukaemia there is no standard staging system; the disease is described as untreated, in remission, or recurrent.

Staging of chronic myelogenous leukaemia is described in three phases:

  • chronic – a few blast cells are found in the blood and bone marrow
  • accelerated – after a few years the leukaemia may suddenly change and grow quicker
  • blast – the number of blast cells increases, causing symptoms to worsen. Blast cells often spread to other organs.

Chronic myelogenous leukaemia is described as stage 0 to IV, determined by the lymphocytes in the blood, size of lymph nodes and organs such as liver and spleen (larger = higher stage) and impact on red blood cells and platelets (fewer = higher stage).


Causes

The cause of acute leukaemia is unknown, but factors that put some people at higher risk are:

  • exposure to intense radiation
  • exposure to certain chemicals, such as benzene
  • viruses like the Human T-Cell leukaemia virus.

Most people diagnosed with chronic myeloid leukaemia have an abnormal chromosone called the Philadelphia chromosone. It has also been linked to exposure to high levels of radiation.


Prevention

There are no proven measures to prevent leukaemia.


Treatment

Treatment depends on the type of leukaemia. Acute leukaemias develop quickly and need to be treated urgently, typically within 24 hours of diagnosis.

Common treatment options are:

Acute lymphoblastic leukaemia

  • chemotherapy
  • peripheral blood stem cell and bone marrow transplantation
  • radiotherapy to the head
  • steroid therapy.

Acute myeloid leukaemia

  • chemotherapy
  • peripheral blood stem cell and bone marrow transplantation
  • radiotherapy to the head.

Chronic lymphoblastic leukaemia

  • watchful waiting
  • radiation therapy
  • chemotherapy (chemotherapy with stem cell transplant is being tested in clinical trials)
  • surgery (removal of spleen)
  • monoclonal antibody therapy.

Chronic myeloid leukaemia

  • tyrosine kinase inhibitory therapy
  • chemotherapy
  • biologic therapy
  • high-dose chemotherapy with stem cell transplant
  • donor lymphocyte infusion
  • surgery (removal of spleen).

Prognosis

An individual's prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. For most children and many adults who achieve remission, the leukaemia may be cured with peripheral blood stem cell or bone marrow transplantation and chemotherapy. In Australia, the five year survival rate for chronic lymphocytic leukaemia is around 73%, for acute myeloid leukaemia it is 24%.

For more information, contact Cancer Council 13 11 20 (cost of a local call).

1) Excluding non-melanoma skin cancer, which is the most commonly diagnosed cancer according to general practice and hospitals data, however there is no reporting of cases to cancer registries.

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For more information

Sources

  • Australian Institute of Health and Welfare 2012. Cancer survival and prevalence in Australia: period estimates from 1982 to 2010. Cancer Series no. 69. Cat. no. CAN 65. Canberra: AIHW.
  • Australian Institute of Health and Welfare. ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW.
  • Australian Institute of Health and Welfare & Australasian Association of Cancer Registries 2012. Cancer in Australia: an overview, 2012. Cancer series no. 74. Cat. no. CAN 70. Canberra: AIHW.

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This page was last updated on: Wednesday, May 25, 2016