Leukaemia — cancer of blood-forming cells
Leukaemia is malignancy of haematopoietic stem cells in bone marrow — abnormal white cells crowd out normal blood production.
~10,000 UK cases/year — only cancer more common in children than adults proportionally — ALL peak age 2–5.
Types overview
| Type | Cell line | Pace | Typical age |
|---|---|---|---|
| ALL | Lymphoid | Acute | Children, also adults |
| AML | Myeloid | Acute | Adults, some teens |
| CLL | Lymphoid | Chronic | Older adults |
| CML | Myeloid | Chronic | Middle age |
How leukaemia affects the body
Marrow failure:
- Anaemia → fatigue, breathlessness
- Thrombocytopenia → bruising, bleeding
- Neutropenia → infection risk
Leukaemic infiltration:
- Bone pain
- Hepatosplenomegaly
- Lymphadenopathy
Red flags for GP
NICE 2-week wait haematology:
- Persistent unexplained blood count abnormality
- Blood film suggesting leukaemia
- Splenomegaly with cytopenia
Children — parent concern:
- Pallor + bruising + limp
- Recurrent infections
Diagnosis pathway
- FBC + film
- Urgent haematology
- Bone marrow — aspirate + trephine
- Immunophenotyping, genetics
- Staging — lumbar puncture in ALL — CNS involvement
Treatment by type
ALL
- Induction → consolidation → maintenance — 2–3 years children
- CNS prophylaxis
- CAR-T — relapsed/refractory
AML
- Intensive chemo — age/fitness dependent
- Transplant — high-risk genetics
CLL
- Watch and wait if asymptomatic
- Chemoimmunotherapy or targeted agents when symptomatic — B symptoms, marrow failure, bulky nodes
CML
- Tyrosine kinase inhibitors — imatinib first line
- Excellent long-term control — near-normal lifespan many patients
Living through treatment
Neutropenic sepsis — temperature 37.5°C once during chemo — 999 or emergency unit — don’t wait
Fertility — ** sperm/egg storage before treatment**
Late effects — children — growth, heart, second cancers — long-term follow-up
Unexplained bruising + fatigue — GP blood test this week — not rare in busy lives — rare disease needs early pick-up.
Common questions about leukaemia
- What are the symptoms of leukaemia?
- Fatigue and breathlessness (anaemia), frequent or severe infections (low normal white cells or dysfunctional leukaemic cells), easy bruising and bleeding (low platelets), bone or joint pain, swollen lymph nodes, enlarged spleen causing fullness after eating, night sweats, weight loss, fever. Acute leukaemia symptoms worsen over weeks; chronic may be silent early.
- What is the difference between acute and chronic leukaemia?
- Acute — immature blast cells multiply rapidly — ALL and AML — need immediate chemotherapy. Chronic — mature but abnormal cells accumulate slowly — CLL and CML — some patients monitored without treatment for years until symptoms or counts warrant therapy.
- How is leukaemia diagnosed?
- Full blood count shows high white cells (or sometimes low), low haemoglobin, low platelets. Blood film shows blasts. Bone marrow aspirate and biopsy confirms type and genetics — guides treatment. Flow cytometry, cytogenetics, molecular tests (BCR-ABL in CML, Philadelphia chromosome).
- How is leukaemia treated?
- Chemotherapy mainstay — intensive multi-drug regimens for acute leukaemia. Targeted drugs — imatinib for CML, venetoclax for CLL. Immunotherapy — CAR-T cells for some relapsed ALL. Stem cell transplant for high-risk disease. Radiotherapy to spleen or brain if needed. Supportive care — transfusions, antibiotics, G-CSF.
- Can leukaemia be cured?
- Many childhood ALL patients cured. Adult acute leukaemia — cure possible in selected patients. CLL often managed as chronic disease — not always curable but long survival. CML controlled long-term with tyrosine kinase inhibitors in most cases.
Sources
How we reviewed this page
Medically reviewed by the HealthAnswers UK doctor review panel
- First published
- Medically reviewed
- Next review due
- or sooner if NHS or NICE guidance changes
Written by HealthAnswers editorial team. Published by HealthAnswers (Elite Digital AI Solutions Ltd). How we review content · Report a problem with this page