It’s true, leukaemia isn’t a single disease.
It’s a group of blood cancers, and the exact type plays a major role in how it’s treated.
Understanding these differences can help patients and families feel more informed and prepared.
Leukaemia is a cancer of the blood and bone marrow, where blood cells are made.
Unlike cancers that start in one organ and spread, leukaemia is usually considered a whole-body, or systemic, disease right from the beginning.
In leukaemia, the bone marrow produces abnormal white blood cells.
These cells don’t work properly and can crowd out healthy cells.
This can lead to:
- Fatigue and weakness (from low red blood cells).
- Easy bruising or bleeding (from low platelets).
- Frequent infections (from a weakened immune system due to low white blood cells).
- Shortness of breath.
- Bone pain or tenderness.
- Swollen lymph nodes.
- Enlarged liver or spleen.
- Fever or chills.
- Unintentional weight loss.
Patients may overlook early leukaemia symptoms because they may resemble symptoms of the flu and other common illnesses.
There are four main types of leukaemia:
- Acute lymphocytic leukaemia (ALL) – the most common type of leukaemia in young children, but it can also occur in adults.
- Acute myeloid leukaemia (AML) – the most common type of acute leukaemia in adults.
- Chronic lymphocytic leukaemia (CLL) – the most common chronic leukaemia in older adults.
- Chronic myeloid leukaemia (CML) – mainly affects adults of various ages.
They’re grouped based on how fast they grow and the type of blood cell involved:
- Acute leukaemias develop quickly and need urgent treatment.
- Chronic leukaemias grow more slowly and may not need treatment right away.
- Lymphocytic leukaemias affect lymphocytes, a type of white blood cell involved in the immune system.
- Myeloid leukaemias affect cells that develop into red blood cells, platelets and other types of white blood cells.
Each type – and even subtypes within them – can behave quite differently.
For example, some people may have a slow-growing form of CLL that may not need treatment for years, while others may have a faster-growing subtype that requires treatment soon after diagnosis.
Diagnosis often begins with a routine blood test that shows abnormal cell counts.
If leukaemia is suspected, a bone marrow biopsy – taking a small sample from the hip bone – is usually needed to confirm the diagnosis.
From there, more detailed testing is done, including:
- Flow cytometry to identify cell types.
- Cytogenetics to study chromosomes.
- Molecular testing to look for genetic changes.
Accurate diagnosis is essential because different types of leukaemia require different treatments.
ALSO READ: Acute myeloid leukaemia: New test improves survival time
Some therapies only work for certain genetic markers, and the expected outcome can vary widely.
These tests allow doctors to match patients with therapies that target their specific disease, making leukaemia treatment highly individualised.
Treatment may include:
- Chemotherapy – a drug treatment that uses powerful chemicals to kill fast-growing cells in your body.
- Targeted therapy – a treatment that uses medicines that attack specific targets in the cancer cells.
- Immunotherapy – treatments that help the immune system fight cancer.
These include CAR-T (chimeric antigen receptor T) cell therapy – engineered immune cells that attack cancer cells – and bispecific antibodies that help immune cells find cancer cells.
- Stem cell transplantation – a treatment that replaces diseased bone marrow with healthy cells, often using donor cells.
ALSO READ: What is CAR-T cell therapy?
When deciding the best treatment, doctors consider several factors, including:
- The exact type and subtype of leukaemia.
- Genetic and molecular test results.
- How quickly the disease is progressing.
- The patient’s age and overall health.
- The patient’s personal preferences.
ALSO READ: What young cancer survivors care about
The future of leukaemia treatment is focused on precision medicine – tailoring treatments to the genetic makeup of each patient’s leukaemia – and improving long-term outcomes with fewer side effects.
With advances in testing and therapy, care is becoming more personalised than ever, offering hope for even better results in the coming years. – By Dr William Hogan/Mayo Clinic News Network/Tribune News Service
Dr William Hogan is a haematologist in the United States.
