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Acute leukaemia at a glance

Leukaemia is a cancer of some of the cells that make up the blood - the white blood cells. These are part of the immune system, the body’s defence against infection.

Although leukaemia is the most common form of childhood cancer, it affects three times as many adults as children.

There are two main types of leukaemia, acute leukaemia and chronic leukaemia. The number of people who develop chronic leukaemia or acute leukaemia is about the same.

You can read about chronic leukaemia in a separate section of this website. This section is about acute leukaemia in adults.

Acute leukaemias account for less than one per cent of newly diagnosed cancers in the UK. Each year, there are around 3,000 new cases.

Acute leukaemia can progress very rapidly. Immature white blood cells accumulate in, and interfere with, many different parts of the body. Depending on the type of white blood cell affected, acute leukaemia is called either acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML).

Click on the links below to find out more about acute leukaemia.

• Risks and causes
• Signs and symptoms
• Detection
• Treatment

If you are a patient looking for information on acute leukaemia, please visit our patient information website, CancerHelp UK.

Risks and causes

The following things affect a person's chances of developing acute leukaemia:

Slightly more men than women develop acute leukaemia.

Exposure to high levels of radiation, for example through radiotherapy for another cancer, slightly increases the risk of developing acute leukaemia many years later.

Exposure to the chemical benzene for a long time increases the risk of acute myeloid leukaemia (AML).

Researchers estimate that smoking causes more than 1 in 4 cases of AML.

Treatment for certain other cancers, such as Hodgkin's and non-Hodgkin's lymphomas, or childhood acute lymphoblastic leukaemia (ALL), slightly increases the risk of developing acute leukaemia many years later. However, the benefit of treating a cancer will outweigh the very small risk of leukaemia.

Diseases that damage the bone marrow, such as aplastic anaemia or myelodysplastic syndrome, may increase the risk of leukaemia.

You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.

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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.

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Detection

Initially the doctor will ask questions about previous medical problems, and carry out a physical examination. After referral, a haematologist (a doctor who specialises in diseases of the blood) may carry out specific tests. Some cases of leukaemia are diagnosed quite by chance when a person has a routine blood test for some other reason.

Tests may include:

• A blood test
• A bone marrow test
• Lumbar puncture
• An X-ray
• Genetic analysis (to find out the exact type of leukaemia)

Occasionally, doctors may suggest the following tests, which are not routine:

• Bone scan
• CT or MRI scans
• Ultrasound scan
• Tissue typing

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Treatment

The main treatments for acute leukaemia are:

Doctors will usually give a combination of several drugs to treat acute leukaemia. Generally, chemotherapy for acute leukaemia is given in higher doses than for other cancers.

Your doctor may suggest steroids as part of your treatment. Steroids are substances made naturally in the body. They can also be made artificially and used as drugs. Doctors have found that treatment for ALL is more successful when steroids are given along with chemotherapy drugs.

Doctors may apply radiotherapy to the area of the body where leukaemia cells have accumulated. They might also use it in preparation for a bone marrow transplant.

Doctors may use high-dose chemotherapy or radiotherapy in combination with a bone marrow or stem cell transplant.

Growth factors are natural substances that stimulate the bone marrow to make blood cells. Some of these substances can now be made artificially and given as treatments to increase the number of white blood cells and stem cells in the blood.

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