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Chronic leukeamia 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, chronic leukaemia and acute leukaemia. The number of people who develop chronic leukaemia or acute leukaemia is about the same.

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

Chronic leukaemia accounts for about one per cent all newly diagnosed cancers in the UK. Each year, there are about 3,000 new cases.

In chronic leukaemia, the white cells become slightly abnormal and do not function as well as they should do. The number of abnormal cells increases less rapidly than it does in acute leukaemia, so the disease gets worse more slowly. Depending on the type of white blood cell affected, chronic leukaemia is called either chronic lymphocytic leukaemia (CLL) or chronic myeloid leukaemia (CML).

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

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

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

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Risks and causes

Depending on the type of white blood cell affected, chronic leukaemia is called either chronic lymphocytic leukaemia (CLL) or chronic myeloid leukaemia (CML). They have slightly different risk factors.

The following things affect a person's chances of developing chronic myeloid leukaemia (CML):

The risk of CML increases with age. It is most common in people aged between 40 and 60.

CML slightly is more common in men than in women.

People exposed to high levels of radiation, for example through radiotherapy for another cancer, are at slightly increased risk of developing CML many years later.

Prolonged exposure to the chemical benzene may slightly increase the risk of CML.

The following things affect a person's chances of developing chronic lymphocytic leukaemia (CLL):

Most cases of CLL occur later in life. It is uncommon in people under 50.

Men are twice as likely to develop CLL as women.

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

A large minority of patients have no symptoms, particularly in the case of chronic lymphocytic leukaemia (CLL). If symptoms are present they will often be vague and non-specific, and may appear like flu.

The following signs may be due to chronic myeloid leukaemia (CML) or chronic lymphocytic leukaemia (CLL):

• abdominal discomfort (this could be the result of an enlarged spleen)
• infections caused by not having enough healthy white blood cells
• fever
• night sweats
• swollen lymph glands
• bone pain
• weight loss
• headaches and vision problems.

In addition to the above symptoms, CLL can also cause:

• tiredness
• anaemia.

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
• Tissue typing
• X-ray

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

• Genetic analysis (to find out the exact type of leukaemia)
• Bone scan
• CT or MRI scans
• Ultrasound scan

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Treatment

The main treatments for chronic leukaemia are:

Doctors will either use a single drug or a combination of drugs to treat chronic leukaemia. Chemotherapy may be used on its own, or in combination with radiotherapy.

If you have chronic lymphocytic leukaemia (CLL) 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. They may be given with chemotherapy, or on their own.

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.

Radiotherapy is sometimes used to treat leukaemia that has spread to the brain and spinal cord. Doctors might also use it in preparation for a bone marrow transplant, or to relieve pain caused by damage to bones that results from the disease.

Doctors sometimes use interferon alpha or monoclonal antibodies for the treatment of chronic leukaemia.

Glivec (imatinib) is a new treatment for chronic myeloid leukaemia. It is a type of biological treatment, and has been developed to target a specific protein produced by CML cells.

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