Leukaemia

Question 1

What is Leukaemia?

Answer 1

A cancer of the blood cells. The blood cells begin to grow before reaching maturity. This means that the ‘leukaemic’ or abnormal cells outnumber the normal blood cells

Question 2

Leukaemia classification

Answer 2

MYELOID ORIGIN

LYMPHOID ORIGIN

Question 3

Symptoms of leukaemia

Answer 3

Fevers, frequent infections
Night sweats
Fatigue (feeling tired or washed out), pallor, confusion, headaches, blurred vision, shortness of breath
Weight loss
Easy bleeding or bruising, gum bleeding
Less common - swellings, bone pain, other pain.

Question 4

Diagnosis of leukaemia

Answer 4

Full blood count and blood film
Biochemistry (kidney/liver function tests, haemolysis)
Bone marrow biopsy
Immunophenotyping and genetic analysis
Chest x-ray
Lumbar puncture

Question 5

Treatment of leukaemia

Answer 5

Transfusions

Chemotherapy

Steroid therapy

Growth factors

Radiotherapy

Bone marrow/stem cell transplant

Question 6

Chemotherapy for leukaemia

Answer 6

Kill leukaemia cells – intensive - tablets or injection.

Induction - first part. Several blocks each lasting a
few days with several weeks rest in between.

Question 7

Transfusions

Answer 7

Red blood cells (from leukaemia and/or chemo)

Platelets

Plasma (only if bleeding or coagulopathy)

Question 8

Radiotherapy of leukaemia

Answer 8

Kill any cells in the CNS that may have survived chemotherapy (blood/brain barrier).

May be given as a preventative treatment to the brain and spine

Question 9

Bone marrow/stem cell transplant

Answer 9

Intensive chemotherapy +/- total body irradiation
Also kills healthy bone marrow cells including stem cells. To survive - a bone marrow or stem cell transplant is given.
Transplant is given like a transfusion.
Allogeneic (close relative e.g. brother or sister or an unrelated donor from bone marrow register) or autologous

Question 10

Transplantation may fail due to

Answer 10

Graft failure
Graft versus host disease
Leukaemia relapse
Infection