So, what is acute leukemia?

Leukemia is a type of blood cancer that affects white blood cells, which typically fight infection.

Healthy and abnormal white blood cells are produced in the bone marrow, along with other types of cells found in the blood. As far as we know, there is no definitive cause of leukemia, but when abnormal white cells are produced in large amounts, they can take over the bone marrow and spill out into the blood stream, causing the symptoms associated with these diseases; including fatigue, susceptibility to infections and weight loss.

Leukemias can be split into several different subtypes, depending on how fast they progress (acute leukemias develop faster, and chronic leukemias develop slower), or on the type of cells affected (lymphoid or myeloid). The various subtypes of leukemia have different symptoms, and therefore have their own specific treatment regimes.

Want to know more? Here is a presentation: ALAN Acute Leukemia training

There are also trustworthy resources you can use to learn more about acute leukemia, and to guide decisions as a patient, carer or family/friend. See our resources page for more information.

Symptoms of leukemia can be vague and non-specific, and not everyone experiences the same symptoms before diagnosis. Knowing what to look out for could help you make the decision to visit your doctor sooner.

Early diagnosis saves lives !

Fatigue 

Fatigue is by far the most common symptom experienced by blood cancer patients prior to a diagnosis.

Fatigue is defined as extreme tiredness that results from mental or physical exertion, or illness. Everyone will experience fatigue at some point as it is simply the body’s natural way of showing that rest is needed. However, exhaustion that lasts for prolonged periods of time is not normal.

Below are some signs that you should pay close attention to:

  • Weakness or tiredness that lasts for longer than 2 weeks
  • Weakness or tiredness accompanied by a loss of weight
  • Tiredness that remains even after rest or sleep, it keeps coming back, or is getting worse.
  • You are continually finding yourself more tired than usual or breathless during or after an activity.
  • You’re spending extra time in bed and/or sleeping for unusual amounts of time.
  • You are finding it significant difficulty to concentrate and becoming confused more easily.
  • You have also noticed other symptoms of leukemia or anemia

Infections

About a quarter of  leukemia patients will experience frequent or repeated infections as a symptom prior to their diagnosis. Recurrent infections can occur because your body isn’t producing enough white blood cells to keep your immune system working properly. This means that the you are unable to rapidly destroy any harmful viruses, bacteria or fungi that have made their way into the body.

Infections are associated with signs such as fever, sweating or chills, sore throat and/or cough, redness, swelling or pain around a wound.

Shortness of breath

Approximately one-third of patients will report feeling weak or breathless as a symptom prior to being diagnosed with leukaemia. However, because breathlessness has many possible causes, ranging from a cold, chest infection to lack of fitness or smoking, it can often be mistaken as harmless or simply as a sign of getting older.

Below are some signs that you should pay close attention to:

  • Sudden breathlessness that comes on unexpectedly
  • Breathlessness during everyday activities (that you would normally find effortless)
  • Breathlessness that has lasted for longer than a month or has gradually become more noticeable
  • You have noticed a “sudden drop in fitness”
  • You have also been coughing for three weeks or more
  • You notice other symptoms of leukemia or anemia

Bruising or bleeding

Easily bruising and bleeding is the 4th most common leukemia symptom.

Although bruises from leukemia are very similar to ordinary bruises, there are a few things you can look out for to help spot the difference:

  • They occur in unusual places
  • There are lots of them
  • You can’t explain why they are there
  • They take longer than usual to disappear
  • You have been experiencing excess bleeding

Fever or night sweats

It is certainly not unusual to sweat during the night, especially in the summer when your room or bedding becomes too hot. However, severe night sweats that occur to an extent that your bed sheets or pyjamas become soaking wet, despite sleeping in a cool environment, can sometimes be a sign of leukemia.

Below are some signs that you should pay close attention to:

  • You regularly have night sweats that wake you up at night
  • You have never experienced night sweats before
  • You are having severe night sweats but can’t work out why
  • You also have a fever, a cough or diarrhoea
  • You are experiencing unexplained weight loss alongside your night sweats
  • You are also displaying other symptoms of leukemia

Pain in bones or joints

About a quarter of people experienced bone or joint pain as a symptom prior to their diagnosis. However, this common leukemia symptom can easily be mistaken for conditions such as arthritis or growing pains.

Depending on where it is felt, bone pain can be a sharp pain or a constant dull ache in one or more bones. It differs from muscle or joint pain because it is present regardless of whether you are moving or not. Bone pain caused by leukemia is most commonly felt in the long bones of the arms and legs, or in the ribs and sternum of the rib cage.

Joint pain in the wrists or ankles and swelling of large joints, such as the hips and shoulders, is usually experienced later, sometimes weeks after bone pain first begins.

Weight loss

Unexplained weight loss or loss of appetite can be associated with acute leukemia.

If your doctor suspects you may have leukemia, they will conduct a variety of tests to confirm this. The tests may include a full blood count, bone marrow biopsy, and other general health tests and infection screening

Acute Lymphoblastic Leukemia (ALL)

ALL is a type of acute leukemia that affects a specific type of blood stem cell called lymphoblasts – these are the precursors of some white blood cells. These cells are produced in the bone marrow and, when they are abnormal, they multiply excessively preventing the production of other types of blood cells. The reduced number of healthy white blood cells, red blood cells and platelets results in the symptoms experienced by patients, such as fatigue, bleeding/bruising, and infections.

Despite certain risk factors being associated with ALL, there is no definitive cause. ALL is more common in young children but adults are affected too. Symptoms can be vague but they do include enlarged lymph nodes, enlarged liver or spleen and joint pains. Treatment can include chemotherapy, immunotherapy, targeted therapy, radiation therapy or stem cell transplant.

Here is a leaflet explaining ALL –> read here: know the basics_ALL

Acute Myeloid Leukemia (AML)

AML is a type of acute leukemia that affects young myeloid cells. Normal myeloid cells will mature into red blood cells, some types of white blood cells and platelets. If abnormal, myeloid cells can grow excessively and overcrowd the bone marrow, preventing the production of healthy cells, and therefore causing symptoms commonly experienced by AML patients, such as fatigue, bleeding/bruising and infections.

Despite many risk factors being associated with AML, there is no definitive cause. AML is more common in older people, and affects men and women in a similar way. AML can progress from myelodysplastic syndrome (MDS) or myeloproliferative neoplasms (MPN), which is why these diseases are often referred to when discussing acute leukemias. Like ALL, symptoms can be vague, but include bone pain, enlarged liver or spleen and swollen gums. Treatment can include chemotherapy or stem cell transplant.

Here is a leaflet explaining AML –> read here: know the basics_AML

Acute Promyelocytic Leukemia (APL)

APL is a rare form of AML. It affects promyelocytes, which develop into granulocytes, a type of white blood cell. There is no definitive cause for APL, but most people with the disease have a faulty gene in the leukemia cells called PML/RARA. There is also a slightly higher risk of developing APL if you have received treatment for other types of cancer. APL is treated in a very different way to AML because the usual treatments for AML may seriously affect blood clotting in these patients. Treatment can include all-trans retinoic acid (ATRA), anthracyclines, arsenic trioxide (ATO), and blood, platelet or plasma transfusion.

Here is a leaflet explaining APL –> read here: Know the basics-APL

The type of treatment you receive will depend on the type of acute leukemia you have. As the disease can progress rapidly, it is likely that you will discuss treatment options with your doctor within the first few days after diagnosis. At this time, it is important that you make every effort to fully understand your diagnosis, the treatment options available and how they will impact your life. We know this can be tricky, whilst digesting a diagnosis, there should always be someone to help. You can contact your professional healthcare team to discuss any questions you may have, as well as clarifying anything you may not understand about your diagnosis.

Some of the strategies being used to treat acute leukemia are:

  • Chemotherapy – drugs that destroy abnormal and rapidly dividing cells. Chemotherapy is usually administered intravenously (in the vein)
  • Radiation therapy – high-energy radiation that destroy cancer cells. It is typically only used in advanced or metastatic leukemia
  • Targeted therapy – drugs that target specific mutated genes or proteins
  • Immunotherapy – drugs that boost the immune system, enabling them to kill cancer cells more effectively
  • Stem cell transplant – replacement of bone marrow from either yourself or a donor. This encourages the production of healthy white blood cells
  • Clinical Trials – clinical trials can enable you to access the most cutting-edge treatments as they are designed to determine which treatments are the most effective in specific patient group. These trials will define the best standard of care for patients