Leukaemia Awareness (Part 1)

What is Leukaemia?

Leukaemia is a type of cancer that affects the blood and bone marrow. The cancer cells can grow and spread to other parts of the body. Leukaemia is cancer of the bone marrow which is where new blood cells are made but later go into the blood. When someone has leukaemia, their bone marrow produces too many abnormal white blood cells. The two types of white blood cells that can turn into leukaemia are lymphocytes and myelocytes.

When leukaemia is in the lymphocytes it is called lymphocytic leukaemia. Myeloid leukaemia is a type of cancer that affects myeloid cells. Leukaemia cells can travel throughout the body in the blood. That means they can reach most organs. There are many ways leukaemia can manifest itself, depending on which organs are affected.

The symptoms of leukaemia can vary depending on the type of leukaemia, but they can include a swollen lymph node, fever, night sweats, and bone pain. People with leukaemia do not have enough healthy blood cells, which can lead to symptoms. However, some people with chronic leukaemia have no symptoms.

The symptoms of leukaemia can vary from person to person but may include a change in the colour of your blood or a mass in your chest. People with leukaemia have a lower number of healthy blood cells, which can cause symptoms. Some people with chronic leukaemia may not have any symptoms.

Here are some common symptoms of leukaemia:

• Fever with chills and sweating
• Infections that won’t go away
• Weakness, fatigue, or pale skin that may be signs of anemia
• Small red spots and bruising under the skin
• Frequent nosebleeds
• Painful or bleeding gums
• Swollen lymph nodes, liver or spleen
• Pain in the bones or joints
• Cough, shortness of breath and chest pain
• Loss of appetite and weight loss

Seek medical attention if these symptoms persist. These symptoms are not unique to leukaemia. Many of the conditions that can cause them are less serious. Some special tests are needed to confirm a diagnosis of leukaemia. Leukaemia is treated using a variety of methods, depending on the type of leukaemia. Some leukaemia can be treated with radiation therapy, while others may require chemotherapy or surgery.

Leukaemia is the most common form of cancer and chemotherapy is the most common treatment for it. Other types of treatments for leukaemia include radiation therapy, targeted therapy, stem cell transplant, biological therapy, and surgery.

Each is described below:

Chemotherapy. Most people with leukaemia are treated with chemotherapy. The treatment uses medicine to kill cancer cells. Some people take two or more medicines orally (by eating), but most are given intravenously (by injection). This treatment is considered systemic, meaning it destroys cancer cells throughout the entire body.

Radiation Therapy is a form of treatment that uses radiation to destroy cancer cells. The purpose of radiation is to use x-rays to kill cancer cells. This treatment is sometimes used in combination with chemotherapy or with a stem cell transplant. You can receive radiation over the whole body, called total body irradiation (TBI).You may be given radiation to just one part of your body where more leukaemia cells have gathered. Sometimes radiation is used to treat leukaemia in the brain or to prevent it from spreading there.

Targeted Therapy is a type of treatment that is specifically designed to address the underlying causes of a person’s symptoms. This is a new type of treatment that is being used nowadays. Cancer treatment uses medicine to attack specific factors that differentiate cancer cells from normal cells. This treatment is most effective against leukaemia cells, not healthy cells. This means that it may cause fewer side effects than other treatments. It is usually the first treatment used for CML, although targeted therapy can also be used to treat other types of leukaemia.

Stem Cell Transplant refers to a medical procedure in which a patient’s own stem cells are used to help them recover from an illness or injury. The goal of this treatment is to kill as many cancer cells as possible by using very high doses of chemotherapy and radiation. Normally, the body cannot handle such high doses because they kill the stem cells in the bone marrow. Therefore, after a person is treated with such high doses, it is necessary to restore the blood with new healthy stem cells. The new stem cells can come from the blood or bone marrow of a donor. Then it’s called a transplant from a donor who is not the recipient’s own tissue. A less common source of stem cells for transplants is from the person’s own blood or bone marrow.

In Autologous Transplants, the stem cells are collected and stored before the treatment with high-dose chemotherapy. Stem cell transplants are done in centres that are specifically designed to perform this type of treatment.

Biological Therapy. The goal of this treatment is to help your body fight leukaemia. Surgery is a way to fix problems with your body. Surgery is an important part of keeping you healthy. This term is less commonly used for leukaemia. In some cases, your doctor may perform surgery to remove a swollen spleen.

Dr Ntomboxolo Mboyi has a BSc (UKZN), MBCHB (Medunsa), Fc Rad Onc (SA), and is a Postgraduate in Cancer Biology and Therapeutics: High Impact Cancer Research Program (Harvard Medical School). She is a member of the South African Oncology Consortium (SAOC), South African Society of Clinical and Radiation Oncology (SASCRO), American Society of Clinical Oncology (ASCO), and American Brachytherapy Society (ABS) and a Chairperson of the leading body of CanSurvive, a non-benefit association offering support to cancer patients.