Leukaemia

Definition

• Leukaemia: A group of blood cancers that result from the overproduction of immature or abnormal white blood cells, which interfere with the production of normal blood cells.

Classification

• Acute: Rapid progression and accumulation of immature blood cells.
  • Acute Lymphoblastic Leukaemia (ALL)
  • Acute Myeloid Leukaemia (AML)
• Chronic: Slower progression, accumulation of mature but abnormal cells.
  • Chronic Lymphocytic Leukaemia (CLL)
  • Chronic Myeloid Leukaemia (CML)

Epidemiology

• Most common in children (ALL) and adults over 55.
• More common in males than females.

Risk Factors

• Ionising radiation exposure.
• Previous chemotherapy or radiation therapy.
• Genetic disorders like Down syndrome.
• Exposure to certain chemicals (e.g., benzene).
• Family history of leukaemia.

Clinical Features

• Fatigue or anaemia.
• Frequent infections due to leukocyte dysfunction.
• Bruising or bleeding easily.
• Fever or night sweats.
• Swollen lymph nodes.
• Bone or joint pain.
• Unintended weight loss.

Investigations

• Full Blood Count (FBC): Shows elevated white cell count and reduced platelets and haemoglobin.
• Bone Marrow Biopsy: Confirms diagnosis and type of leukaemia.
• Cytogenetic studies: To identify chromosomal abnormalities.
• Immunophenotyping: Differentiates between ALL and AML.

Management

• Chemotherapy: Mainstay of treatment for most types.
• Radiation therapy: For areas with a bulk of disease or prior to stem cell transplant.
• Stem cell transplantation: Can be curative for some types of leukaemia.
• Targeted therapies: Specific for certain types of leukaemia (e.g., tyrosine kinase inhibitors for CML).

Prognosis

• Varies widely based on type of leukaemia, age, overall health, and chromosomal abnormalities.
• Early diagnosis and prompt treatment often lead to better outcomes.