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Leukaemia begins in the bone marrow but often rapidly travels into the blood. It can then reach to other parts of the body, such as the lymph nodes, liver, central nervous system, spleen and other organs. It is a complex disease with many diverse types and subtypes.
All of the different types of blood cells are made in the bone marrow. Bone marrow includes blood-forming cells, fat cells and tissues that aid the development of blood cells. Early blood cells are called stem cells which grow in an orderly process to produce red blood cells, white blood cells and platelets.
Any of the blood-forming or lymphoid cells can turn into a leukemic cell. Once that happens, the cell reproduces to form several new cancer cells. In time, these cells can overwhelm the bone marrow, spilling out into the bloodstream and spread to other organs.
Leukaemia can present with a short period of illness or with a long period of deteriorating ill health. Patients commonly have bleeding (heavy periods in women or gum bleeding) or extensive easy bruising. Impaired white cell function can lead to recurrent chest infections and ulcers in the mouth whilst anaemia can cause or intensify tiredness fatigue or shortness of breath.
It is extremely important to identify which sub-type of leukaemia patients are suffering from because this dictates treatment and outcomes. This requires a bone marrow sample to be taken for specialised genetic and molecular studies; less commonly this can be performed on a blood sample. Acute leukaemia requires a prolonged period of in-patient care with long term follow-up, chronic leukaemias can usually be managed and treated as an out-patient.
Patients with leukaemia have numerous treatment options.
The options are:
- Biological therapy (Biological therapy works by helping your immune system recognize and attack leukaemia cells)
- Chemotherapy (Chemotherapy is the major form of treatment for leukaemia, this drug treatment uses chemicals to kill leukaemia cells.)
- Radiation therapy (Radiation therapy uses X-rays or other high-energy beams to damage leukaemia cells and stop their growth.)
- Stem cell transplant (A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow.)
- Targeted therapy (Targeted therapy uses drugs that attack specific vulnerabilities within the cancer cells)
Sometimes a combination of these treatments is used.
The choice of treatment depends mainly on the following:
- If leukemia cells were found in your cerebrospinal fluid
(This is a fluid that circulates throughout the central nervous system)
- The type of leukemia (acute or chronic)
Gene expression profile:
Gene expression profiling is a laboratory technique that allows you to measure the activity of thousands of genes at the same time and build up a picture of the genetic activity of a cell.
The pattern of activity provides a genetic signature that is unique to that patient and their disease and helps the clinician to select the best treatment.