Leukaemia: symptoms, diagnosis and treatment

Leukaemia is a blood cancer in which abnormal blood-forming cells grow in the bone marrow and interfere with healthy blood cells.

It is a group of conditions rather than one single disease. The type is described by the blood cell line involved and by how quickly it tends to develop, such as acute or chronic disease. The abnormal cells may spill into the bloodstream and affect the immune system, oxygen-carrying red cells or clot-forming platelets.

Leukaemia can present with easy bruising, persistent fatigue, unexplained fever and unexplained weight loss. These symptoms can also have many non-cancer causes, so they do not establish a diagnosis on their own.

Reduced healthy blood cells may cause tiredness or breathlessness, repeated infections, fever, pale skin, nosebleeds or bleeding gums. Bruises may appear without a clear injury. Seek prompt medical assessment for persistent symptoms, unusual bleeding, or fever with signs of infection.

Leukaemia begins when blood-forming cells acquire changes that make them grow or survive abnormally. In many people, the exact reason those changes developed is not known. The condition is not caused by ordinary contact with another person and cannot be passed between people.

The course depends on the leukaemia type, the blood cell lineage involved, genetic features of the abnormal cells and the person’s general health. Acute forms can develop quickly and usually need prompt treatment. Chronic forms may progress more gradually, sometimes beginning with monitoring before treatment is needed.

Risk can be influenced by age, certain inherited conditions, previous chemotherapy or radiotherapy, and some types of high-dose radiation exposure. Some leukaemias are associated with particular genetic or immune conditions. Having a risk factor does not mean a person will develop leukaemia, and many people diagnosed with it have no clear risk factor.

Assessment commonly starts with a medical history, examination and blood count. A blood film can show unusual cells. Doctors may recommend a bone marrow biopsy to examine the marrow directly and identify the type of leukaemia.

Additional laboratory tests can classify abnormal cells and look for genetic features that guide treatment. Imaging or other tests may be used when doctors need to assess organs, lymph nodes or complications.

Treatment is tailored to the leukaemia type, its features, symptoms and the person’s health. Chemotherapy may destroy rapidly dividing abnormal cells. Targeted therapy acts on a specific feature found in some leukaemia cells. Some people need blood transfusion support while healthy blood-cell production is reduced.

For selected situations, a stem cell transplant replaces diseased blood-forming marrow with healthy stem cells. Treatment may involve more than one approach, with close blood-test monitoring and adjustments for response or side effects.

Keep a record of temperatures, medicines and new symptoms during treatment. Contact the care team promptly for fever, chills, worsening breathlessness, bleeding or signs of infection. Practical support with nutrition, activity, work and emotional wellbeing can be included in the care plan.

Low blood-cell levels can lead to infection, anaemia, bruising or bleeding. Leukaemia or its treatment can also affect appetite, energy, fertility or other organs. The clinical team checks for these problems and can provide transfusions, antimicrobial treatment or other supportive care when appropriate.

Most leukaemia cannot be prevented because its initiating cell changes are usually not predictable. Avoiding tobacco and unnecessary radiation supports general health, but no lifestyle change can reliably prevent every type. People with known inherited or treatment-related risks can ask a clinician about appropriate monitoring.

A haematologist or haemato-oncologist can confirm the diagnosis and coordinate treatment. Bring blood-test results, a medicine list and details of previous cancer treatment to the appointment. Ask which leukaemia type is present, what the treatment aims to be, and which symptoms require an urgent call.