Leukemia is a form of cancer that begins in the blood-forming cells of the bone marrow—the soft, inner part of the bones. Leukaemia occurs when there is an excess of abnormal white blood cells in the blood. In leukaemia no single tumour is formed as is the case with other cancer forms, but cancer cells exist in circulating blood and bone marrow. Sometimes cancerous cells also accumulate in lymph nodes and other organs. There are several different leukaemia types. These are classified as chronic and acute leukaemias.
Some 150-200 leukaemia cases are diagnosed in Finland annually, nearly 50 of these with children
Symptoms
Leukaemia symptoms are often quite hard to define and similar symptoms can also be seen with other, perfectly harmless diseases.
Typical symptoms described by leukaemia patients are fatigue, paleness and lengthy or repeating infections. Due to a low platelet count bleeding symptoms (e.g. small haematomas and general propensity for bruising) can occur. Bone aches (pain in feet, pain in the back) are also common, due to cancer cells building up in the bone marrow. In medical examinations enlarged spleen or liver are often found, which can cause stomach swelling with children (swollen lymph nodes in the neck, armpits, groin or stomach area are possible).
Subtypes
Leukaemias are divided into subtypes. The main types are the two mentioned above, chronic and acute leukaemia, which both are further divided into myeloid and lymphocytic leukaemia. Acute lymphocytic is the most common leukaemia with children and chronic lymphocytic with adults.
Acute leukaemias can start quite suddenly (even over a few days or weeks) and they progress fast. Immediate medical care is necessary. They are most common with children, youngsters and young adults. Chronic leukaemias progress slowly and are most common with older people.
Generally speaking, the youngest patients (excluding babies) have the best prognosis. Of children approximately four out of five (80%) and of adults approximately 50% are completely cured.
Treament
The most common treatment method for leukaemia is cytostatic treatment. Additionally, radiation therapy and on rare occasions surgery (e.g. when the spleen or a tumour formed by the leukaemia cells needs to be removed) can be used as treatment methods.
The treatment method varies considerably depending on the leukaemia type. An adult's slowly progressing, chronic lymphatic leukaemia may initially be only observed and later, with symptoms increasing, be treated with gradually increased medication. With young patients' fast-progressing disease an active treatment with a combination of several medications is usually started within a couple of days. With patients below the age of 50-55, who have a recurrent disease or one with a bad prognosis, bone marrow transplant is also possible.
The average duration of treatment is 6 months to one year (acute myeloid leukaemia), or 2-3 years (acute lymphocytic leukaemia). After the active treatment period all patients are observed with gradually reducing hospital visits for 5-10 years in order to observe possible repetition of the disease and possible post-treatment side effects.
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