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Leukaemia
Leukaemiaisacanceroftheblood-formingcells,whicharemadeinthebonemarrow.Leukaemia causeslargenumbersofwhitebloodcellstobeproduced.Thiscancrowdthebonemarrowand mayaffecttheproductionofnormalcells.Apersonwithleukaemiamaybemorelikelytopickup infectionsandhavetroublegettingridofthem.Over660Victoriansdevelopleukaemiaeveryyear. Therearefourmaintypesofleukaemia.Inmanycases,leukaemiacanbecuredorkeptunder controlformanyyears.Chemotherapyisthemaintreatment. Large numbers of abnormal white cells Bloodismostlymadeupofplasma,whichisaclearfluid.Floatinginthisfluidarethreetypesof cells: Red blood cellsthatcarryoxygenaroundthebody White blood cellsthatfightdiseaseandinfection Plateletsthathelptostopbleedingwhenitstarts.

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Bloodcellsaremadeinthebonemarrow,whichisthespongypartinthecentreofthebone. Whenthebodyishealthy,thenumbersofredcells,whitecellsandplateletsinthebloodarekept inbalance.Inpeoplewithleukaemia,thebonemarrowmakestoomanyabnormalwhiteblood cells.Theseabnormalcellsareunabletocarryouttheirnormalfunctionandcancrowdthebone marrow.Thismeansthatthereisnotenoughroominthebonemarrowformakingnormalwhite bloodcells,redbloodcellsandplatelets. Whitebloodcellsnormallyhelptofightinfection.Inapersonwithleukaemia,alargenumberof thesecellsareabnormal.Ifapersonhastoomanyabnormalwhitebloodcells,theyaremorelikely topickupinfectionsandhavetroublegettingridofthem. Risks and causes Thecauseofmostcasesofleukaemiaisunknown.Thereareseveralriskfactorsthatmayincrease yourchanceofdevelopingthisdisease.Themainonesare: Exposuretointenselevelsofradiationnocasesofleukaemiahavebeenlinkedto radiationfromx-raysandCTscans Exposuretoachemicalcalledbenzeneatworkoverlongperiodsoftime Cigarettesmokingthiscanincreaseyourriskofsometypesofleukaemia Geneticfactorscertaininheritedconditionscanincreaseyourriskofdevelopingsome typesofleukaemia Familyhistory,ageandgenderthesecanallhaveaneffectonyourriskofdeveloping certaintypesofleukaemia.

Researchintofurtherpossiblecausesisongoing. Different types Therearedifferenttypesofleukaemiaandthetreatmentforeachisdifferent.Theconditionmay: Developsuddenly(overdaysorweeks)thisiscalledacuteleukaemia. Developovermonthsoryearsthisiscalledchronicleukaemia. Involveeitherthemyeloidorlymphoidcellstheconditionisnamedforthetypeofblood cellaffected.

Most common types of leukaemia Therearefourmaintypesofleukaemia.

Leukaemia

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Acute lymphocytic leukaemia (ALL) ALLaffectslymphocytes(atypeofwhitebloodcell,whosemainfunctionistoprotectthebody frominfection)sotheycannotworkproperly.Thismaycauseaseriousinfection.Italsocauses manyabnormallymphocytestobemade,whichcrowdoutthenormalredbloodcellsandplatelets. ALListhemostcommontypeinchildren.Itisrareinadults. Chronic lymphocytic leukaemia (CLL) CLLalsoaffectsthelymphocytesbutdevelopsmoreslowlythanALL.MostpeoplewithCLLarenot evenawarethattheyhavethediseaseandmayonlybediagnosedduringanexaminationfor anothermedicalproblem.CLLaffectsadultsanddoesnotoccurinchildren. Acute myeloid leukaemia (AML) AMLmainlyaffectsthemyeloidcellsknownasgranulocytes.Thesecellssearchforinfectious invadersinthebloodandnearbytissue.InAML,toomanyyoungmyeloidcellsareproducedand therearenotenoughmaturemyeloidcells.Theyoungmyeloidcellscanblockbloodvessels.AML mainlyaffectsadults,butcanoccurinchildrenandadolescents. Chronic myeloid leukaemia (CML) ToomanymaturemyeloidcellsarepresentinCMLandtheydonotfunctionproperly.CMLisalso differentfromthemorecommontypesofleukaemiabecauseithastwostages: Abnormalcellsslowlymultiply Quicklychanging,itbecomesexactlylikeAML.

Thisleukaemiacanoccuratanyage,butisuncommonbelowtheageof20years. Symptoms Thesymptomsofleukaemiamayvaryslightlydependingonthetypeandstageofleukaemiayou have.Symptomsforacuteleukaemiausuallyhappenquitesuddenly.Theyinclude: Weakness,tirednessandlookingwashedout Regularinfectionsandhightemperatures Bleedingeasily Bleedingfromthegumsandnose Bruisingeasilywithnoobviouscause Paininthebonesandjoints Weightloss Swollenlymphglands Abdominaldiscomfortduetoanenlargedspleen.

Peoplewithchronicleukaemiawillalsohavemanyofthesesymptomsbuttheytendtodevelop overmonthsoryears. Mostpeoplewhohaveanyofthesesymptomswillnothaveleukaemia.Theyaremorelikelytobe sufferingfromamuchlessseriousproblem,suchasaninfection.However,itisalwaysimportant toseeyourdoctorifyouhavesymptoms. Diagnosis Teststohelpdiagnoseleukaemiamayinclude: Blood teststocheckforlargenumbersofabnormalwhitebloodcells. Bone marrow biopsyasmallamountoffluidistakenfromthebonemarrowusinga needle.Thesamplesarethenexaminedunderamicroscope.Thistestcanhelpworkout whichtypeofleukaemiaispresent. Lymph node biopsyasmallamountoftissueisremovedwithaneedlefromaswollen lymphnode.Itisexaminedunderamicroscope. Lumbar puncturefluidisremovedwithaneedlefromaspacebetweenthebonesinthe back.Thefluidislookedatunderamicroscope.

Ifthesetestsshowthatyoudohaveleukaemia,youmayalsoneedtohavefurtherbloodandbone marrowtestsaswellassomescans(CT,ultrasoundorMRI).

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Testresultscantakeafewdaystocomeback.Itisverynaturaltofeelanxiouswhilewaitingto getyourresults.Itcanhelptotalktoaclosefriendorrelativeabouthowyouarefeeling.You couldalsocontactyourlocalcancerinformationandsupportservice. Treatment Mostchildrenandmanyadultswithacuteleukaemiacanexpecttobecured.Formostpeople, chronicleukaemiacanbesuccessfullymanagedforlongperiodsoftime. Treatmentdependsonthetypeofleukaemia,butmayinclude: Chemotherapywithcancer-killingdrugs.Theseareusuallygivenintravenously,but maysometimesbegivenastablets.Forsomepeople,chemotherapyforacuteleukaemia willmeanspendingseveralweeksinhospital.Othersmaybeabletostayathomebutwill needregularhospitalcheck-upsandfurthertreatments. Intensive treatment such as a stem cell transplantatransplantallowsyoutohave muchhigherdosesofchemotherapythanusual,whichmayhelptoimprovethechancesof curingsometypesofleukaemiaorlymphomaorofprolongingremission.Veryhighdoses ofchemotherapy,sometimeswithtotalbodyirradiation(TBI),areusuallygivenoverafew days.Thehigh-dosetreatmentdestroysthebonemarrowandstemcells(stemcellsare immaturecellsfromwhichbloodcellsevolve,whichgrowinthebonemarrow).Afterthe high-dosetreatment,youwillbegivenadrip(infusion)ofeitheryourownstemcells (autologoustransplant)orstemcellsfromadonor(allogeneictransplant). Biological therapyalsoknownasimmunotherapy.Thisistheuseofsubstancesthat arenaturallyproducedwithinthebodytoencouragetheimmunesystemtofightdisease. Interferonandgrowthfactorsareusedtotreatleukaemia. Radiotherapymaybeusedfordifferenttypesofleukaemiatohelpcontrolsymptoms, aspartofintensivetreatmentregimesortotreatcancerthathasspreadtothebrainor spinalcord. Steroidsresearchhasshownthattreatmentforsometypesofleukaemiaisbetterif steroidsaregivenalongsidethechemotherapy. All-trans-retinoic acidthisisaformofvitaminAusedtotreatatypeofacutemyeloid leukaemia.Itisusuallytakenastabletswithchemotherapy.

Treatment side effects Alltreatmentshavesideeffects.Thesewillvarydependingonthetypeoftreatmentyouare having.Manysideeffectsaretemporarybutsomemaybepermanent.Yourdoctorwillexplainall thepossiblesideeffectsbeforeyourtreatmentbegins. Where to get help Yourdoctor CancerCouncilVictoria,InformationandSupportServiceTel.131120 www.cancervic.org.au MultilingualCancerInformationLine,VictoriaseetheCCVwebsiteforcontactdetails www.cancervic.org.au/other_languages/multilingual_cancer_information_line LeukaemiaFoundationofVictoriaTel.1800620420or(03)99495800 LeukaemiaFamilySupportGroupTel.(03)93427888

Things to remember

Leukaemiaisacancerofblood-formingcells,whichcauseslargenumbersofwhiteblood cellstobemade. Alotofleukaemiacanbecuredorkeptundercontrolformanyyears. Therearefourmaintypesofleukaemia. Themaintreatmentiswithchemotherapy.

This page has been produced in consultation with, and approved by:

CancerCouncilVictoria

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

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