Acute lymphoblastic leukaemia - Complications

Complications-Acute lymphoblastic leukaemia

Contents

1. Overview
2. Diagnosis
3. Treatment
4. Complications

Being immunocompromised (having a weakened immune system) is a possible complication for some people with acute leukaemia.

There are two reasons for this:

• the lack of healthy white blood cells means your immune system is less able to fight infection 
• many of the medicines used to treat acute leukaemia can weaken the immune system 

This makes you more vulnerable to developing an infection, and any infection you do have is more likely to cause serious complications.

You may be advised to take regular doses of antibiotics to prevent infections occurring. You should report any possible symptoms of an infection immediately to your GP or care team because prompt treatment may be needed to prevent serious complications.

Acute lymphoblastic leukaemia - Treatment

Treatment-Acute lymphoblastic leukaemia

Contents

1. Overview
2. Diagnosis
3. Treatment
4. Complications

Acute lymphoblastic leukaemia is an aggressive condition that develops quickly, so treatment usually begins a few days after diagnosis.

Stages of treatment

Treatment for acute lymphoblastic leukaemia is usually carried out in 3 stages.

They are:

• induction – the aim of the initial stage of treatment is to kill the leukaemia cells in your bone marrow, restore the balance of cells in your blood, and resolve any symptoms you may have 
• consolidation – this stage aims to kill any remaining leukaemia cells in your central nervous system 
• maintenance – the final stage involves taking regular doses of chemotherapy tablets to prevent the leukaemia returning 

Acute lymphoblastic leukaemia -Diagnosis

Diagnosis-Acute lymphoblastic leukaemia

Contents

1. Overview
2. Diagnosis
3. Treatment
4. Complications

The first step in diagnosing acute lymphoblastic leukaemia is to check for physical signs of the condition, such as swollen glands, and to take a blood sample.

If the blood sample contains a high number of abnormal white blood cells, it could be a sign of acute leukaemia. Your GP will refer you to a haematologist (a specialist in treating blood conditions).

Bone marrow biopsy

To confirm a diagnosis of acute leukaemia, the haematologist will take a small sample of your bone marrow to examine under a microscope.

The haematologist will use a local anaestheticto numb the skin over a bone – usually the hip bone – before removing a sample of bone marrow with a needle. You may experience some pain once the anaesthetic wears off and some bruising and discomfort for a few days afterwards. The procedure takes around 15 minutes and you shouldn't have to stay in hospital overnight.

The bone marrow will be checked for cancerous cells and, if found, the type of acute leukaemia will be determined at the same time.

Some people with acute leukaemia will need to have a bone marrow assessment to check for cancerous cells every three months for at least two years during maintenance treatment or after having a bone marrow transplant.

Acute lymphoblastic leukaemia -Overview

Overview-Acute lymphoblastic leukaemia

Contents

1. Overview
2. Diagnosis
3. Treatment
4. Complications

Acute lymphoblastic leukaemia is a type of cancer that affects the white blood cells. It progresses rapidly and aggressively and requires immediate treatment. Both adults and children can be affected.

Acute lymphoblastic leukaemia is very rare, with around 650 people diagnosed with the condition each year in the UK. Half of all cases diagnosed are in adults and half in children.

Although rare, acute lymphoblastic leukaemia is the most common type of childhood leukaemia. About 85% of the cases that affect children occur in those younger than 15 (mostly between the ages of two and five). It tends to be more common in males than females.

Acute lymphoblastic leukaemia is different to other types of leukaemia, including acute myeloid leukaemia, chronic lymphocytic leukaemia and chronic myeloid leukaemia.

What happens in acute lymphoblastic leukaemia

All of the blood cells in the body are produced by bone marrow, a spongy material found inside bones.

Bone marrow produces specialised cells called stem cells, which have the ability to develop into three important types of blood cells:

• red blood cells – which carry oxygen around the body 
• white blood cells – which help fight infection 
• platelets – which help stop bleeding 

Normally, bone marrow doesn't release stem cells into the blood until they are fully developed blood cells. But in acute lymphoblastic leukaemia, large numbers of white blood cells are released before they are ready. These are known as blast cells.

As the number of blast cells increases, the number of red blood cells and platelet cells decreases. This causes the symptoms of anaemia, such as tiredness, breathlessness and an increased risk of excessive bleeding.

Also, blast cells are less effective than mature white blood cells at fighting bacteria and viruses, making you more vulnerable to infection.