Every year, around 1,000 people in Switzerland develop leukaemia, making it a rare cancer, strictly speaking. In children, however, leukaemia is the most common type of cancer. However, although leukaemia occurs more frequently in children, it can occur at any age.

Leukaemia at a glance

Leukaemia, colloquially known as blood cancer, is a illness of the haematopoietic system characterised by the uncontrolled growth of altered white blood cells. These cancer cells multiply rapidly and displace healthy blood cells in the bone marrow, which can lead to a variety of health complications. Leukaemia can take different forms and progress differently depending on whether it is acute or chronic and which blood cells are affected. Acute types of leukaemia develop rapidly and can quickly become life-threatening if they are not treated swiftly. Chronic types of leukaemia develop more slowly and often progress gradually for a long time before they are even discovered. 

Lymphatic leukaemia

Lymphatic leukaemia is a type of blood cancer that affects the cells of the lymphatic system, especially the lymphocytes. This illness leads to an uncontrolled proliferation of immature or dysfunctional lymphocytes in the bone marrow, blood and sometimes in the lymphatic system.

  • Acute lymphocytic leukaemia (ALL)
    Acute lymphocytic leukaemia (ALL) affects lymphatic cells, in particular the B and T lymphocytes. In this process, the progenitor cells, from which lymphocytes normally arise, develop into malignant leukaemia cells. ALL is the most common form of childhood leukaemia, but it can also occur in adults.

  • Chronic lymphocytic leukaemia (CLL)
    Chronic lymphocytic leukaemia, or CLL for short, affects the B-lymphocytes. CLL involves an accumulation of dysfunctional (immune-incompetent) lymphocytes in the bone marrow, blood circulation and lymphatic system. This form of leukaemia occurs almost exclusively in adults and is the most common type found in older people, especially those over 60 years of age. Because CLL usually occurs in older age, it is occasionally referred to colloquially as old-age leukaemia. CLL progresses slowly and in many cases is discovered by chance during routine examinations.

Myeloid leukaemia

Myeloid leukaemia is a form of blood cancer that affects myeloid cells – cells that usually develop into granulocytes, red blood cells and platelets. This type of leukaemia leads to an uncontrolled proliferation of immature or dysfunctional myeloid cells in the bone marrow and blood.

  • Acute myeloid leukaemia (AML)
    Acute myeloid leukaemia, or AML for short, is a biologically heterogeneous illness of the haematopoietic system in which immature myeloid progenitor cells, in particular granulocytes, erythrocytes and platelets, grow uncontrolled. AML occurs predominantly in older adults over 60 years of age. It progresses very rapidly and becomes life-threatening if left untreated.

  • Chronic myeloid leukaemia (CML)
    In contrast to acute myeloid leukaemia (AML), chronic myeloid leukaemia (CML) progresses slowly. CML is characterised by a degeneration of blood stem cells, which leads to an uncontrolled proliferation of certain subgroups of white blood cells (leukocytes), in particular granulocytes.

Causes and risk factors of leukaemia

For most types of leukaemia, the causes are largely unclear. However, one thing that all forms of blood cancer have in common is that they originate from the progenitor cells, known as stem cells, of the blood. The progenitor cells affected by leukaemia multiply in an uncontrolled manner and displace the production of healthy blood cells.

Although the causes of leukaemia are not yet fully understood, there are several factors that can increase the risk of blood cancer:

Genetic mutations

Genetic mutations can play a role in the development of certain types of leukaemia. One known genetic defect is the Philadelphia chromosome, which is caused by a genetic change on chromosome 22. This mutation is characteristic of chronic myeloid leukaemia (CML). However, it is not known why this genetic defect occurs.

Other genetic mutations or hereditary illnesses may also increase the risk of different types of leukaemia, especially in families with a high incidence of blood cancer.

 

Radiation exposure

Radiation exposure, especially to radioactive radiation, is a known risk factor for leukaemia. People who have been exposed to high doses of ionising radiation have an increased risk of developing blood cancer.

Contact with chemicals

Certain chemicals, mainly benzene and formaldehyde, are carcinogenic and can promote the development of leukaemia. Benzene, which is found in the chemical industry and also in cigarette smoke, is particularly dangerous for the haematopoietic system.

Medication

Certain medications, particularly cytostatic drugs, used for chemotherapy, may paradoxically increase the risk of developing leukaemia. These medications target fast-growing cells and can cause secondary leukaemia in some patients after treatment of other types of cancer, usually in the form of acute myeloid leukaemia (AML).

Symptoms

The symptoms of leukaemia are very diverse and can be attributed primarily to disordered blood formation.

  • Anaemia, fatigue and shortness of breath: These symptoms occur when the production of red blood cells (erythrocytes) is impaired, as they are responsible for transporting oxygen in the body.
  • Increased tendency to bleed: If the formation of platelets (thrombocytes), which are responsible for blood clotting, is impaired, this leads to an increased tendency to bleed. This often manifests itself in recurring nosebleeds or bleeding gums.
  • Susceptibility to infection, fever and inflammation: Because leukaemia also affects the white blood cells, the immune defence cells in the blood, the immune system is severely weakened. This leads to an increased susceptibility to infections, often accompanied by fever and inflammatory reactions in the body.
  • Enlargement of the spleen or liver: Many forms of leukaemia can lead to painful enlargement of the spleen (splenomegaly) or liver (hepatomegaly). These organs try to compensate for functional disorders in blood cell production, and become overworked in the process.
  • Bone pain: Because blood formation takes place in the bone marrow, leukaemia can also affect the bone marrow and lead to bone pain. These often occur in the long bones or back.

In acute leukaemia in particular, these signs appear quickly and severely, while chronic leukaemia often does not show any symptoms for a long period of time.

Diagnosis of leukaemia

Leukaemia is usually diagnosed by a combination of blood tests and bone marrow tests. A blood count often provides initial clues, such as an increased number of immature white blood cells, which is typical for leukaemia. For a precise diagnosis, a bone marrow biopsy is performed to determine the exact type of leukaemia and to plan the appropriate therapy.

Treatment of leukaemia

The treatment of leukaemia depends on the type of leukaemia, its progression (acute or chronic), and the general state of health of the patient. Different forms of therapy are used depending on the form and stage of disease.  The treatment is usually individually adapted to the patient.

  • Chemotherapy: Chemotherapy is the most commonly used treatment for leukaemia and aims to destroy cancer cells throughout the body.
  • Radiotherapy: Radiotherapy is predominantly used in combination with chemotherapy, particularly in the treatment of advanced illness.
  • Bone marrow transplantation (stem cell transplantation): This therapy offers a chance of recovery in many forms of leukaemia by replacing the diseased bone marrow with healthy bone marrow.
  • Immunotherapy: Immunotherapy, such as antibody therapy, uses the body’s own immune system to fight cancer cells.

Today, most cases of childhood leukaemia can be cured. Very good treatment results can also be achieved in adulthood for certain forms, such as chronic myeloid leukaemia (CML).

Preventative measures

Little is known about specific preventive measures against leukaemia, as the exact causes are not fully understood. However, a healthy lifestyle can reduce the overall risk of cancer. These include not smoking, a balanced diet, regular exercise and the avoidance of environmental toxins. Undergoing regular health check-ups can also help detect the disease at an early stage and improve the prognosis.

Centres 2

Visalisation of leukaemia