Understanding Leukaemia: Symptoms, Causes and Treatment Options

What Is Leukaemia?

Leukaemia is a type of cancer of the blood and bone marrow, where the body produces abnormal white blood cells that don’t function properly and multiply uncontrollably. These cells crowd out healthy blood cells, leading to problems with immunity, bleeding, and oxygen delivery.

Symptoms

Symptoms can vary, but often include:

• Fever or chills

• Fatigue or weakness

• Shortness of breath and pale skin

• Getting infections more frequently or more severely

• Swollen lymph nodes or an enlarged liver or spleen

• Bleeding or bruising easily

• Frequent nosebleeds

• Pain or tenderness in the bone

• Losing weight for no clear reason

• Small red spots on the skin (called petechiae)

• Heavy sweating, especially at night

Leukaemia Causes and Risk Factors

Leukaemia happens when the DNA in white blood cells (called leukocytes) changes, causing these cells to grow and divide abnormally. Sometimes, these changed cells avoid the immune system and start growing uncontrollably, taking over the healthy blood cells.

While the exact cause of leukaemia isn’t always clear, certain factors like radiation exposure can increase the risk of developing it.

The following are the risk factors of leukaemia:

• Gender

Men have a higher chance of developing leukaemia compared to women.

• Age

The risk increases as you get older. Most people diagnosed with common types like AML (Acute Myeloid Leukaemia), CLL (Chronic Lymphocytic Leukaemia), or CML (Chronic Myeloid Leukaemia) are 65 or older.

• Blood disorders

Some blood conditions, like polycythaemia vera and myelofibrosis, can increase the chance of developing AML.

• Family history

Leukaemia isn’t usually inherited. However, if you have a close family member with CLL or an identical twin with AML or ALL (Acute Lymphocytic Leukaemia), your risk may be higher.

• Genetic conditions

Certain birth disorders, like Down syndrome and Fanconi anaemia, can raise the risk of AML.

• Smoking

Smoking cigarettes raises the risk of AML, even if it is not a direct cause.

• Radiation

Exposure to high levels of radiation, like from atomic bombs or long-term exposure to low-level radiation (like living near power lines) may increase leukaemia risk.

• Previous cancer treatments

Chemotherapy and radiation therapy used for other cancers can also raise the chance of developing leukaemia.

• Chemicals

Being around certain chemicals, such as benzene or some pesticides, over a long time can increase your risk.

Types and Classifications of Leukaemia

Leukaemia is grouped based on the type of white blood cells affected and how fast the disease grows:

• Lymphocytic leukaemia

This type starts in white blood cells called lymphocytes, which are made in the bone marrow. It is also known as lymphoid or lymphoblastic leukaemia.

• Myeloid leukaemia

Also called myelogenous leukaemia, this type begins in white blood cells other than lymphocytes. It can also affect red blood cells and platelets.

Leukaemia is also described by how quickly it develops:

• Acute leukaemia

It grows quickly and leads to a buildup of immature, non-functioning blood cells in the bone marrow. As a result, the bone marrow can’t make enough healthy blood cells.

• Chronic leukaemia

This type develops more slowly. It causes a buildup of more mature, but still abnormal, white blood cells. It usually takes longer to show symptoms, but it can sometimes be harder to treat

Types

There are four main types of leukaemia, and they are grouped based on how fast they grow and which blood cells are affected:

1. Acute lymphocytic leukaemia (ALL)

This type is most common in kids, teens and young adults under 40.

2. Acute myelogenous leukaemia (AML)

AML usually affects adults, especially those over 65.

3. Chronic lymphocytic leukaemia (CLL)

CLL mostly affects older adults (over 65). It grows slowly, so symptoms might not show up for years.

4. Chronic myelogenous leukaemia (CML)

This type is more common in older adults but can occur at any age. It is rare in children, and symptoms often take several years to show up.

Diagnosis

Routine blood tests can sometimes detect signs of leukaemia before symptoms appear. If symptoms are present, your doctor will recommend further tests to diagnose the condition.

Common tests include:

• Physical exam

Your doctor will check for signs like swollen lymph nodes, an enlarged liver or spleen, bleeding gums or skin rashes.

• Complete blood count (CBC)

This test checks the levels of red and white blood cells and platelets. Abnormal results may point to leukaemia.

• Blood cell tests

Additional blood tests, like a peripheral smear or flow cytometry, can help detect leukaemia cells and identify the type.

• Imaging tests

X-rays, CT scans or MRIs may be done if there is concern that leukaemia has affected organs or bones. While leukaemia itself doesn’t usually show up on scans, these tests can help spot changes caused by the disease.

• Bone marrow biopsy

A small sample of bone marrow fluid (usually from the hip) is taken with a needle to look for leukaemia cells. This test confirms the diagnosis and shows how advanced the condition is.

• Lumbar puncture (spinal tap)

If needed, doctors may test spinal fluid to check if leukaemia has spread to the brain or spinal cord.

Treatment

The treatment depends on the type of leukaemia you have, along with other factors like your age, overall health and whether the cancer has spread.

Common treatments include:

• Chemotherapy

Chemotherapy is a common treatment that uses drugs to kill leukaemia cells or stop them from growing. These medicines can be taken as pills or given as injections, and they are often combined to work more effectively.

• Radiation therapy

This treatment uses high-energy rays to destroy leukaemia cells or stop their growth. Sometimes, radiation targets specific areas or the whole body, especially before a stem cell transplant.

• Immunotherapy

This treatment helps boost your immune system so it can better recognise and fight leukaemia cells.

• Targeted therapy

Targeted therapy uses drugs that focus on specific parts of leukaemia cells (like a gene or protein), stopping them from growing or killing them directly. This treatment is less likely to damage healthy cells.

• Stem cell transplant

Stem cell transplant replaces damaged bone marrow with healthy stem cells. These cells can come from your own body or from a donor to help your body produce healthy blood cells again.

• CAR T-cell therapy

A CAR T-cell therapy is a new treatment that uses your own immune cells (called T-cells). These cells are changed in a lab to better recognise and attack leukaemia cells, then put back into your body to help fight the cancer.

Impact on Health and Lifestyle

Leukaemia can affect your health and lifestyle in many ways, such as:

• Ongoing fatigue even after treatment

• Weakened immune system

• Emotional effects about cance relapse

• Financial strain because of long-term treatments and regular checkups can sometimes lead to financial stress.

• Physical side effects from chemotherapy or radiation.

How Leukaemia May Affect Health Insurance Eligibility

Leukaemia can affect your health insurance eligibility in the following ways:

• Pre-existing condition

Leukaemia is seen as a pre-existing condition, so some insurance companies might not offer full coverage right away, or they may have waiting periods before certain treatments are covered.

• Higher premiums

If you do get coverage, the premium might be higher because of the increased health risk.

• Limited plan options

Some private insurers may not accept people with a history of leukaemia, especially if the condition was diagnosed recently or is still active.

• Medical check-ups required

Insurers may ask for detailed medical records, recent tests, and doctor reports before approving your application.

• Waiting periods

Even if your policy is approved, treatments related to leukaemia might not be covered right away. You may have to wait 1-4 years before certain benefits kick in.