![]() The Western Front Museum Last updated: Introduction How much have we raised so far How did we become involved What is Leukaemia? What is normal blood made up of? How is leukaemia diagnosed and assessed? |
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What is Leukaemia?
Leukaemia is a cancer of cells in the bone marrow (the cells which develop into blood cells).
Cancer is a disease of the cells in the body. There are many types of cancer which arise from different types of cell. What all cancers have in common is that the cancer cells are abnormal and do not respond to normal control mechanisms. Large numbers of cancer cells build up because they multiply 'out of control', or because they live much longer than normal cells, or both.
With leukaemia, the cancerous cells in the bone marrow spill out into the bloodstream. There are several types of leukaemia. Most types arise from cells which normally develop into white blood cells. (The word leukaemia comes from a greek work which means 'white blood'.) If you develop leukaemia it is important to know exactly what type it is. This is because the outlook (prognosis) and treatments vary for the different types. Before discussing the different types of leukaemia it may help
to know some basics about normal blood cells and how they are made.
What is normal blood made up of?Blood cells, which can be seen under a microscope, make up about 40% of the blood's volume. Blood cells are divided into three main types:
These make blood a red colour. One drop of blood contains about five million red cells. Red cells contain a chemical called haemoglobin. This binds to oxygen, and takes oxygen from the lungs to all parts of the body.
There are different types of white cells which are called neutrophils (polymorphs), lymphocytes, eosinophils, monocytes, and basophils. They are part of the immune system. Their main role is to defend the body against infection.
These are tiny and help the blood to clot if we cut ourselves.
Plasma is the liquid part of blood and makes up about 60% of the blood's volume. Plasma is mainly made from water, but contains many different proteins and other chemicals such as hormones, antibodies, enzymes, glucose, fat particles, salts, etc.
How is leukaemia diagnosed and assessed?A blood test can often suggest the diagnosis of leukaemia as abnormal cells are often detected in the blood test. Further tests are usually done to confirm the diagnosis.
For this test a small amount of bone marrow is removed by inserting a needle into the pelvis bone (or sometimes the breastbone (sternum)). Local anaesthetic is used to numb the area. A small sample of bone may also be taken. The samples are put under the microscope to look for abnormal cells, and tested in other ways. This can confirm the diagnosis. (A separate leaflet describes bone marrow biopsy in more detail.) A bone marrow test may not be needed to confirm the diagnosis of CLL.
Detailed tests are often done on abnormal cells obtained from the bone marrow sample or blood test. These find out the exact type, or sub-type, of the cell that is abnormal.
This test collects a small amount of fluid from around the spinal cord (cerebrospinal fluid - CSF). It is done by inserting a needle between the vertebra in the lower (lumbar) region of the back. A separate leaflet describes this test in more detail. By examining the fluid for leukaemia cells, it helps to to find out if the leukaemia has spread to the brain and spinal cord. This is mainly done when assessing ALL, and sometimes AML.
A chest x-ray, blood tests, and other tests are done to assess your general wellbeing.
The treatment advised depends on the exact type of leukaemia, and the stage it is at. For example, ALL is usually treated as soon as possible with intensive chemotherapy. On the other hand, people in the early stages of CLL may not need any treatment. This is because CLL often progresses very slowly and may not need treatment for several years.
The outlook varies for each of the different leukaemias. However, the overall outlook may be better than many people imagine. For example, the outlook for ALL has greatly improved over the last 20 years or so. Most children with ALL (about 7-8 in 10 cases) can be cured. Also, the chronic leukaemias (CLL and CML) often progress slowly - often over several years. Even in those cases which are not cured, treatment with chemotherapy and other treatments can often prolong survival for quite some time.
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