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symptoms and course of leukaemia

Leukaemia develops when white blood cells become malignant and multiply in an uncontrolled way. Learn about the warning signs of leukaemia, how to treat this kind of cancer and which types of leukaemia can be cured.


Leukaemia is a cancer of the hematopoietic system, which includes bone marrow and blood cells. The white blood cells (leukocytes) are pathologically altered and multiply quickly and uncontrollably.

Leukaemia is relatively rare compared to other cancers such as breast or colon cancer. In Switzerland, around 1,100 people fall ill with leukaemia every year – men slightly more often than women. Four out of every 100 people affected are children under the age of 15.

The stem cells in a person’s bone marrow develop into precursor cells, which in turn form blood cells. The myeloid cells produce red blood cells, platelets and some of the white blood cells. Lymphocytes, a group of white blood cells, are formed from the lymphatic cells.

A distinction is made between myeloid and lymphatic leukaemia depending on the cell type involved.

In addition, leukaemia may be acute (sudden symptoms, rapid progression) or chronic (slow development). Thus, there are essentially four types of leukaemia:

  • Acute myeloid leukaemia (AML)
  • Acute lymphoblastic leukaemia (ALL)
  • Chronic myeloid leukaemia (CML)
  • Chronic lymphocytic leukaemia (CLL). This is not actually a blood cancer, but a form of lymph node cancer (lymphoma).

The signs of acute leukaemia begin suddenly, whereas the symptoms of chronic leukaemia often only become apparent after months or years. The following symptoms may occur:

  • Fatigue
  • Weakness, dizziness
  • Bleeding, e.g. nosebleeds, gingival bleeding
  • Skin changes: bruising, red spots, hives, rash, lumps under the skin, itching
  • Frequent infections
  • Fever
  • Headache
  • Nocturnal sweats
  • Anaemia, paleness
  • Loss of appetite, weight loss
  • Palpitations
  • Shortness of breath
  • Enlarged lymph nodes in lymphatic leukaemia
  • Bone pain, e.g. in the arms and legs

If the spleen or liver is enlarged by the disease, abdominal pain may also occur.

The various forms of leukaemia are treated differently.

Treatment of acute leukaemia

The initial treatment goal is to cure acute leukaemia. The most important treatment method is chemotherapy (cytostatics via infusion or as tablets). In the case of ALL, radiation treatment is also an option in addition to chemotherapy.

If these methods are unsuccessful, a stem cell transplant may be considered, though this is a risky procedure. Once the diseased cells have been removed by chemotherapy, healthy stem cells (from the patient themselves or a donor) are introduced into the bloodstream via an infusion. From there, they migrate into the bone marrow and form new blood cells. Regular check-ups by a doctor ensure that relapses can be detected as early as possible and help to alleviate the consequences of cancer treatment.

Treatment of chronic leukaemia

CLL can often remain untreated for a long time. If blood counts or symptoms get worse, patients are usually treated with chemotherapy, monoclonal antibodies and tyrosine kinase inhibitors. If these methods do not work well enough, a stem cell transplant – a serious and risky procedure – is considered.

When it comes to chronic myeloid leukaemia, the situation is different. If left untreated, CML will turn into acute leukaemia (blast crisis) after some time. The aim of treatment is to prevent this from happening. There are several ways to do this:

  • Tyrosine kinase inhibitors block the growth of cancer cells.
  • If this is unsuccessful, interferons (natural proteins) are used.
  • If this does not work either, a stem cell transplant is an option.
  • If CML worsens quickly and severely, it is treated with chemotherapy like acute leukaemia.

Other treatments

In the case of both acute and chronic leukaemia, further treatments can be given to increase patients’ well-being. These include:

  • Antiemetics for nausea and vomiting caused by chemotherapy
  • Antibiotics for bacterial infections
  • Blood transfusions for anaemia
  • Painkillers
  • Antimyotics for fungal infections
  • Psycho-oncological treatment

If a cure cannot be achieved, palliative therapies are used in the final stage of the disease. These are primarily aimed at alleviating pain and reducing the psychological burden on the affected person and their family members.

The life expectancy of leukaemia patients depends on many factors, in particular the type of leukaemia and the stage of the disease at diagnosis.

Although chronic leukaemia cannot be cured (except via stem cell transplantation), its progression can be slowed by treatment.

Acute leukaemia can be cured. If left untreated, however, it progresses rapidly and usually leads to death within a few months.

The five-year survival rate for ALL is 95% in children and 70% in adults. AML causes death within five years in approximately half of patients under 60 years of age. In the over-60s, this figure is as high as 80%.

In most cases, the cause of death is leukaemia itself. However, patients can also die from complications such as pneumonia, blood poisoning or brain haemorrhage.

In order to diagnose blood cancer, various examinations are carried out following a medical history consultation:

  • Physical examination (e.g. listening to the lungs and heart, palpation of the liver, spleen and lymph nodes)
  • Blood pressure measurement
  • Blood tests (complete and differential blood count): are certain blood values elevated or decreased?
  • Blood smear: the appearance of the blood cells is checked under a microscope.
  • Bone marrow biopsy: this is essential for diagnosing leukaemia.
  • In addition, imaging techniques such as ultrasound, CT, MRI or scintigraphy help to assess whether cancer cells are also present in other organs or in the bone.

The causes of leukaemia are not yet known exactly. There are probably several risk factors involved in the development of blood cancer:

  • Genetic factors: predisposition and certain genetic defects may play a role. However, leukaemia is not hereditary in the proper sense.
  • Age: the risk of AML and CML increases with age, while ALL mainly affects children.
  • Ionising radiation (e.g. radioactive or X-ray radiation)
  • Medications such as cytostatics
  • Chemical substances (e.g. work-related contact with benzene)
  • Viruses (only for T-cell leukaemia, which is very rare in Europe)
  • Smoking: the risk of developing AML is 40% higher in smokers.

Environmental influences and lifestyle factors may also have an impact on the risk of developing leukaemia, but this has not been proven.

Patienten mit Bluthochdruck müssen sich nicht mit der Diagnose abfinden. Sie können selbst dazu beitragen, die Werte zu senken. Dazu gehört ein aktiver Lebensstil mit viel Bewegung, eine gesunde Ernährung und das Vermeiden von dauerhaftem Stress. Der Konsum von Tabak und Alkohol sollte ebenfalls reduziert werden.

Wenn es Ihnen schwerfällt abzunehmen, schliessen Sie sich einer Selbsthilfegruppe an. Zudem kann es helfen, die Familie mit in den neuen Lebenswandel einzubeziehen, also gemeinsam sportlichen Aktivitäten nachzugehen oder gesunde Mahlzeiten zuzubereiten. Auf diese Weise fühlen sich Betroffene nicht allein oder ausgegrenzt.

For more information and support services, please contact the Swiss Cancer League:

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  • Leitlinie der Deutschen Gesellschaft für Hämatologie und Medizinische Onkologie: Diagnostik,Therapie und Nachsorge für Patienten mit einer chronischen lymphatischen Leukämie (CLL) (Stand: März 2018), unter: (Abrufdatum: 08.11.2022)
  • Leitlinie der Deutschen Gesellschaft für Hämatologie und Medizinische Onkologie: Chronische Myeloische Leukämie (CML) (Stand: Juni 2018), unter: (Abrufdatum: 08.11.2022)
  • Leitlinie der Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH): Akute myeloische Leukämie – AML – im Kindes- und Jugendalter (Stand: März 2019), unter (Abrufdatum: 08.11.2022)
  • Leitlinie der Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH): Akute lymphoblastische Leukämie – ALL – im Kindes- und Jugendalter (Stand: Mai 2021), unter (Abrufdatum: 08.11.2022)
  • Onko Internetportal der Deutschen Krebsgesellschaft: Leukämie – Ursachen und Risikofaktoren, unter (Abrufdatum: 08.11.2022)
  • Kompetenznetz Leukämien: Blut und Blutbildung, unter (Abrufdatum: 08.11.2022)
  • Kompetenznetz Leukämien: Aktuelle Therapieempfehlungen der AML-Intergroup für die Behandlung der akuten Promyelozytenleukämie, unter (Abrufdatum: 08.11.2022)
  • Universitätsspital Zürich: Leukämie, unter (Abrufdatum: 08.11.2022)
  • Zentrum für Krebsregisterdaten am Robert Koch Institut: Leukämien, unter (Abrufdatum: 08.11.2022)
  • Onkodin: Palliativmedizinische Betreuung, unter (Abrufdatum 08.11.2022)