Leukaemia:
symptoms and course of leukaemia

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.

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.

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.