Leukaemia

Leukaemia is divided into ‘acute’ or ‘chronic’ depending on how fast its growing and where it originated.¹ Under this umbrella, there are four types of leukaemia:^1,4

• Acute myeloid leukaemia (AML): is the most common leukemia in adults and the most aggressive
• Acute lymphocytic leukaemia (ALL):  this type of leukaemia occurs more in children rather than adults
• Chronic myeloid leukaemia (CML): this type of leukaemia mainly occurs in adults and is usually slow growing. It is often actively monitored and only treated when/if it progresses and symptoms evolve
• Chronic lymphocytic leukaemia (CLL): this form of leukemia is similar to CML, in that it usually affects adults, and occurs more so in older adults and is slow growing. Treatment may not occur until the disease progresses

Leukaemia symptoms may differ according to the type diagnosed - for instance acute leukaemia symptoms can be more severe and develop faster,¹ while chronic leukaemia symptoms usually tend to develop more slowly, and this may take months or years.^1,4 

Leukaemia symptoms may include:^1,5,6

• Weakness and fatigue that doesn’t improve with rest
  
• Loss of appetite
• Anaemia (low number of red blood cells)
• Frequent infections that may include high temperatures, coughing, increased passing of urine, boils, sore throat
• Bruising
• Bleeding easily, particularly from gums and nose
• Swollen lymph glands (often noticeable in the armpits, neck, and groin)

Having any of these symptoms doesn't necessarily mean that you have leukaemia, however speak with your GP or specialist if you have any questions or concerns.

It’s not known exactly what causes leukaemia.⁶ However, some factors appear to increase the risk of getting leukaemia, including:^1,6

• Advanced age (average age for some types of leukaemia is 65)
  
• Exposure to intense radiation
• Smoking - the benzene in cigarettes is thought to increase the risk of leukaemia
• Certain genetic syndromes, including Down syndrome, Klinefelter syndrome, Fanconi anaemia, Bloom syndrome, trisomy 8, and Li–Fraumeni syndrome
• Certain viral infections such as the Human T-Cell leukaemia virus

If you have any questions or concerns about potential risk factors, it is recommended that you make an appointment with your GP or specialist.

Your GP will refer you to a specialist if they are concerned about your symptoms and risk factors for leukaemia. In addition to a physical examination, your doctor may also order a range of tests to better understand any symptoms, help diagnose and determine the type of leukaemia.^1,6

These tests may include:^1,6

• Blood tests
  
• Bone marrow biopsy
• Lumbar puncture
• Imaging tests: such as X-rays, computed tomography (CT) scans

Your doctor will explain more about what each of the tests are and why they may be considered.

If you are found to have leukaemia, your doctor will explain what stage your cancer is and how far it has progressed. 

• Peripheral blood stem cell and bone marrow transplantation
• Tyrosine kinase inhibitory therapy
• Allogeneic stem cell transplantation (HSCT)
• Hypomethylating agents (HMAs)
• Checkpoint inhibitors
• Bispecific antibodies,
• Chimeric antigen receptor (CAR)-T cells
• Combination of  the above

Cancer treatment often results in side effects, yet the type and severity of side effects may vary between individuals.^11,12 You can ask your doctor for detailed information about side effects and how to best manage them.

The following list may help when researching the types of activities and nutrition you can consider during treatment.¹³ Your treating doctor can also provide further information or point you towards the right resources:

• Get as much rest as possible
  
• Aim for a wholefood, varied diet, and we also encourage you to think about eating foods that interest you rather than what you think you should eat
• Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent snacks and avoiding smells that make you nauseous
• Drink lots of water
• Reach out to support groups and others who have had cancer treatment
• Record your side effects in a diary or journal
• Speak to your doctor about incorporating some gentle exercise into your weekly routine
• It is important to acknowledge when you are fatigued and rest when you need to
• Ask for and accept help from family, friends and neighbours
• Be open with employers about your treatment and discuss flexible working options if you need them