Chronic Leukaemia
Chronic Leukaemia is a type of cancer that affects the cells in your blood that fight diseases. Usually, chronic leukaemias are more slowly growing than acute leukaemias.
This page gives you information about these diseases.
What we do
Methods used to diagnose chronic myeloid leukaemia (CML) and chronic lymphocytic leukaemia (CLL) include:-
- Blood tests for the presence of abnormal white cells
- Bone marrow biopsy (please see acute leukaemia section above)
- Lymph node biopsy (getting a sample of a lymph node for tests). This test is performed by a surgeon or radiologist (x-ray specialist).
Chronic leukaemia symptoms
Your doctor (GP) will send you to hospital for further investigation if you have chronic leukaemia symptoms (listed below), and blood tests results indicating that you may have chronic leukaemia.Symptoms of chronic leukaemia include
- tiredness, loss of appetite and weight loss
- increased sweating
- abnormal bruising and bleeding
- regular drenching night sweats
- swelling of the spleen
- repeated infections in a short space of time
- easily-bruised and itchy skin
- persistently swollen lymph nodes (glands)
Your GP will also take a blood test to see how many white blood cells are present. Too many white blood cells may indicate chronic leukaemia.
Chronic myeloid leukaemia (CML) treatment
For newly diagnosed CML, tablets called tyrosine kinase inhibitors (TKIs) are the mainstay of treatment. They specifically target the genetic abnormality in CML. Examples include imatinib nilotinib and dasatinib. They prevent CML from reaching the accelerated or acute (blast crisis) phase. .
Find out more about this on the CML support group website[AA(R1] , which provide emotional understanding and updated information on treatment options. For late stage CML, chemotherapy is given.
Chronic lymphocytic leukaemia (CLL) treatment
Some patients may not need any treatment at all; simply monitoring with regular blood tests to check that it is stable. If your condition worsens youmay require get a course of chemotherapy, or a newer ‘targeted therapy’, which will control the symptoms of CLL.
Chemotherapy (CML and CLL)
This is the use of drugs to kill leukaemia cells. It is given either as tablets to swallow, or can be injected directly into the vein as well. This treatment may be given on an outpatient basis meaning you don't have to stay overnight in hospital.
Bone marrow or stem cell transplant
Occasionally, a transplant is needed to give the best possible chance of curing chronic leukaemia. Before transplantation, you have aggressive high-dose chemotherapy and possibly radiotherapy to destroy leukaemia cells. This puts massive strain on the body and causes significant side-effects and potential complications. Transplantations are usually more successful in fitter people.
Bone marrow or stem cell transplantation is a possible alternative if you do not respond to treatment for chronic leukaemia. For some patients, a transplant may offer the best chance of cure.
Being referred to us
We will see you within two weeks of getting a urgent referral from your doctor.
What happens when you see us
You'll see a doctor at the clinic who is an expert in treating blood conditions (haematologist). The haematologist might suggest extra tests such as a bone marrow biopsy, during which a small sample of your bone marrow is examined under a microscope. The biopsy is usually carried out under a local anaesthetic (meaning you don’t go to sleep).
The procedure is quick – taking 15 minutes. – and usually painless. You may have bruising for a few days after.
The sample is checked for the presence of leukaemia cells. If they are present, the biopsy will be able to determine if it is CML or CLL.
It’s important to know the progress and extent of chronic leukaemia if it is detected. Therefore a number of additional tests may be used:
- Cytogenetic and molecular testing: this identifies the genetic makeup of the leukaemia cells. This can have an important impact on treatment. Certain genetic types respond well to certain medicines.
- Sometimes, it can be helpful to carry out further biopsies of enlarged lymph nodes, if we are unable to make a diagnosis from the blood or bone marrow.
- CT or PET/CT scans: These may be used to check if these organs are involved by the leukaemia.
What happens next
Test results are examined by the multi-disciplinary team (MDT) who are a group of doctors and health professionals that specialise in different aspects of treating leukaemia. They discuss your test results and decide on the best treatment plan. You are consulted fully so that you play a role in whatever treatment you receive.
Members of the team include:
- several haemato-oncologists (specialists in the non-surgical treatment of leukaemia using medicines)
- a pharmacist
- a transplant specialist
- specialist leukaemia nurses
The specialist nurse will be with you throughout your treatment journey. The nurse is available to answer any questions you or your family may have. The nurse also acts as the first point of contact between you the MDT.
More information
Clinical trials
You may be asked to take part in a clinical trial. Clinical trials help us learn more about the best way to treat specific conditions. Find out more here.
Related links
Visit the MacMillan Cancer website here
Visit the Cancer Research UK website here
Visit the NHS Choices - Cancer website here
Visit the Bloodwise website here
Visit the CLL Support Association website here
