Adult & Paediatric: Acute & Chronic Leukaemias

When the bone marrow produces abnormal blood cells—typically White Blood Cells (WBCs)—that do not perform as they should, they start to build up in your bone marrow and blood, causing leukaemia. The cells in the bone marrow (white blood cells, red blood cells, and platelets) have different functions –

• White Blood Cells (WBCs) help your body fight infections
• Platelets prevent excess bleeding by promoting blood clots
• Red Blood Cells (RBCs) deliver oxygen from the lungs to other organs and tissue

What are the types of Adult and Paediatric Acute and Chronic Leukaemias?

Leukaemia comes in various forms, and acute leukaemia increases quickly. If it is not treated, it typically gets worse very fast.

Below are the types of acute and chronic leukaemia in children and adult –

• Acute Lymphocytic Leukaemia (ALL) is the most prevalent malignancy and kind of leukaemia in children, in which the bone marrow overproduces Lymphocytes.
• When the bone marrow produces aberrant myeloblasts, a kind of white blood cell, red blood cells, or platelets, patients develop Acute Myeloid Leukaemia (AML).

There are additional chronic (slow-growing) forms of leukaemia. They grow slowly and get worse over time –

• CLL (Chronic Lymphocytic Leukaemia) is leukaemia in which the bone marrow produces aberrant cells.
• The bone marrow produces aberrant granulocytes, a type of white blood cell, in Chronic Myeloid Leukaemia (CML).
• Juvenile Myelomonocytic Leukaemia (JMML) is one of several additional uncommon forms of leukaemia in kids.

What are the Signs and Symptoms of Acute and Chronic Leukaemia?

The following are the signs and symptoms of acute leukaemia –

• Frequent and severe nosebleeds
• Gum bleeding
• Fever
• Pale skin
• Bone pain
• Shortness of breath
• Lumps in and around the neck, armpits, belly, or groyne

The following are the signs and symptoms of chronic leukaemia –

• Swollen lymph nodes
• Fatigue
• Fever
• Night sweats
• Sudden weight loss

What are the Causes of Leukaemia in Adults and Children?

Leukaemia in children and adults occurs due to changes in the genetic material in the bone marrow cells. Though the cause of the condition is unknown, several factors raise the risk of leukaemia in patients. The following are the risk factors that contribute to the development of leukaemia –

• Family History – According to studies, individuals with biological parents, siblings, or children with leukaemia are two to four times more likely to have this disease themselves.
• Age – The average age of those who receive a diagnosis is 71.
• Gender – Males and those assigned male at birth (AMAB) are more likely to acquire leukaemia than females and those individuals assigned female at birth (AFAB).
• Monoclonal B-cell Lymphocytosis – When you have monoclonal B-cell lymphocytosis, your blood contains more identical B-cells than is typical. There is a small chance that you could develop leukaemia if you have this condition.

In addition, people undergoing chemotherapy in the past, exposed to radiation (radiation therapy), and having genetic conditions such as – Ataxia Telangiectasia, Down Syndrome, Li-Fraumeni Syndrome, Fanconi Anaemia, etc. – are at more risk of developing leukaemia.

How is Acute and Chronic Leukaemia Diagnosed at Apollo Hospitals, Karnataka?

Diagnosis of leukaemia in adults and children is somewhat the same. Before recommending any diagnostic tests, the doctors at Apollo Hospitals, Karnataka, ask about the symptoms and complications. They may also perform a physical examination to look for symptoms like bruising, bleeding, etc. After a complete physical examination, they will recommend you the following tests –

• Complete Blood Count – This is done to detect the number of white blood cells. It also detects the insufficient amount of red blood cells and platelets. It also shows the appearance of the blast cells, which are usually found in the bone marrow.
• Bone Marrow Test – A sample of the bone marrow is taken and sent to the lab to look for leukaemia cells. This will be further evaluated based on their shape, size, and other genetic or molecular features to understand whether the cells began from B or T lymphocytes.
• Imaging Test – CT Scans, MRIs, and X-Rays are some of the most commonly used imaging tests to determine if cancer has spread to other body parts, such as the brain or spinal cord.
• Spinal Fluid Test – Also known as Spinal Tap, is done to detect if the fluid has spread to the spinal fluid. This is done by taking a sample of the spinal fluid and testing it in the lab.

In chronic leukaemia, an additional test – Fluorescence in situ hybridisation (FISH)- is sometimes done. It is a diagnostic test that looks for abnormalities in the chromosomes of malignant lymphocytes. Doctors occasionally use this data to assess your prognosis and guide treatment selection.

How is Acute and Chronic Leukaemia Treated at Apollo Hospitals?

Acute leukaemia treatment typically consists of the following phases –

• Induction Treatment – In the initial treatment stage, most leukaemia cells in the blood and bone marrow are eliminated, and regular blood cell production is reinstated.
• Consolidation Treatment – This stage of treatment, also known as post-remission therapy, aims to eradicate any leukaemia that may still be present in the body.
• Maintenance Therapy – The third stage of therapy stops the regrowth of leukaemia cells. The medicines employed at this stage are often administered over a lengthy period, frequently years, at substantially lower doses.
• Prevention of Spinal Cord Damage – Acute lymphocytic leukaemia patients may receive extra treatment at each phase of therapy to eradicate leukaemia cells that have spread to the central nervous system.

As leukaemia transforms into a chronic stage, the following forms of treatments are administered –

• Chemotherapy – Chemotherapy treatments can be given intravenously or taken as pills. Depending on your circumstances, your doctor may prescribe a single chemotherapy agent or a combination of medications.
• Radiation Therapy – High-powered beams, such as X-rays or protons, are used in radiation therapy to kill cancer cells. Your doctor can suggest radiation therapy if the cancer cells have progressed to the central nervous system.
• Targeted Therapy – Targeted medication therapies concentrate on particular defects prevalent in cancer cells. These therapies can kill cancer cells by preventing these aberrations.
• Bone Marrow Transplant – In the event of relapse, a bone marrow transplant may be used as consolidation therapy, sometimes referred to as a stem cell transplant.

Any cancer diagnosis is unsettling, but a leukaemia diagnosis could seem frightening for the patients. It can be challenging to envision the therapy process without a tumour that can be surgically removed. Be mindful that leukaemia is a complex disease with multiple outcomes, and it requires medical intervention from the world-class medical professionals at Apollo Hospitals, Karnataka.

The expert oncologists, haematologists, and the entire interdisciplinary medical team at Apollo Hospitals, Karnataka, will assess your condition, even down to the peculiarities of the leukaemia cells, to plan an effective & personalised course of treatment.

Book a consultation with our doctors to discuss the implications of a leukaemia diagnosis and treatment.