Leukaemia

Bone marrow

Bone marrow is a spongy, red substance found in the innermost part of the bones. It is found especially in the pelvis, breast bone, ribs and vertebrae.

The bone marrow contains stem cells, which then turn into three important components of our blood:

• red blood cells that transport oxygen to all of our body parts
• white blood cells that fight infections
• platelets that ensure that blood clots and stop bleeding

After a ripening process, these blood cells enter the bloodstream.

What is it?

With leukaemia, there is a disturbance in the formation of certain white blood cells, or, more specifically, in the maturation process. Abnormal cells that have not matured sufficiently accumulate in the bone marrow and impair the production of normal blood cells in the bone marrow. At first, there is only a large quantity of immature white blood cells in the bone marrow, but over time, those are released into the blood stream, where they are then carried to other organs (e.g. spleen or liver) and lymph nodes.

We distinguish various types of chronic leukaemia.

Acute leukaemia

With acute leukaemia, the white blood cells do not mature. After just a short time, there is an accumulation of immature blood cells and a lack of mature white blood cells.

Chronic leukaemia

With chronic leukemia, the cells mature reasonably well and the disease process is slower than with acute leukaemia. Depending on the sort of white blood cell that causes the disease, we refer to either lymphatic or myeloid leukaemia. There are four types of leukaemia:

• acute lymphatic leukaemia (ALL)
• acute myeloid leukaemia (AML)
• chronic lymphatic leukaemia (CLL)
• chronic myeloid leukaemia (CML)

The age of onset is different depending on the type of leukaemia. Acute lymphatic leukaema (ALL) is particularly found in children and young adults. It is the most common cancer in children younger than 14 years old. Acute myeloid leukaemia (AML) is primarily found in (older) adults. Chronic leukaemia is usually found in people who are middle-aged or older.

Symptoms

Symptoms of leukaemia vary. With acute leukaemia, the symptoms can be quite sudden and quickly become worse if there is no treatment. With chronic leukaemia, the symptoms can present for a long time and only worsen gradually.

Symptoms with acute leukaemia are caused by the large quantity of immature white blood cells in the bone marrow. There is also less space for the formation of red blood cells and platelets. There will be a shortage of healthy white blood cells, red blood cells and platelets.

Several symptoms can accompany acute leukaemia:

• paleness (due to a shortage of red blood cells)
• fatigue and shortness of breath (due to a shortage of red blood cells)
• dizziness and palpitations (due to a shortage of red blood cells)
• spontaneous bleeding (due to a shortage of platelets)
• bruising easily (due to a shortage of platelets)
• infections that recur or do not heal well (due to a shortage of healthy white blood cells)
• fever
• periods of heavy night sweats
• headache

Treatment

The most common treatment for acute leukaemia is chemotherapy, though not in combination with a stem cell transplant (SCT) and/or radiation therapy.

Latest publication date: 28/12/2023