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Understanding Leukaemia

Higher Incidence in Males

Blood Cancer Incidence Statistics: Analysis of Leukemia and Lymphoma Data

Leukaemia, also known as blood cancer, is one of the common types of cancer. In 2012, 489 leukaemia cases were reported in Hong Kong, with 274 cases (approximately 56%) occurring in males and 215 cases (about 44%) in females. In the same year, 276 deaths were attributed to leukaemia, comprising 181 males and 95 females.

Physical Reactions

Common Blood Cancer Symptoms: Anemia, Fever, Bruising Could Be Warning Signs

Leukemia, also known as blood cancer, is one of the common fatal cancers in Hong Kong. In 2022, there were 368 recorded deaths due to leukemia, accounting for 2.5% of all cancer deaths, ranking it as the ninth most fatal cancer. Leukemia affects males more than females, among the deaths, 210 were male and 158 were female.

Unlike most cancers, leukemia has a unique age distribution pattern. It is not only the most common cancer among children (0-19 years), but its incidence also peaks in the elderly population (85 years and above).Leukemia is the most common type of cancer in this age group, with an incidence rate significantly higher than in other age groups. The incidence rate begins to rise steadily from around 50 years of age and reaches its peak among males aged 85 and above.

The prognosis of leukemia varies significantly depending on the specific type and age of onset. According to data from 2012 to 2021, the overall five-year relative survival rate for leukemia in Hong Kong is 42%. The cure rate for childhood leukemia is relatively high, while certain types of leukemia in adults present greater challenges.

Chemical Environment

Analyzing Blood Cancer Causes: Hematopoietic Cell Mutations and Environmental Factors

In general, the following factors may increase the risk of developing leukaemia:

  • Excessive exposure to radiation, including X-rays
  • Long-term contact with certain chemicals
  • Viral infections
Initial Diagnostic Tests for Patients:
  • Bone Marrow Biopsy

Applicable to both chronic and acute leukaemia. A doctor uses a thin needle to extract a small sample of bone marrow from the patient’s hip bone to check for leukaemia cells or abnormal chromosomes.

  • Chest X-ray

Used for acute leukaemia to determine whether cancerous cells from the lymph nodes have spread to the chest area.

If necessary, after these initial tests, the doctor may request further in-depth examinations:

  • Chromosome or DNA Analysis

Used for acute leukaemia to assess whether cancerous cells in the lymph nodes have spread to the chest area.

  • Lymph Node Biopsy

Used for chronic leukaemia. After administering local or general anaesthesia, the doctor removes a small piece of swollen lymph node tissue for examination.

  • Computed Tomography (CT) Scan

Primarily used for chronic leukaemia. X-rays scan the patient’s body and produce images to check for abnormalities in lymph nodes and spleen enlargement.

  • Lumbar Puncture (Spinal Tap)

Used for acute leukaemia. After the patient takes pain relief medication, the doctor inserts a thin needle into the lower spine to extract fluid and check for cancerous cells.

  • Staging of Chronic Leukaemia

Doctors classify chronic leukaemia by stages, though the staging differs between chronic lymphocytic leukaemia (CLL) and chronic myeloid leukaemia (CML).

Chronic lymphocytic leukaemia often shows little change in the first 10 years. CLL is generally divided into three stages based on the number of affected lymph nodes in the neck, armpits, groin, liver, and spleen.

Doctors typically stage chronic leukaemia to assess disease progression, but staging differs between chronic lymphocytic leukaemia (CLL) and chronic myeloid leukaemia (CML).

Chronic Lymphocytic Leukaemia (CLL) generally shows minimal changes during the first decade. Staging for CLL is based on the number of affected lymphatic areas, including lymph nodes in the neck, armpits, groin, and involvement of the liver and spleen. It can be broadly divided into three stages:

  • Early Stage (Stage 1):

Disease is limited to a few lymph node regions, often with no noticeable symptoms.

  • Intermediate Stage (Stage 2):

Multiple lymph node areas are affected, possibly including the liver or spleen. Patients may experience fatigue, weight loss, and anaemia.

  • Advanced Stage (Stage 3):

Extensive involvement of multiple lymphatic tissues and organs, significantly impaired bone marrow function, severe anaemia, low platelet count, compromised immunity, and frequent infections.

Chronic Myeloid Leukaemia (CML), on the other hand, can be classified into three phases:

  • Chronic Phase:  

Marked by an elevated white blood cell count, but the disease progresses slowly with minimal or no symptoms.
Treatment response is generally favourable, and patients have stable disease with a high survival rate.

  • Accelerated Phase:

Disease progression accelerates with further increases in white blood cells and immature cells.
Patients may experience fever, night sweats, weight loss, and significant spleen enlargement.
Treatment response is reduced compared to the chronic phase, requiring more aggressive management.

  • Blast Crisis (Acute Phase):  

Rapid deterioration, characterised by a substantial increase in immature cells (blast cells) in blood and bone marrow.
Symptoms become severe, including bleeding, increased infection risk, and severe anaemia.
Treatment responses are usually poor, with the primary goal shifting to symptom control and life extension.

Early diagnosis and accurate staging are critical for prognosis and guiding treatment strategies for patients with chronic leukaemia. Regular medical evaluations are essential for monitoring disease progression and adjusting treatment accordingly.

Multiple Treatment Options

Blood Cancer Treatment Methods: New Advances in Chemotherapy and Bone Marrow Transplantation

After staging the patient’s condition, doctors will select an appropriate treatment plan. Chronic lymphocytic leukaemia currently has no complete cure, and patients typically manage their condition through close monitoring and various treatments to maintain an everyday life. Chronic myeloid leukaemia is primarily treated with bone marrow transplants, chemotherapy, or a medication called imatinib. For acute leukaemia, chemotherapy or radiation therapy may be used.

  • Chemotherapy
  • This treatment involves administering drugs into the patient’s body, which travel through the bloodstream to target and kill cancer cells or slow their growth. Chemotherapy for acute leukaemia is divided into three phases:
    • Induction Chemotherapy
    • This intensive phase lasts 4 to 6 weeks and aims to eliminate as many cancer cells as possible. Typically, 3 to 4 drugs are administered intravenously. This phase can clear cancer cells from the blood and bone marrow if successful.
    • Consolidation Chemotherapy
    • This phase targets any remaining cancer cells missed during induction. The choice of drugs depends on whether the patient is hospitalised and whether oral or intravenous administration is preferred. Side effects are generally milder in this phase.
    • Maintenance Chemotherapy
    • Less intensive than consolidation, this phase can span 2 years. Patients may opt for oral or intravenous drugs, but must attend regular follow-ups to monitor effectiveness.

Side effects of chemotherapy may include easy bruising, fatigue, nausea, mouth sores, increased susceptibility to infections, hair loss, and infertility.

  • Bone Marrow Transplant

Since chemotherapy can damage bone marrow stem cells, transplanting peripheral or bone marrow cells can help restore healthy blood cell levels. Stem cells may come from the patient’s blood, bone marrow, or a donor. Post-transplant side effects, such as bruising, bleeding, fatigue, and nausea, are usually temporary.

  • Radiation Therapy

Also known as “radiotherapy,” this method is used for chronic and acute leukaemia. The patient lies in a machine that emits radiation (e.g., X-rays or gamma rays) to target and inhibit cancer cell growth. Treatment duration depends on tumour size and the patient’s health.

Side effects may include skin redness (similar to sunburn) in the treated area, fatigue, and hair loss.

  • Imatinib

This medication treats chronic myeloid leukaemia (CML). Most CML patients have an abnormal chromosome called the “Philadelphia chromosome,” which was discovered in Philadelphia, USA. Imatinib works by blocking the protein produced by this chromosome, suppressing its growth and alleviating leukaemia symptoms.

Possible side effects include nausea, eye swelling, diarrhoea, and rashes, which are generally mild and manageable.

Healthy Living

Blood Cancer Personal Care: How to Prevent Infection During Chemotherapy?

After undergoing various treatments, patients should take medications as prescribed and attend regular check-ups to allow doctors to monitor and manage their condition while assessing any risk of recurrence. Additionally, patients must pay special attention to home and personal hygiene, avoid crowded public places to prevent bacterial infections, and avoid contact with individuals who have chickenpox, as this could lead to life-threatening complications.

Further Understanding

Read More

Note 1: The hip bone refers to the pelvic bone.

Sources:
Hospital Authority
Cancer Foundation
Mayo Clinic
Cancer Online Resource Hub




▣ The information on this website has been reviewed by the HEAL Medical Team and is regularly updated according to the most recent clinical evidence. All content is provided for general informational purposes only and should not replace professional medical advice. Please consult your doctor or another qualified healthcare professional for personalized medical guidance.

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