onkommon.com
Blood cancers · free patient guide
Leukaemia
Acute and chronic leukaemias. ALL, AML, CLL, CML
Haemato-oncology clinic
What it is
Leukaemia is cancer of the blood-forming cells in the bone marrow. Because the marrow makes red cells, white cells and platelets, symptoms come from all three failing: tiredness, infections and bruising or bleeding.
The distinction between acute and chronic is not about severity of feeling, it is about the speed of the disease, and it changes everything about urgency.
Leukaemia includes both the most urgent cancers in medicine and some of the most indolent. Acute leukaemia can require treatment within days; chronic leukaemia may be watched for years without treatment.
Warning signs worth acting on
- Unexplained bruising, or small red spots under the skin
- Bleeding gums or nosebleeds that are new and persistent
- Persistent tiredness with breathlessness
- Repeated or unusually severe infections
- Unexplained fever, night sweats or weight loss
- Bone or joint pain, particularly in children
- An abnormal blood count on a routine test
How it is diagnosed
- Full blood count and blood film
- Bone marrow aspirate and biopsy
- Flow cytometry to classify the cells
- Cytogenetics and molecular testing, which determine the subtype and the treatment
- Lumbar puncture in defined situations
Cytogenetics and molecular markers define the subtype and drive both treatment choice and monitoring. Residual-disease monitoring is central here: measuring what remains after treatment, at a level nothing else can see.
Is it inherited?
Most leukaemia is not inherited. Some predisposition syndromes exist, particularly where there is childhood onset or a strong family pattern, and are worth investigating.
Genetic counselling & family risk →
Prevention & early detection
There is no established screening. An unexplained abnormal blood count is worth following up rather than repeating indefinitely.
Treatment options
What may form part of a plan
Which of these apply to you depends on your stage, your pathology, your other health and what you want from treatment. That decision belongs at a tumour board, not on a website.
Chemotherapy
Drug treatment that acts on rapidly dividing cells throughout the body.
Targeted therapy
Medicines matched to a specific alteration found in your tumour.
Stem cell & bone marrow transplant
High-dose treatment followed by restoration of the blood-forming system.
CAR-T cell therapy
Your own immune cells, collected, re-engineered and returned.
Immunotherapy
Treatment that works on the immune system rather than directly on the tumour.
Conservative management & active surveillance
Sometimes the right decision is to watch carefully and treat nothing yet.
Clinical trials
Most Indian patients never learn a trial exists, because nobody is looking.
At KPCIRC
The pathway for this disease
- A distinct diagnostic pathway routed through partners and read back into the board
- Same-day escalation for suspected acute leukaemia, this is not a scheduled referral
- Residual-disease monitoring candidacy assessed explicitly rather than assumed
- Infection and neutropenia protocol as a standing companion to treatment
- Transplant-referral opinion where indicated
- High-frequency follow-up, because the interval between visits is itself a clinical decision
Support that matters most here
Take this with you
Questions to ask your own doctor
These work wherever you are treated. Print the page or take a photograph of this list.
- Is this acute or chronic, and what does that mean for how fast we move?
- What subtype is it, and what did the cytogenetics show?
- Will residual-disease monitoring be used, and at what intervals?
- Is transplant likely to come into the plan, and when would we decide?
- What do I do about a fever at home?
This page is not an emergency service. Severe breathlessness, chest pain, uncontrolled bleeding, a high fever during chemotherapy, or a sudden change in alertness means going to your nearest emergency department now, not reading further.