Leukaemia is divided into ‘acute’ or ‘chronic’ depending on how quickly it is growing and the type of blood cell affected.¹ Under this umbrella, there are four main types of leukaemia:^1,4

Acute myeloid leukaemia (AML): the most common type of acute leukaemia in adults and typically aggressive.

Acute lymphocytic leukaemia (ALL): more common in children than in adults.

Chronic myeloid leukaemia (CML): mainly occurs in adults and is usually slow growing. It is often actively monitored and may only be treated if it progresses or symptoms develop.

Chronic lymphocytic leukaemia (CLL): similar to CML in that it usually affects adults, particularly older adults, and is typically slow growing. Treatment may not be required unless the disease progresses.

Symptoms of leukaemia may differ depending on the type diagnosed. Acute leukaemia symptoms can be more severe and develop quickly,^1,4 while chronic leukaemia symptoms tend to develop more slowly, sometimes over months or years.^1,4

Leukaemia symptoms may include:^1,5,6

• Weakness and fatigue that does not improve with rest
• Loss of appetite
• Anaemia (low number of red blood cells)
• Frequent infections, which may include high temperatures, coughing, increased urination, boils or sore throat
• Bruising
• Bleeding easily, particularly from the gums or nose
• Swollen lymph glands (often noticeable in the armpits, neck and groin)

Having any of these symptoms does not necessarily mean you have leukaemia. However, speak with your GP or specialist if you have any questions or concerns.

It is not known exactly what causes leukaemia.6 However, some factors appear to increase the risk of developing leukaemia, including:^1,6

• Advanced age (the average age at diagnosis for some types of leukaemia is around 65)
• Exposure to high levels of radiation
• Smoking — benzene in cigarettes is thought to increase the risk of leukaemia
• Certain genetic syndromes, including Down syndrome, Klinefelter syndrome, Fanconi anaemia, Bloom syndrome, trisomy 8 and Li–Fraumeni syndrome
• Certain viral infections, such as the Human T-cell leukaemia virus

If you have any questions or concerns about potential risk factors, it is recommended that you make an appointment with your GP or specialist.

Tests for leukaemia may include:^1,6

• Blood tests
  
• Bone marrow biopsy
• Lumbar puncture
• Imaging tests: such as X-rays, computed tomography (CT) scans

Your doctor will explain what each test involves and why it may be recommended.

If you are diagnosed with leukaemia, your doctor will explain the stage of the disease and how far it has progressed.

Active monitoring (sometimes called watchful waiting) involves closely observing the cancer without starting immediate treatment. It may be recommended for some slow-growing blood cancers where there are no significant symptoms.

Chemotherapy uses anti-cancer medicines to destroy or control cancer cells. In blood cancers, it is often given intravenously or orally and works by targeting rapidly dividing cells. It may be used alone or in combination with other treatments.

Surgery is less commonly used in blood cancers but may be performed in certain situations, such as removing an enlarged spleen or obtaining tissue for diagnosis.

Radiation therapy uses high-energy radiation to destroy cancer cells or shrink areas of disease. In blood cancers, it is sometimes used to treat specific affected areas, relieve symptoms, or as part of preparation for stem cell transplantation.

Targeted therapy uses medicines designed to specifically target certain molecules or genetic changes within cancer cells. These treatments aim to block cancer growth while limiting damage to healthy cells.

• Peripheral blood stem cell and bone marrow transplantation
• Tyrosine kinase inhibitory therapy
• Allogeneic stem cell transplantation (HSCT)
• Hypomethylating agents (HMAs)
• Checkpoint inhibitors
• Bispecific antibodies,
• Chimeric antigen receptor (CAR)-T cells
• Combination of  the above