Leukaemia is a type of cancer of the blood cells. Blood is made up of different types of cells that are made in the centre of bones, in a part called the bone marrow.

About acute leukaemia

When people have leukaemia, their bone marrow makes abnormal blood cells instead of normal blood cells. These abnormal blood cells grow out of control, get into the blood, and travel around the body. Sometimes, these cells collect in certain parts of the body.
When the bone marrow makes abnormal blood cells, it does not make the normal blood cells that a person’s body needs. This can cause symptoms.
There are different types of leukaemia. Some types grow very slowly (‘chronic leukaemias’), while others grow much faster (‘acute leukaemias’). Sometimes, people have a type of chronic leukaemia that is slow-growing at first and later becomes a fast-growing acute leukaemia. 

Types of acute leukaemia

There are two types of acute leukaemia:

  • Acute myeloid leukaemia (AML) and
  • Acute lymphoblastic leukaemia (ALL) 

Symptoms

Leukaemia does not always cause symptoms, especially at first. When it does cause symptoms, the most common ones include:

  • Feeling tired or weak
  • Weight loss (without trying) 
  • Night sweats
  • Bleeding or bruising easily 
  • Paler skin than usual – on brown or black skin this may be easier to see on the palms of your hands or insides of your eyelids
  • Frequent infections 
  • Swollen glands, usually in the neck, armpits and groin
  • Aches and pains in your bones
  • High temperature/recurrent infection

Diagnosis

There are different tests to diagnose leukaemia. These include:

  • Blood tests
  • Bone marrow biopsy – For this test, a doctor takes a small sample of the bone marrow. The sample is then examined under a microscope to see if abnormal (cancer) cells are present

At the Leukaemia clinic you will see a doctor who is an expert in treating blood conditions (haemato-oncologist). The haematologist might suggest the following tests:

Bone marrow biopsy

A small sample of your bone marrow is examined under a microscope. The biopsy is usually carried out under a local anaesthetic (meaning you don’t go to sleep).

The procedure is quick (usually takes about 20-30 minutes) and carried out as an outpatient procedure. 

The sample is checked for the presence of leukaemia cells. If they are present, the biopsy will also determine which type of leukaemia is present: acute myeloid leukaemia (AML) or acute lymphoblastic leukaemia (ALL).

Further tests

A number of additional tests might be used:

  • Cytogenetic and molecular testing: This identifies the genetic make-up of the leukaemia cells. This can have an important impact on treatment. Certain genetic types respond better with special treatments.
  • Lymph node biopsy: Sometimes, it can be helpful to carry out further biopsies of enlarged lymph nodes, if we are unable to make a diagnosis from the blood or bone marrow.
  • CT or PET-CT scans: These might be used to check if these organs are involved by the leukaemia.
  • Lumbar puncture: If there is a risk that the leukaemia has spread to your nervous system, a lumbar puncture might be carried out. This test uses a needle to extract a sample of cerebrospinal fluid (the fluid that surrounds and protects your brain and spinal cord) from your back. The fluid is then tested to see if the leukaemia has reached your nervous system.

Most of these results will be available quickly so a treatment plan can be made and started within a couple of days. Some tests (cytogenetic and molecular testing) might take a little longer but this is very unlikely to affect the first few weeks of treatment.

Treatment at The Clatterbridge Cancer Centre

Acute leukaemias are an aggressive type of blood cancer. They need prompt treatment and are treated in different ways.

The right treatment will depend on the type of leukaemia you have, your age, and any other health conditions you have.

Planning treatment

Specialists from different medical areas meet weekly to discuss patient treatment options. This multidisciplinary team meeting (MDT) is central to the way we work. The MDT gives advice, support and creates individualised patient plans – so you get offered a treatment path that is right for you.

Treatment for leukaemia can include 1 or more of the following.

Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. 

This therapy can be:

  • Intensive chemotherapy – given as an inpatient in hospital on Ward 4 or Ward 5 in Clatterbridge Cancer Centre – Liverpool, or 
  • Gentle chemotherapy – this can be given as an outpatient

Your doctor will discuss treatment options with you. If appropriate, you may be offered ambulatory care where you receive part of your intensive care as outpatient. 

This is the term doctors use for medicines that kill cancer cells by recognising proteins on the cancer cells so the immune system can attack them. 

This treatment replaces cells in the bone marrow that are killed by chemotherapy or radiation. These ‘donor’ cells can come from different places, including your own bone marrow or another person's bone marrow. 

If you need a stem cell transplant, you will be seen in our dedicated stem cell (bone marrow) transplant clinic for assessment and future treatment. 

This is a type of gene therapy which can be used to target cancer cells in some leukaemias.

After treatment

What happens after treatment?

After treatment, you will have check-ups every so often so we can watch for any signs that the leukaemia might have come back. Regular follow-up tests include talking with your doctor, physical check-ups, and blood tests. Sometimes, the doctor will also do a bone marrow biopsy.

What happens if the leukaemia comes back?

If the leukaemia comes back, you might have more chemotherapy, radiation, a stem cell transplant or we might offer other treatments to help you with symptoms or supportive care.

Our team

We provide specialist care for acute leukaemias and we are with you every step of the way. Specialist leukaemia nurses stay with you throughout your treatment journey, from your first clinic appointment to aftercare. They are there to help with problems and questions you – or your family – may have.

We diagnose and treat both types of acute leukaemia:

  • Acute myeloid leukaemia (AML) and
  • Acute lymphoblastic leukaemia (ALL).

If you come to the hospital you can expect:

  • Acute leukaemia diagnosis – Your doctor (GP) will send you to hospital for further investigation if you have symptoms of leukaemia and blood test results indicating that you might have leukaemia. 
  • Experts working together to give you the best treatment tailored to your disease.
  • Access to cutting-edge treatments – Clinical trials are vital in the fight against leukaemia. Our trials programme makes the latest treatments available to patients – offering the best chance of beating the disease.
  • Regional treatment centre – The hospital is the regional centre for bone marrow and stem cell transplantation, important for the treatment of some patients with acute leukaemia.
  • Research-driven care – As a major cancer centre, we lead research into leukaemia diagnosis, biology and treatment. 

Some of the services we provide include:

  • Clinics in Clatterbridge Cancer Centre – Liverpool (CCC-Liverpool) and Clatterbridge Cancer Centre – Aintree (CCC-Aintree)
  • Outpatient chemotherapy in CCC-Liverpool and the Marina Dalglish Centre (Aintree)
  • Inpatient care on Ward 4 and Ward 5 at CCC-Liverpool 
  • Blood cancer services to all acute hospitals in Liverpool 
  • Regional support to haematology teams in Merseyside, Cheshire and North Wales
  • Outreach services to the Isle of Man
  • Clinical trials are delivered at Clatterbridge Cancer Centre – Liverpool 

Our team is made up of the following members:

  • Consultants 
  • Specialist Registrar 
  • Advanced Nurse Practitioner
  • Clinical Nurse Specialists 
  • Research Nurses
  • Pharmacist 
  • Ward nurses

Consultants 

Dr Muhammad Saif – Stem Cell Transplant Director and Service Lead 
Dr Gabe Toth (Leukaemia and transplant physician / leukaemia lead)
Dr Tom Seddon (Leukaemia and transplant physician)
Dr Shahid Iqbal (Locum consultant, Leukaemia and transplant physician) 

Nursing

Advanced Nurse Practitioner
Janine Collins

Myeloid Clinical Nurse Specialists (CNS)
Aoife Brennan
Faye Finneran

Research Nurses
Elizabeth Dale
Sarah Watmough

Other team members

Senior Pharmacist
The senior pharmacists ensure that any treatment or chemotherapy you receive is prescribed and administered correctly. Our senior pharmacists are Jennifer Gibson, Niamh McLaughlin, Daniel Coca-Peinado and Sophie Hughes.

Patient Counsellor and Clinical Psychologists

Linda Boyne is the counsellor for patients with blood cancer. 

There is a team of clinical psychologists who can offer more advanced psychological support. One of the team will suggest this to you if they feel it is in your best interests. You might then be referred to the psychology specialist team.

Further information

Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but we also have outpatient service in Aintree Hospital.

There are also local Macmillan services in other hospitals across our region.

External sites that offer extra support and information about different types of blood cancer include: