Blood cancer

Leukaemia

Leukaemia, i.e. cancer of the blood, is a malignant disease where the early forms of white blood cells in the bone marrow transform, start to reproduce uncontrollably and collect in the bone marrow, blood and with blood to the rest of the body. A chronic case of leukaemia may be discovered by chance in a symptom-free patient; however, an acute case of leukaemia usually leads to a poor condition and hospital treatment very quickly.

In acute leukaemia, the affected cells are in an early form and undifferentiated, so they divide and reproduce quickly in the body. In chronic leukaemia, the cells have had the time to differentiate to a great extent and they resemble mature cells, so they divide and reproduce slowly. Thereby, the clinical picture and treatment of acute and chronic leukaemia differ from one another greatly.

Most often, a patient suffering from acute leukaemia comes to Tays via the first aid unit. The diagnosis is quick by means of blood and bone marrow samples that are used for determining factors impacting the disease classification, prognosis and form of treatment. With the patient’s consent, samples are also taken for the national Hematological Biobank that uses the samples in further development of leukaemia treatment.

Treatment of acute leukaemia

The treatment of leukaemia is becoming increasingly more individual. We use chemotherapy combinations and immunological treatments, and some patients are referred to the allogeneic transfer of stem cells, i.e. stem cells collected from a healthy donor. In Finland, the transfers have been centralised at the university hospitals of Helsinki and Turku.

There are clinical drug trials ongoing at the ward and patients may be asked to take part in them. A stem cell collection team also operates at the ward. The team handles not only haematological patients but also stem cell collection for cancer diseases and paediatrics. Treatment impact is monitored with the help of blood and bone marrow samples.

The leukaemia meeting held every other week discusses all new leukaemia diagnoses and agrees on the best-suited monitoring methods in cooperation with laboratory doctors and geneticist. We also meet on a weekly basis with infection diseases specialists who have specialised in the infections of leukaemia patients.

We aim to discharge the patient whenever possible in view of the disease and its treatment and we also utilise the Patient Hotel. At the end of treatment, monitoring is ensured by the haematology outpatient clinic of Tays or the central hospital. The treatment of acute leukaemia is followed by approximately five years of monitoring.

Treatment of chronic leukaemia

We aim to treat chronic leukaemia at the outpatient clinic whenever possible, but some forms of treatment are provided at the ward. The treatment methods include oral, IV and subcutaneous chemotherapy, other cancer medication and antibody treatments.

Cases of chronic leukaemia are diagnosed in special health care, but their monitoring and even treatment may sometimes be implemented in primary health care.

Further information about leukaemia

The ultimate cause of leukaemia is not known, even if much is known about the genetic damage of the cells taking place in connection with leukaemia. Different risk factors, such as radiation, certain cytostatic medication and some rare hereditary diseases, are also known. Leukaemia is not, however, a hereditary disease.

Annually, approximately 200 people are diagnosed with acute leukaemia, approximately 150 of whom are adults. Of the cases of acute leukaemia, four-fifths are cases of acute myeloid leukaemia (AML) and the rest acute lymphoblastic leukaemia (ALL). Annually, approximatively 150–200 new cases of chronic leukaemia are diagnosed. Of the chronic leukaemia types, the most common is chronic lymphocytic leukaemia (CLL). Chronic myeloid leukaemia (CML) is rarer.

The prognosis of leukaemia has much improved over the last decades. The prognosis is largely dependent on the type of leukaemia, age of the patient, provided treatment and other illnesses, but on average half the patients recover permanently.