Acute Leukaemia

Acute myeloid leukaemia is more common in adults, while acute lymphoblastic leukaemia is the commonest type seen in children and young adults. Symptoms include anaemia, fever and bleeding, and patients are more prone to infection. Usually, blood tests show low haemoglobin count, high white cell count and low platelet count. Leukaemia cells are immature white cells found in blood and bone marrow. The lymph nodes, liver and spleen may be enlarged. In some cases, the skin and central nervous system may also be affected.

• Full blood counts
• Peripheral blood film examination
• Bone marrow biopsy
• Lumbar puncture
• Cytochemical study and immunophenotyping to define the subtype
• Cytogenetic and molecular genetic studies are essential

Treatments
Intensive chemotherapy is necessary for cure, and infection must be treated without delay. Supportive care is also important. Patients may require blood and platelet transfusions, and haematopoietic growth factor (e.g. G-CSF) is frequently used for treating the disease. Some patients may need an allogeneic bone marrow transplantation, while gentle chemotherapy is considered appropriate for the elderly patients. All-trans retinoic acid and arsenic trioxide are used to treat acute promyelocytic leukaemia. An unrelated marrow donor registry is available in Hong Kong, i.e. Hong Kong Bone Marrow Donor Registry, which is linked to the registries of Taiwan and the Mainland. 
 

Prognosis

• It is a curable disease for young patients
• Most patients respond well to chemotherapy
• Cure rate may exceed 50% for younger patients
• Survival rate improves with bone marrow transplantation