Understanding your diagnosis
Your test results provide a lot of information about your leukaemia.
This will include:
- the type of blood cell the leukaemia started in
- whether it is growing quickly (acute) or more slowly (chronic)
- whether there are abnormal chromosomal or other genetic changes in the blood cells.
Your specialist uses this information to explain how the leukaemia could affect you in the future (your prognosis), and what your possible treatment options are.
Your specialist may arrange further tests if more information is required.
What you need to know
Blood cells are formed through a process called haematopoiesis. This usually occurs in the bone marrow, which is a sponge-like tissue found inside many bones in the body. It may also occur in other tissues, like the spleen, liver, thymus (a gland behind the breastbone), and lymph nodes.
During this process, immature cells called haematopoietic stem cells develop into different types of blood cells.
The three main types of blood cells are:
- red blood cells
- white blood cells
Blood cancers start when a part of haematopoiesis goes wrong, and one or more cells become abnormal and start growing and dividing rapidly.
These immature abnormal blood cells crowd out normal blood cells in the bone marrow. They can also enter into the blood or lymphatic circulation and travel around the body.
The main types of blood cancer are:
In leukaemia abnormal blood cells divide uncontrollably. They have no useful function and crowd out the bone morrow preventing the development of normal blood cells. Sometimes, there are so many in the bone marrow that they also spill out into the blood circulation
The main types of leukaemia and their major characteristics are:
- acute leukaemias
- develop quickly and progress rapidly (over weeks)
- involve mainly large numbers of immature cells (blasts)
- need prompt treatment.
- chronic leukaemias
- develop and progress more slowly (over months)
- involve more mature but still abnormal blood cells
- may not need treatment when diagnosed.
There are 2 main types of acute leukaemia. Both develop rapidly and require prompt treatment:
- acute lymphocytic leukaemia (ALL)
- affects white blood cells called lymphocytes
- occurs more often in children – 60% of people diagnosed with ALL are under the age of 14 years
- has better outcomes in children than in adults
- acute myeloid leukaemia (AML)
- affects any white blood cells apart from lymphocytes
- occurs more often in people 60 years or older.
What to ask or talk about
Talking about prognosis
Prognosis means what is likely to happen to you in the future because of your cancer. You may find it hard to talk about prognosis but it can help you make decisions about the treatment and care you want.
Everyone’s cancer is different, and everyone responds differently to treatment. Because of this, doctors can’t tell you exactly what will happen to you. Instead, they can give you the best information they have about what to expect.
Doctors work out prognosis based on statistics. These show what happens in large groups of people with cancer. They cannot predict what will happen to you or any other individual person.
Prognostic factors for acute leukaemia
The following things are generally associated with a worse prognosis:
- older age
- poor general health and other health problems
- higher number of leukaemia cells at diagnosis
- some chromosome abnormalities
- having had previous cancer treatment
- leukaemia cells in the fluid around the spinal cord and brain
- poor response to treatment.
Your specialist will share information about you and your cancer with a multidisciplinary team (MDT) to decide the best treatment options for you.
You may need more than one type of treatment or have a choice of treatments. You may also need to see other specialists during treatment planning.
Dealing with your diagnosis
Getting a cancer diagnosis is very distressing for the person with cancer, and their carers, family and friends. Different people react in different ways. They can be upset and angry or just in shock. Many people find it difficult to take in all the information and understand what it will mean for them.
The situation can be especially difficult for people who get a diagnosis of advanced cancer.
If you need to speak to someone about your diagnosis, you can call the Cancer Council on 13 11 20.