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Haematological malignancies: Treatment, symptoms, advice and help

 

Leukaemias: Acute and Chronic


  • Approx 5000 adult cases per year (all types) in England and Wales
  • 75% occur in patients aged over 60 years, but all ages can be affected
  • Risk factors include previous chemotherapy/radiotherapy and exposure to radiation
  • Most cases are diagnosed following a blood count undertaken because of symptoms and/or signs of bone marrow failure (fatigue, pallor, bruising, bleeding, infections etc)
  • Some leukaemias may present with enlarged lymph glands and/or liver and spleen
  • Chronic lymphocytic leukaemia (CLL) is an indolent disease normally diagnosed on blood film, which does not usually require urgent referral


Non Hodgkin's Lymphoma


  • Approx 7000 adult cases per year in England and Wales
  • 67% of cases occur in patients aged over 60 years, but all ages can be affected
  • Presenting features include:
    • Enlarged lymph glands
    • Enlarged liver and spleen
    • Fatigue
    • Weight loss
    • Night sweats
    • 40% present with tumour outside lymph glands


Hodgkin's Disease


  • Approximately 1200 new cases per year in England and Wales
  • Over 50% of cases occur below the age of 40 years
  • Clinical features similar to those for Non-Hodgkin's lymphomas (but 95% present with lymph gland involvement)


Myeloma


  • Approximately 3000 new cases per year in England and Wales
  • 99% of cases are aged over 40 years and 95% are aged over 50 years
  • Clinical features include:
    • Bone pain +/- bone fractures
    • Symptoms of anaemia
    • Kidney problems
  • Erythrocyte sedimentation rate (ESR) or plasma viscosity may be grossly elevated


See your doctor if you have:


  • Enlarged lymph glands (> 1 cm) persisting for 6 weeks
  • Enlarged liver and spleen
  • Bone pain associated with anaemia and a raised ESR (or plasma viscosity)
  • Constellation of 3 or more of the following symptoms:
    • Fatigue
    • Night sweats
    • Weight loss
    • Itching
    • Breathlessness
    • Bruising
    • Recurrent infections
    • Bone pain