Leukaemia (all types)
Leukaemia means cancer of the blood-forming cells, but the four main types share little beyond the name: acute lymphoblastic and acute myeloid leukaemia are emergencies treated with intensive therapy, while chronic lymphocytic and chronic myeloid leukaemia are slow diseases controlled for years with pills. Each has its own page.
Overview
Leukaemias arise when a blood stem cell or its progeny acquires mutations that block maturation and drive proliferation, flooding the marrow and blood with abnormal cells. They are classified by speed (acute or chronic) and lineage (lymphoid or myeloid). Acute lymphoblastic leukaemia is the commonest childhood cancer and is cured in about 90 percent of children; acute myeloid leukaemia is mainly a disease of older adults treated with intensive chemotherapy, venetoclax combinations and transplant; chronic lymphocytic leukaemia is often watched for years and then controlled with BTK and BCL2 inhibitors; chronic myeloid leukaemia became the model of targeted therapy with imatinib. Rarer forms include hairy cell leukaemia and chronic myelomonocytic leukaemia. CAR-T cells and bispecific antibodies are changing the acute leukaemias.
State of the art
- Childhood ALL cure rates near 90 percent through risk-adapted chemotherapy and measurable residual disease monitoring.
- CML patients live near-normal lifespans on tyrosine kinase inhibitors, and many can stop treatment.
- Venetoclax made AML treatable in older adults; CAR-T and blinatumomab rescued relapsed ALL.
- Treatment-free remission and measurable residual disease guide therapy across the chronic leukaemias.
Anatomy and lymph node drainage
Leukaemias, myeloma and MDS live in the marrow and blood; lymphomas grow in lymph nodes and spleen. The node stations are the disease map, not a route of spread, and staging counts them.
- Bone marrow (leukaemia, MDS, MPN, myeloma)Acute lymphoblastic leukaemia (ALL) · Acute myeloid leukaemia (AML) · Chronic lymphocytic leukaemia (CLL) · Chronic myeloid leukaemia (CML) · Hairy cell leukaemia · Chronic myelomonocytic leukaemia (CMML) · Blastic plasmacytoid dendritic cell neoplasm (BPDCN)
- Lymph node germinal centre (lymphomas)
- SpleenHairy cell leukaemia
- Blood (leukaemic phase)Chronic lymphocytic leukaemia (CLL)
- Lytic bone lesions (myeloma)
- Skin and extranodal sites
- cervical
- axillary
- mediastinal
- para-aortic and mesenteric
- inguinal
In lymphoma the node stations are the disease itself; staging (Ann Arbor / Lugano) counts how many regions and sides of the diaphragm are involved.
Same organ: Acute myeloid leukaemia, Acute lymphoblastic leukaemia, Chronic lymphocytic leukaemia, Chronic myeloid leukaemia (CML), Diffuse large B-cell lymphoma, Follicular lymphoma, Hodgkin lymphoma, Mantle cell lymphoma, Multiple myeloma, Non-Hodgkin lymphoma (all types), Myelodysplastic syndromes / neoplasms (MDS), Myeloproliferative neoplasms (PV, ET, myelofibrosis), Polycythaemia vera (PV), Essential thrombocythaemia (ET), Waldenström macroglobulinaemia, Hairy cell leukaemia, Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma), Blastic plasmacytoid dendritic cell neoplasm (BPDCN), Burkitt lymphoma, HIV-associated (AIDS-related) lymphomas, Chronic myelomonocytic leukaemia and MDS/MPN overlap neoplasms, Systemic mastocytosis, Erdheim-Chester disease, Rosai-Dorfman disease and other histiocytic neoplasms, Langerhans cell histiocytosis (LCH), Post-transplant lymphoproliferative disorder (PTLD)
About 490,000 new cases and 300,000 deaths a year worldwide; the commonest cancer of childhood, where most cases are now cured, and a group of very different diseases in adults.
- AI in radiologyEstablished
- cfDNA fragmentomicsEstablished
- Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)Standard of care
- DNA methylation profilingEstablished
- HCC surveillance in cirrhosis (ultrasound + AFP)Standard of care
- High-risk pancreatic surveillance (CAPS / PRECEDE)Established
- A 28-day national pathway for people with a positive multi-cancer blood test
- A breath test to rule out cancer in people with vague symptoms
- A cancer blood test for older people arriving at A&E with unexplained symptoms
- A legislated, publicly reported 28-day standard from urgent referral to diagnosis
- A live national dashboard of stage at diagnosis as the scorecard for early detection
- A single 'cancer check at 60' appointment bundling all screening tests
Background: Alpha-fetoprotein (AFP), Barrett's oesophagus, CA 19-9, Early detection, Faecal immunochemical test (FIT). Also on OnCo: Symptoms and red flags · Early detection roadmap.
Cases by country
No country-level case numbers. This cancer is not mapped to a GLOBOCAN site.
Blood count and film, bone marrow aspirate and biopsy, flow cytometry, cytogenetics and molecular panel; the subtype then sets the pathway.
By type on the subtype pages: intensive chemotherapy and transplant for acute leukaemias, tyrosine kinase inhibitors for CML, BTK and BCL2 inhibitors for CLL.
Subtypes & biomarkers
top- Flow cytometry immunophenotype
- Cytogenetics and fusion genes (BCR-ABL1, PML-RARA, KMT2A)
- Mutations (FLT3, NPM1, IDH1/2, TP53, IGHV status)
- Measurable residual disease by flow or PCR
How often this target appears
- 1845Virchow names leukaemia
White blood in a patient's vessels described as a disease of the blood itself.
- 1948Farber induces remissions in childhood ALL with aminopterin
- 1960Philadelphia chromosome discovered in CML
- 2001Imatinib approved
The first kinase inhibitor and the model for targeted therapy.
- 2017Tisagenlecleucel: the first CAR-T approval, for childhood ALL
What is in development for Leukaemia (all types), drawn from the whole corpus: 0 items. Drugs are grouped by the most advanced trial phase they have reached anywhere; approved treatments sit under standard of care. Technologies are the methods being tested for this cancer, trials are the studies recorded here, and ideas are proposals not yet in a trial.
Nothing recorded in development for this cancer yet.
Open problems and what is being done
Adult ALL and TP53-mutated AML still have poor outcomes.
Infant and relapsed childhood leukaemias.
and how the field plans to fix it →What is being done about thisRecurrence and residual diseaseAvailable now- Multiparameter flow cytometry MRDStandard of care
- TisagenlecleucelApproved
- Liquid biopsy (ctDNA)Standard of care
- MRD / molecular residual disease testingEstablished
- NGS-based MRD (clonoSEQ and molecular MRD)Standard of care
- SignateraEstablished
In trials- ADAURAPositive
- CAMBRIA-1 & CAMBRIA-2Active
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- ctDNA monitoring in lymphoma (PhasED-seq, clonoSEQ)Emerging
- DYNAMICPositive
- IMvigor011Positive
Ideas and roadmaps- A blood test for the pre-metastatic niche
- A bone marrow niche on a chip to study human dormancy
- A dedicated clinic for people whose blood test says the cancer is back
- A drug screen that only rewards killing sleeping cancer cells
- A national platform trial that every ctDNA-positive patient can join
- A national residual-disease weather service: serial blood tests for every curatively treated patient, pooled
Background: Circulating tumour DNA (ctDNA), Disseminated tumour cells (DTCs), Late recurrence, Minimal / molecular residual disease (MRD), MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶). Also on OnCo: Treatment journeys · Survivorship planner.
Access to CAR-T and transplant outside rich countries.
and how the field plans to fix it →What is being done about thisCost and accessAvailable now- ImatinibApproved
- HPV & HBV vaccinationStandard of care
- Trastuzumab biosimilarsApproved
In trials- Gefitinib vs gefitinib plus pemetrexed-carboplatin in EGFR-mutant lung cancer (Tata Memorial)Positive
- IARC India HPV vaccine dose study (one, two or three doses)Positive
- IMAGINE (varnimcabtagene autoleucel, Immuneel)Positive
- Low-dose nivolumab plus metronomic chemotherapy (Tata Memorial)Positive
- Low-dose olanzapine for cancer anorexia (Tata Memorial)Positive
- METRO PLUS (Tata Memorial Centre, Varanasi)Positive
Ideas and roadmaps- 90-day reliance approval for cancer drugs cleared by two stringent regulators
- A cheap old tablet to restore appetite
- A combination pricing rule so two-drug regimens are not priced as two monopolies
- A coordinated reserve and shared schedule for the world's medical isotope reactors
- A dedicated global financing window for cancer, modelled on the Global Fund
- A delinked market-entry reward paid by payers when a repurposed generic wins approval
Background: Accelerated approval, Biosimilar, Real-world evidence. Also on OnCo: Financial help · Coverage by country · HTA decisions.
Late effects of childhood treatment.
and how the field plans to fix it →What is being done about thisSide effects and quality of lifeAvailable now- Cardio-oncologyEstablished
- Exercise & lifestyle oncologyEstablished
- Geriatric assessmentEstablished
- IMRT / IGRT (modern external beam)Standard of care
- Oncology nutrition assessment and medical nutrition therapyEstablished
- Proton therapyEstablished
In trialsIdeas and roadmaps- A cheap old tablet to restore appetite
- A coordinated FLASH radiotherapy evidence programme with shared dose-rate standards
- A dedicated programme for cachexia and treatment toxicity research
- A dietitian in every gastrointestinal and head and neck tumour board
- A funded programme of organ-preservation trials to avoid radical surgery
- A lifelong late-effects registry linked to every treatment for adult survivors
Background: CTCAE toxicity grading (grade 3-4 adverse events), De-escalation, escalation and response-adapted therapy, Immune-related adverse events (irAEs), Quality of life, Toxicity grade. Also on OnCo: Side effects by symptom · Immune-related side effects · Toxicity compare · Survivorship planner.
Trials
topTrials recruiting now
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Expert centres
topExpert centres
- via Chronic lymphocytic leukaemia
- GIMEMARome, ITvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Chronic lymphocytic leukaemia, Imatinib
- American Society of HematologyWashington, DC, USvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- European Hematology AssociationThe Hague, NLvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- HOVONRotterdam, NLvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- via Acute myeloid leukaemia, Chronic myeloid leukaemia (CML), Imatinib
- Seoul St. Mary's HospitalSeoul, KRvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Imatinib
- via Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Children's Hospital of PhiladelphiaPhiladelphia, PA, USvia Acute lymphoblastic leukaemia, Tisagenlecleucel
- Christian Medical College, VelloreVellore, INvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Comprehensive Cancer Center Freiburg (CCCF)Freiburg im Breisgau, DEvia Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- via Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Hospital Clínic de Barcelona / IDIBAPSBarcelona, ESvia Acute lymphoblastic leukaemia, Chronic lymphocytic leukaemia
- Hospital Universitari i Politècnic La FeValencia, ESvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- IRCCS Ospedale San RaffaeleMilan, ITvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Peking University People's HospitalBeijing, CNvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Ramathibodi Hospital, Mahidol UniversityBangkok, THvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Rigshospitalet, Copenhagen University HospitalCopenhagen, DKvia Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- Ruijin Hospital, Shanghai Jiao Tong UniversityShanghai, CNvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Tata Medical Center, KolkataKolkata, INvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- The Ohio State University Comprehensive Cancer Center, James Cancer Hospital and Solove Research InstituteColumbus, OH, USNCI comprehensivevia Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- University Cancer Center Frankfurt (UCT)Frankfurt am Main, DEvia Acute lymphoblastic leukaemia, Acute myeloid leukaemia
- Walter and Eliza Hall Institute of Medical ResearchMelbourne, AUvia Acute myeloid leukaemia, Chronic lymphocytic leukaemia
- ACCELERATEBrussels, BEvia Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- All India Institute of Medical Sciences, New DelhiNew Delhi, INvia Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- via Chronic lymphocytic leukaemia
- Cancer Institute (WIA), AdyarChennai, INvia Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- Cancer Research UK Manchester InstituteManchester, GBvia Acute myeloid leukaemia
- Central Drugs Standard Control OrganizationNew Delhi, INvia Imatinib
- via Acute myeloid leukaemia
- Children's Cancer and Leukaemia GroupLeicester, GBvia Acute lymphoblastic leukaemia
- Children's Oncology Group (COG)Monrovia, CA, USvia Acute lymphoblastic leukaemia
- Chinese PLA General HospitalBeijing, CNvia Acute myeloid leukaemia
- via Acute myeloid leukaemia
- Comprehensive Cancer Center Tübingen-StuttgartTübingen, DEvia Acute myeloid leukaemia
- via Chronic lymphocytic leukaemia
- ECOG-ACRIN Cancer Research GroupPhiladelphia, PA, USvia Acute lymphoblastic leukaemia
- via Chronic myeloid leukaemia (CML)
- Groote Schuur Hospital / University of Cape TownCape Town, ZAvia Acute lymphoblastic leukaemia
- Hadassah Medical CenterJerusalem, ILvia Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- Hospital de Clínicas de Porto AlegrePorto Alegre, BRvia Acute lymphoblastic leukaemia
- Hospital Universitario 12 de OctubreMadrid, ESvia Acute myeloid leukaemia
- via Acute myeloid leukaemia
- Institut Paoli-CalmettesMarseille, FRvia Acute myeloid leukaemia
- Instituto Nacional de Câncer (INCA)Rio de Janeiro, BRvia Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- Kidwai Memorial Institute of OncologyBengaluru, INvia Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- King Hussein Cancer CenterAmman, JOvia Acute lymphoblastic leukaemia
- Kyoto University HospitalKyoto, JPvia Acute myeloid leukaemia
- via Acute myeloid leukaemia
- Narayana Health (Mazumdar Shaw Medical Centre)Bengaluru, INvia Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- National Taiwan University HospitalTaipei, TWvia Acute myeloid leukaemia
- via Acute myeloid leukaemia
- via Acute myeloid leukaemia
- Newcastle Cancer Centre / Northern Centre for Cancer CareNewcastle upon Tyne, GBvia Acute lymphoblastic leukaemia
- Nordic Lymphoma GroupStockholm, SEvia Chronic lymphocytic leukaemia
- Northwell Health Cancer InstituteNew Hyde Park, NY, USvia Chronic lymphocytic leukaemia
- via Acute myeloid leukaemia
- Philippine General HospitalManila, PHvia Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- Queen Mary Hospital / University of Hong KongHong Kong, HKvia Acute myeloid leukaemia
- Rambam Health Care CampusHaifa, ILvia Acute myeloid leukaemia
- Royal Adelaide HospitalAdelaide, AUvia Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia
- Siriraj Hospital, Mahidol UniversityBangkok, THvia Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia
- via Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- Tawam HospitalAl Ain, AEvia Acute lymphoblastic leukaemia
- Texas Children's Cancer and Hematology CenterHouston, TX, USvia Acute lymphoblastic leukaemia
- The Hospital for Sick Children (SickKids)Toronto, ON, CAvia Acute lymphoblastic leukaemia
- via Chronic lymphocytic leukaemia
- via Acute lymphoblastic leukaemia
- University Hospital Düsseldorf / CIO DüsseldorfDüsseldorf, DEvia Acute lymphoblastic leukaemia
- via Chronic lymphocytic leukaemia
- via Acute lymphoblastic leukaemia
- via Chronic myeloid leukaemia (CML)
- via Acute lymphoblastic leukaemia
- via Acute myeloid leukaemia
- via Acute myeloid leukaemia
- Weizmann Institute of ScienceRehovot, ILvia Acute myeloid leukaemia
- via Acute myeloid leukaemia
- via Acute lymphoblastic leukaemia
Questions to ask
topQuestions to ask your oncologist about Leukaemia
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Why: Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example Flow cytometry immunophenotype, Cytogenetics and fusion genes, Mutations, Measurable residual disease by flow or PCR), and what were the results?Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Why: Recognised subtypes for this cancer include Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Chronic lymphocytic leukaemia.
- Is germline (inherited) genetic testing recommended for me or my family?Why: Inherited variants can change treatment and matter for relatives.
Diagnosis
- For my situation (diagnosis), which of the standard options do you recommend and why?Why: Guideline options include: Blood count and film, bone marrow aspirate and biopsy, flow cytometry, cytogenetics and molecular panel; the subtype then sets the pathway.
Treatment
- For my situation (treatment), which of the standard options do you recommend and why?Why: Guideline options include: By type on the subtype pages: intensive chemotherapy and transplant for acute leukaemias, tyrosine kinase inhibitors for CML, BTK and BCL2 inhibitors for CLL.
Any stage
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Why: Supportive care improves quality of life and helps patients complete treatment.
- I read that “Adult ALL and TP53-mutated AML still have poor outcomes”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
- I read that “Infant and relapsed childhood leukaemias”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
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Direct links plus the targets, companies, and technologies of this cancer's products.
Latest papers
topQuery for this cancer: (TITLE:"Leukaemia" OR ABSTRACT:"Leukaemia" OR TITLE:"all types" OR ABSTRACT:"all types" OR TITLE:"Leukemia" OR ABSTRACT:"Leukemia" OR TITLE:"Blood cancer leukaemias" OR ABSTRACT:"Blood cancer leukaemias") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Leukaemia (all types), not a curated reading list.
Similar pages
not linked directly; found by shared links- JournalLeukemia research
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- JournalCurrent hematologic malignancy reports
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- TargetCD123
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- PersonJanet Rowley
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- PersonHagop M. Kantarjian
Shares Imatinib, Chronic lymphocytic leukaemia, Acute lymphoblastic leukaemia, Acute myeloid leukaemia.
- TrialSafety and Efficacy of Ponatinib for Treatment of Pediatric Recurrent or Refractory Leukemias, Lymphomas or Solid Tumors
Shares Chronic myeloid leukaemia (CML), Acute lymphoblastic leukaemia, Acute myeloid leukaemia.
- JournalLeukemia & lymphoma
Shares Chronic myeloid leukaemia (CML), Chronic lymphocytic leukaemia, Acute lymphoblastic leukaemia, Acute myeloid leukaemia.