Summary Acute Myeloid Leukemia (AML)

Acute myeloid leukaemia, or AML for short, is a malignant disease of the haematopoietic system. It is one of the blood cancer diseases. AML is a rare disease.

Every year, almost 4 out of every 100,000 people contract the disease. It occurs more frequently in older age, the mean age of onset of the disease is between 60 and 70 years. The disease may initially manifest itself through rather unspecific general symptoms such as fatigue and chronic tiredness.

Since the disease, as the name suggests, is relatively acute, the symptoms then multiply within a short time and increase significantly. Possible symptoms are pale skin colour due to anaemia, bleeding signs such as bleeding from the gums or nose, increased occurrence of bruising or small bleedings in the area of the lower legs. These appear as small red spots which appear in groups, they are called petechiae.

In addition, there is often an increased susceptibility to infections. Patients suffer more often from diseases like pneumonia or tonsillitis. Furthermore, there can be severe night sweats.

A thickening of the gums (gingival hyperplasia) can also be a possible symptom. The first step in making a diagnosis is to take a medical history. Here it is particularly important to know which symptoms have existed since when.

The physical examination may reveal bleeding signs such as petechiae or haematomas, and pale skin may be noticeable. The next step is the taking of blood samples. The so-called differential blood count together with the symptoms often provides important information about the possible presence of AML.

To confirm the diagnosis, the bone marrow puncture must be performed; the puncture is then examined microscopically and the diagnosis is made. Once the diagnosis has been made, the appropriate therapy should be initiated quickly. The main focus here is on chemotherapy with a combination of several drugs.

In the first phase of chemotherapy, patients are highly susceptible to life-threatening infections due to a strong weakening of the immune system and therefore have to be isolated in most cases. Another treatment option is stem cell transplantation. The prognosis depends, among other things, on the age and subtype of AML. Some patients can be considered cured by treatment. However, it is not uncommon for others to have a relapse.

Summary Chronic Lymphocytic Leukemia (CLL)

Chronic lymphatic leukemia, or CLL for short, is a non-Hodgkin lymphoma and is the most common form of leukemia in our latitudes. It occurs mainly in advanced age and has the best prognosis of all forms of leukemia. In contrast to acute forms of leukemia, it is chronic, i.e. it can last for many years without worsening the patient’s general condition.

Every year about 4 out of 100,000 people fall ill. The mean age at first diagnosis is between 70 and 75 years. The malignant leukemia cells multiply in the bone marrow and spread there.

As a result, they often displace the cells that actually belong there, namely the haematopoietic cells. As a result, these haematopoietic cells may have to switch to other organs to produce the blood components. The liver and spleen are particularly affected by this.

The liver (hepatomegaly) and the spleen (splenomegaly) may then swell. This is usually not noticed by the patient but only becomes apparent during a physical examination or an ultrasound scan. In addition, CLL often causes swelling of lymph nodes in various parts of the body.

Furthermore, symptoms may appear on the skin, for example with itching or eczema. CLL is often a coincidental finding. The diagnosis is made on the basis of the patient’s medical history and blood count with extended examinations.

In rare cases a bone marrow puncture is also necessary. However, it is usually not absolutely necessary for the diagnosis. The disease is divided into different stages.

In stages A and B, the disease is only treated if it causes symptoms. This is because it often progresses over years without getting worse. In advanced stage C or when symptoms appear, chemotherapy or antibody therapy can be initiated. For selected patients, a stem cell transplantation is also an option. CLL is the least aggressive form of leukemia.