Blood cells are produced in the bone marrow — the soft, spongy tissue inside bones. Leukemia begins when a blood cell (usually a white blood cell or its precursor) develops a genetic mutation and starts dividing uncontrollably. These abnormal cells crowd out normal blood cells — red blood cells (which carry oxygen), healthy white blood cells (which fight infection), and platelets (which help clotting). The main types are Acute Lymphoblastic Leukemia (ALL — most common in children), Acute Myeloid Leukemia (AML — more common in adults), Chronic Myeloid Leukemia (CML), and Chronic Lymphocytic Leukemia (CLL — rare in Africa).
📄 NCCN Harggiyaa Asaa Tamaarettaa Xuufiyaa
Leukemia
A cancer of the blood — affecting children and adults across Ethiopia
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🌍 Itoophiyaasinne Mishiraqe Afrikaas giigettidaagaa
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📖 What Is Leukemia?
🔍 Warning Signs & Symptoms
Leukemia symptoms arise because normal blood cells are being crowded out. Seek urgent medical attention if you notice:
- Persistent fever or frequent infections (low healthy white blood cells)
- Unusual or easy bruising and bleeding — gums, nosebleeds, heavy periods
- Tiny red spots on the skin (petechiae) caused by low platelets
- Fatigue, paleness, and shortness of breath (anaemia from low red blood cells)
- Bone or joint pain, especially in children
- Swollen lymph nodes in the neck, armpit, or groin
- Enlarged spleen causing fullness or discomfort on the left side of the abdomen
- Unexplained weight loss and night sweats
🩺 Diagnosis
Diagnosis begins with a full blood count (FBC/CBC) — this will show abnormal numbers of white cells and often anaemia and low platelets. A peripheral blood smear lets the doctor examine blood cells under a microscope. Bone marrow aspiration and biopsy (taking a small sample from the hip bone under local anaesthesia) is essential to confirm the diagnosis and identify the exact type of leukemia. Additional tests — immunophenotyping, cytogenetics (chromosomal analysis), and molecular testing — guide treatment selection and determine prognosis.
📊 Types & Classification
Acute leukemias grow quickly and require immediate treatment: ALL (Acute Lymphoblastic Leukemia) — most common in children aged 2–10; AML (Acute Myeloid Leukemia) — can occur at any age but peaks in older adults. Chronic leukemias grow more slowly: CML (Chronic Myeloid Leukemia) — caused by a specific gene change (BCR-ABL), highly treatable with daily oral targeted therapy (imatinib/gleevec). Risk stratification (standard, intermediate, or high risk) determines treatment intensity.
💊 Treatment Options
Treatment varies significantly by leukemia type. NCCN Guidelines for common types:
- ALL in children — Multi-phase chemotherapy: induction (to achieve remission), consolidation, and maintenance (2–3 years total)
- ALL in adults — Intensive chemotherapy; Philadelphia chromosome-positive ALL also receives imatinib
- AML — Intensive induction chemotherapy (cytarabine + daunorubicin '7+3 regimen'); allogeneic stem cell transplant for high-risk disease
- CML — Imatinib (Gleevec) or newer TKIs (dasatinib, nilotinib) taken as daily oral tablets; most patients achieve long-term remission
- Supportive care — Blood transfusions, platelet transfusions, and antibiotics are essential during treatment
- Allogeneic stem cell transplant — Curative option for high-risk AML and relapsed ALL
💚 Supporting Children With Leukemia
Treatment for childhood ALL takes 2–3 years. Throughout this time, children need consistent nutritional support, infection prevention (good hygiene, avoiding sick contacts), and emotional support from the family. Many children can attend school during maintenance chemotherapy with appropriate precautions. Parents should be counselled about recognising signs of infection (fever ≥38°C in a child on chemotherapy is a medical emergency). Tikur Anbessa Specialized Hospital has a dedicated paediatric oncology service. With complete treatment, more than 70–80% of children with standard-risk ALL can be cured.
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Yaalaa Hiraagissiyoogaa
Ha xuufiyay tamaariyoos xalaala. NCCN Harggiyaa Asaa Kaallettaa®nne WHO zoriyaa bolla essettidinne Itoophiyaasinne Mishiraqe Afrikaas giigettidaagaa. Eranchcha payyaa oosanchchaa zoriyaa, pacciyaa woykko yaalaa geeddarenna. Itoophiyaa harggiyaa asay yaalaas Finfineen de'iya Tikur Anbessaa Dumma Hospitaaliyaa Onkolojiyaa Kifiliyaa zoriyettana bessees.