Haematological Malignancies

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