November 25, 2025, 4:02 am | Read time: 6 minutes
The term leukemia, colloquially known as blood cancer, is already familiar to most people. No wonder—in Germany, around 12,200 people are diagnosed with it each year. Essentially, anyone can be affected at any age. Statistically, about one in 75 men and one in 99 women will develop it during their lifetime. The tricky part: The signs of the disease are not clear-cut. But they do exist. FITBOOK provides a comprehensive overview of causes, symptoms, and treatment options.
Overview
How to Recognize Leukemia?
There are no definitive symptoms that can be attributed to leukemia, as blood cancer can manifest in various ways. This is also because there is more than one type of blood cancer. Often, the symptoms resemble those of benign conditions and remain unnoticed, especially in chronic forms. Acute leukemias, on the other hand, usually develop suddenly, with a strong feeling of illness, fever, or frequent infections. The following symptoms should be viewed with caution: They may indicate leukemia, but not necessarily.
- persistent fatigue, pallor, and weakness
- frequent or severe infections
- fever and night sweats
- bruises, blue marks, or nosebleeds
- shortness of breath even with slight exertion
- bone pain
- loss of appetite and unintended weight loss
- swollen lymph nodes (neck, armpits, groin)
- pressure or fullness in the upper abdomen (enlarged spleen or liver)
What Happens in Leukemia?
Leukemia is not a single disease but represents various types of blood cancer. However, they all share the uncontrolled proliferation of certain blood cells in the bone marrow.
The triggers are changes in the genetic material of these cells, known as mutations. When several mutations occur together, the affected cell can become malignant and divide uncontrollably. Healthy blood cells are gradually displaced. Most mutations occur randomly, while some are caused by external factors such as radiation or chemicals. Normally, the body corrects such errors, but in leukemia, this protective mechanism fails.
From Childhood to Senior Age
Leukemia can occur at any age. However, there are typical clusters: Acute lymphoblastic leukemias (ALL) are more common in children, especially between two and five years old. Chronic forms like chronic lymphocytic leukemia (CLL) almost exclusively affect adults, usually over the age of 60.
A Current Case
How suddenly leukemia can change life is illustrated by the case of Tatiana Schlossberg, granddaughter of John F. Kennedy. Just a few hours after the birth of her second child, doctors noticed her blood count was highly abnormal. Eventually, the 34-year-old was diagnosed with acute myeloid leukemia with a rare mutation—a form that predominantly affects older patients.
“I just couldn’t believe they were talking about me. The day before, nine months pregnant, I swam a mile in the pool. I wasn’t sick. I didn’t feel ill. I was even one of the healthiest people I knew,” she wrote in the New Yorker.
Origin of the Disease’s Name
In fact, it was a doctor from Berlin’s Charité, Rudolf Virchow, who first described the disease in 1845. The term leukemia comes from Greek and means “white blood”—a designation referring to the pathological proliferation of white blood cells.
The Different Forms
Leukemia is not a single disease. Depending on the course and type of affected blood cells, experts distinguish several forms of the disease.
Acute or Chronic?
The most important difference lies in the progression:
- Acute leukemias arise suddenly and progress rapidly. Patients usually develop noticeable symptoms within a short time, including fever, infections, or a strong feeling of illness. Immediate treatment is necessary.
- Chronic leukemias progress much more slowly. It is often discovered by chance because patients initially have few complaints.
Myeloid or Lymphatic?
A second distinguishing feature concerns the type of cell from which leukemia develops:
- Myeloid leukemias originate from precursor cells that normally develop into red blood cells, platelets, or certain white blood cells.
- Lymphatic leukemias arise from cells involved in the formation of lymphocytes, which are immune cells that fight pathogens.
The Four Main Forms
From the combination of these two characteristics, the four main forms of leukemia emerge:
- Acute myeloid leukemia (AML)—about 23 percent of all leukemia cases
- Acute lymphoblastic leukemia (ALL)—about 6 percent
- Chronic myeloid leukemia (CML)—about 8 percent
- Chronic lymphocytic leukemia (CLL)—the most common form, at about 38 percent1
Leukemia is the most common type of cancer in children.
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How the Diagnosis is Made
- Medical history and physical examination: Doctors inquire about symptoms and check for enlarged lymph nodes, spleen, or liver. Skin pallor, bruises, or signs of infection can also provide initial clues.
- Blood test: A complete blood count shows how many red and white blood cells and platelets are present. In leukemia, these values are often altered—they can be significantly increased, decreased, or remain normal despite the disease.
- Bone marrow examination: To confirm the diagnosis, a small amount of bone marrow, usually from the pelvic bone, is taken. The sample reveals whether and which malignant cells are present and what form of leukemia it is.
- Imaging techniques: Ultrasound, X-ray, or CT help assess whether organs like the spleen, liver, or lymph nodes are affected.
- Molecular genetic tests: They show whether specific genetic changes are present. This information is crucial for tailoring therapy to the specific form of leukemia.
Therapy and Prognosis
How leukemia is treated depends greatly on its form and progression. The goal is always the same: to reduce the number of malignant cells in the blood and bone marrow so that the disease can be controlled or even cured.
In most cases, therapy begins with chemotherapy aimed at destroying leukemia cells. Additionally, modern targeted drugs such as tyrosine kinase inhibitors are often used. They block specific signaling pathways in cancer cells, slowing their growth. Immunotherapies that activate the body’s immune system are also gaining importance.
For certain forms, a stem cell or bone marrow transplant may be necessary. Here, the diseased cells in the bone marrow are replaced with healthy ones. Some are familiar with the process of becoming a stem cell donor. Such a donation can be the only chance for a cure for those affected.
Prognosis
The prognosis varies significantly depending on the form of leukemia. In acute leukemias, success depends heavily on how early the disease is detected and how well it responds to therapy. Children with acute lymphoblastic leukemia (ALL) have very good chances today, as more than 90 percent survive the first five years after diagnosis.2
In adults, the rates are lower but are steadily improving thanks to modern therapies. Chronic leukemias usually progress more slowly and are often considered incurable, but they can be controlled with medication for many years. Overall, the five-year survival rate for all leukemia forms in Germany—depending on age, gender, and type—ranges from about 8 to 95 percent.3
Despite all progress, treatment remains physically and emotionally taxing. Close medical supervision, psychological support, and regular follow-up care are therefore crucial, both during and after therapy.