The first 60 days: Leukaemia (all types)

Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.

• Diagnosis

  Blood count and film, bone marrow aspirate and biopsy, flow cytometry, cytogenetics and molecular panel; the subtype then sets the pathway.

  Multiparameter flow cytometry MRDCytogenetics and FISH

These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.

• PathologistNamed in the standard of care for: Diagnosis.
• Medical oncologistNamed in the standard of care for: Treatment.
• Transplant and cell therapy teamNamed in the standard of care for: Treatment.
• Palliative and supportive care teamNamed in the standard of care for: Supportive care.

A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.

Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.

1. 1.Treatment

   By type on the subtype pages: intensive chemotherapy and transplant for acute leukaemias, tyrosine kinase inhibitors for CML, BTK and BCL2 inhibitors for CLL.

   Acute lymphoblastic leukaemiaAcute myeloid leukaemiaChronic lymphocytic leukaemiaChronic myeloid leukaemia (CML)
2. 2.Supportive care

   Growth factor support, transfusion, infection prevention and tumour lysis prophylaxis around intensive treatment.

   Growth factors: G-CSF and febrile neutropenia preventionTransfusion support and anaemia management

Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.

Trials open now for this cancer in OnCo, largest phase first. Joining a trial is a decision like any other: ask what the comparison arm is, whether a placebo is used, and what happens if you leave. The cancer page searches ClinicalTrials.gov live for more.

• Response-Based Chemotherapy in Treating Newly Diagnosed Acute Myeloid Leukemia or Myelodysplastic Syndrome in Younger Patients With Down SyndromePhase 3 · active · NCT02521493Risk-Stratified Therapy for Acute Myeloid Leukemia in Down Syndrome
• Study to Compare Azacitidine Plus Pevonedistat Versus Azacitidine in Patients With Acute Myeloid Leukemia Not Eligible for Standard ChemotherapyPhase 3 · active · NCT04090736A Randomized Phase III, Multicentre, Open Label Clinical Trial Comparing Azacitidine Plus Pevonedistat Versus Azacitidine in Older/Unfit Patients With Newly Diagnosed Acute Myeloid Leukemia Who Are Ineligible for Standard Induction Chemotherapy
• Efficacy and Safety of Linperlisib in Relapsed/Refractory Large Granular T Lymphocytic LeukemiaPhase 2 · recruiting · NCT06224257A Phase 2, Multicenter, Single-arm, Open-label Study on the Efficacy and Safety of PI3K Inhibitors in Relapsed/Refractory Large Granular T Lymphocytic Leukemia

Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.

• Free in oncologyFree testing, helplines, rides and lodging, second opinions and trial travel help, with who is eligible.
• Financial helpManufacturer programmes, national schemes and charities by country and product.
• Second opinionExpert centres for this cancer in your country and how referral works.

• Leukaemia (all types): the full pageLeukaemia 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.
• One-page appointment sheetYour questions, the words you may hear, what to bring, and space for the answers. Print it.
• Treatment sequencingWhich treatment tends to follow which, line by line.
• NavigatorStandard of care for your stage, what you have tried, and trials near you.