Leukemia in Hong Kong: Causes, Symptoms, Screening and Treatment

Every year, around 400 people are diagnosed with Leukemia in Hong Kong. Leukemia is a type of bone marrow cancer that involves white blood cells. It is the most common cancer in children (affecting 4 in 100,000 children), leading to 50 to 60 children diagnosed with Leukemia per year.

What is Leukemia?

Leukemia harms the body’s ability to make healthy blood cells when normal white blood cells help fight and protect from infections. Affected patients have malfunctional white blood cells and the number of them is so large that they crowd out the red blood cells and platelets. Although leukemia is often linked to children, it actually appears 10 times more in adults, and affects both men and women at similar rates.

The main classification is follows:

  • Acute Leukemia: The abnormal and immature blood cells cannot function normally during rapid multiplication, so the disease worsens quicker. There are 2 types of acute leukemia: acute lymphocytic leukemia (ALL) which occurs more in young children and acute myeloid leukemia (AML) which occurs more in adults.
  • Chronic Leukemia: The abnormal blood cells are more mature, causing blood cells to replicate slower and carry out normal functions for a limited amount of time. This is why some chronic leukemia can go undiagnosed for years and are only usually discovered when a blood test is taken for another reason.

Signs and Symptoms

Depending on the type of leukemia, there might be different symptoms. Below are the most common ones:

  • Recurrent nosebleeds
  • Excessive sweating, especially at night
  • Shortness of breath
  • Fever or chills
  • Persistent fatigue, weakness
  • Unexplained weight loss

These symptoms might occur in case of acute leukemia: easy bruising or bleeding, petechiae (flat, pinpoint spots under the skin caused by bleeding).

Symptoms for specific Leukemia types:

Acute Lymphocytic Leukemia (ALL)

  • Pain in the bones or stomach
  • Pain or feeling of fullness below the ribs
  • Painless lumps in the neck, underarm, stomach, or groin
  • Having many infections

Acute Myeloid Leukemia (AML)

  • Swollen gums
  • Having many minor infections
  • Unwell feeling in bones or joints

Chronic Lymphocytic Leukemia (CLL)

  • Enlarged lymph nodes, especially in the neck
  • Difficulty breathing when performing normal physical activities

Chronic Myeloid Leukemia (CML): pain or a feeling of fullness below the ribs on the left side.

Note: sometimes CML does not have any symptoms at all.

Causes of Leukemia

There is no exact known cause. However, there are certain factors that might increase the risk of getting leukemia:

  • Previous cancer treatment: People who have had chemotherapy or radiation therapy present an increased risk.
  • Genetic disorders: Genetic abnormalities affect the development of leukemia. Therefore, certain genetic disorders, such as Down syndrome, have a correlation with an increased risk in Leukemia.
  • Exposure to certain chemicals: Exposure to certain chemicals, such as benzene is said to be linked to an increased risk of some kinds of leukemia.
  • Smoking: Smoking cigarettes increases the risk of leukemia, particularly Acute Myeloid Leukemia (AML).
  • Family history of leukemia: If any family members have been diagnosed with leukemia, there might be an increased risk of the disease.

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Diagnosis of Leukemia

There are different ways of diagnosis:

  • Physical Exam: Your doctor will search for physical signs of leukemia such as pale skin from anemia, swelling of lymph nodes, and enlargement of your liver or spleen.
  • Blood Tests: Blood will be drawn out to check for any abnormal levels of red or white blood cells or platelets.
  • Bone Marrow Test: Your doctor might also recommend a procedure to collect a sample of bone marrow from the hip bone using a long, thin needle. The sample is then used to search for leukemia cells and reveal characteristics of leukemia. This will help with making a treatment plan.

The Expert Guide to Oncologists in Hong Kong

Treatment options

The treatment you receive depends on the cancer type and stage, they are:

  • Chemotherapy: This is the main form of treatment. It is a drug treatment to kill leukemia cells.
  • Biological Therapy: It is also known as biological response modifiers, which can control or change the activity of cancer cells.
  • Targeted Therapy: Uses drugs that attack specific vulnerabilities in the cancer cell.
  • Radiation Therapy: Uses x-ray or other high energy beams to damage leukemia cells and stop their growth. With this treatment, the radiation will be pointed to a specific point in your body where there is a lot of leukemia cells or the whole body.
  • Stem Cell Transplant: This treatment is to replace the bone marrow affected with a healthy one. It first requires the patient to receive high doses of chemotherapy to destroy the old bone marrow, before an infusion of blood-forming stem cells that help to rebuild the bone marrow that may be received from a donor or from the patient’s own stem cells.
  • Surgery: Removing the spleen that is filled with cancer cells, especially if it is pressing on nearby organs.

With proper treatment, leukemia is not always deadly. The chance of cure by chemotherapy is estimated at 70% – 80% for children and up to 60% for young adults with acute leukemia.

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What is the cost of Leukemia Treatment in Hong Kong?

Cost of Treatment in Hong Kong’s Public Sector:

For eligible persons with a HKID card, the cost for inpatient service is $75 admission fee and $120 per day. Extra medications or other injections needed are not included. For day procedure and treatment at Clinical Oncology Clinics, the cost is $96 per attendance.

For non-eligible persons without a HKID card, the cost for inpatient general hospital is $5,100 per day. For day procedure and treatment at Clinical Oncology Clinics, the cost is $895 per attendance.

Beware of waiting times which can be very long in public sector.

For details, call the Hospital Authority at 2300 6555.

Cost of Treatment in Hong Kong’s Private Sector:

In Hong Kong, fees are determined according to the choice of room (private, semi-private, ward), doctor fees, medication fees, and administration fees of each hospital or clinic, therefore it may vary significantly. Treatments including chemotherapy and target therapy in the private sector range from about $100,000 to $1,000,000.

*All amounts are in HKD and were last updated in July 2019. No responsibility is accepted for any inaccuracies, errors, or omissions. It is always best to call ahead to make sure the information is still up-to-date.

Does insurance usually cover the cost of Leukemia treatment in Hong Kong?

According to AD MediLink, leukemia-related surgery is usually reimbursed under hospital/surgical benefits whereas chemotherapy/radiation therapies are usually reimbursed under cancer cover. Generally, high-end medical plans will reimburse cancer treatments in full without any sub-limit whereas local plans will have sub-limits. If you have any health insurance questions, contact an expert at [email protected].

Useful Resources in Hong Kong

Hong Kong Blood Cancer Foundation

Children’s Cancer Foundation

Hong Kong Cancer Fund

Hong Kong Anti Cancer Society

Make-A-Wish Hong Kong

This article was medically reviewed by Dr. Herman Liu on July 11, 2019. Dr. Herman Liu was a graduate from the University of Hong Kong in 1992. He has been practising haematology and haematological oncology for 20 years. He was a consultant in haematology before he left the public service sector in 2016. His clinic in Central provides a series of haematological consultation, diagnosis and treatment.
This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.