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Fever, uncontrolled bleeding, or extreme breathlessness in someone with leukaemia is an emergency. Go to hospital immediately. Infection in a patient with a low white cell count can become life-threatening within hours. Do not wait for advice.

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Leukaemia: treatment and transplant options

Cancer of the blood-forming cells in the bone marrow. Abnormal cells crowd out normal ones, so the body runs short of the red cells that carry oxygen, the platelets that stop bleeding, and the white cells that fight infection.

Leukaemia covers four main diseases with very different urgencies. Acute leukaemia needs treatment within days. Chronic myeloid leukaemia is now controlled for decades by a daily tablet. Knowing which you have changes everything, including whether travelling is sensible at all.

Clinically reviewed by Dr. Annie Varughese, Consultant Medical Oncologist Clinical oversight Dr. Annie Varughese, MD, FACC Last reviewed August 2026 Editorial and medical review policy
Acute leukaemia
Days, not weeks
Treatment must start urgently, usually locally
Chronic myeloid
A daily tablet
Controlled for decades without transplant in most cases
Transplant
For selected cases
Matched sibling, haploidentical or unrelated donor
Key document
Bone marrow report
With flow cytometry and cytogenetics
On this page
  1. What it is
  2. Symptoms and warning signs
  3. How it is diagnosed
  4. Treatment options
  5. How the choice is made
  6. How urgent is your case
  7. What to send us
  8. Questions patients ask
The condition

What leukaemia is

Blood cells are made in the bone marrow. In leukaemia, one line of cells becomes abnormal and multiplies without control, filling the marrow and preventing normal blood production. The consequences are anaemia, bleeding and infection.

There are four main types. Acute myeloid leukaemia and acute lymphoblastic leukaemia develop over days to weeks and require urgent treatment. Acute lymphoblastic leukaemia is the commonest childhood cancer, and in children the outlook with modern treatment is generally good.

Chronic myeloid leukaemia is driven by a specific genetic change, and tyrosine kinase inhibitor tablets have transformed it from a fatal disease into one most patients live with for decades. Transplant, once standard, is now needed only in a minority. Chronic lymphocytic leukaemia often progresses so slowly that many patients need no treatment for years.

This is why the exact diagnosis matters more than the word leukaemia. Two people given the same one-word diagnosis may face urgent hospital admission or a tablet taken at home indefinitely.

Symptoms

Symptoms and warning signs

Common symptoms
  • Persistent tiredness and breathlessness from anaemia
  • Frequent or unusual infections
  • Easy bruising, or bleeding gums and nosebleeds
  • Small red or purple spots on the skin
  • Fever and night sweats
  • Bone or joint pain, particularly in children
  • Swollen lymph nodes, or a swollen abdomen from an enlarged spleen
Warning signs of an emergency
  • Fever in someone with a known low white cell count
  • Bleeding that does not stop
  • Severe breathlessness
  • Confusion or severe headache
  • Severe abdominal pain
  • Rapidly rising white cell count with breathlessness or confusion

Acute leukaemia is treated where you are, not where you would prefer

Acute leukaemia requires treatment to begin within days of diagnosis. Arranging international travel takes weeks. If you or your child has been diagnosed with acute leukaemia, start treatment at your local hospital immediately and send us the reports in parallel — we will then plan whether a transplant or a later phase of treatment should happen here. Delaying induction chemotherapy to travel is the single most harmful thing a family can do in this situation.

Diagnosis

How it is diagnosed

Blood tests raise the suspicion; the bone marrow examination establishes exactly which disease it is.

Initial tests

  • Full blood count and film — often the first abnormal result
  • Bone marrow aspirate and trephine biopsy — the definitive test
  • Flow cytometry — identifies precisely which cell line is involved
  • Clotting tests, kidney and liver function

The deciding tests

  • Cytogenetics and molecular testing — chromosome and gene abnormalities that determine risk group and drug choice
  • Lumbar puncture — in acute lymphoblastic leukaemia, to check whether the central nervous system is involved
  • HLA typing — of the patient and siblings, where transplant may be needed
  • Minimal residual disease testing — measures response to treatment at a level blood counts cannot detect

HLA typing can often be done in your own country

If a transplant may be needed, tissue typing of the patient and their brothers and sisters is the first step, and it is a blood test that many laboratories in your own country can perform. Arranging it locally saves considerable time and cost, and tells us early whether a matched sibling donor exists. Ask us before you travel — we will tell you exactly what to request.

Options

Treatment options

Treatment depends entirely on which leukaemia it is, and the four behave very differently.

Option one

Induction and consolidation chemotherapy

For acute leukaemia, intensive chemotherapy given in hospital to clear the marrow of abnormal cells, followed by further cycles to prevent return. Induction typically requires four to six weeks in hospital with a prolonged period of very low blood counts requiring transfusion and protection from infection.

Usually appropriate whenAcute myeloid or acute lymphoblastic leukaemia. This should generally begin at home, urgently, rather than waiting to travel.
Option two

Targeted tablets

For chronic myeloid leukaemia, tyrosine kinase inhibitors control the disease in the great majority of patients, taken as a daily tablet at home with periodic blood monitoring. Generic versions are widely available and inexpensive. Similar targeted agents exist for specific subtypes of other leukaemias.

Usually appropriate whenChronic myeloid leukaemia, or another leukaemia carrying a targetable abnormality.
Option three

Bone marrow transplant

Replacement of the diseased marrow with healthy stem cells from a donor. It offers cure for selected patients but carries substantial risk, including graft-versus-host disease. It requires four to six weeks in hospital, much of it in protective isolation, and three to four months in India in total.

Usually appropriate whenHigh-risk acute leukaemia, disease that has returned after chemotherapy, or chronic leukaemia no longer controlled by tablets.
Option four

Watch and wait

For chronic lymphocytic leukaemia without symptoms, monitoring with periodic blood tests is the standard approach, and treating early has not been shown to help. Many patients remain well for years without any treatment at all.

Usually appropriate whenEarly chronic lymphocytic leukaemia without symptoms, anaemia or low platelets.
The decision

How the choice is made

Which leukaemia, precisely

Acute or chronic, myeloid or lymphoid. The bone marrow report with flow cytometry answers this, and nothing can be planned without it.

Then the risk group

Cytogenetic and molecular findings sort patients into risk groups, and this is what determines whether transplant is recommended or chemotherapy alone is sufficient.

Then donor availability

If transplant is indicated, whether a matched sibling exists. Where none does, haploidentical transplant from a parent or child has made transplant possible for nearly everyone who needs one.

If your diagnosis is chronic myeloid leukaemia, the honest answer is usually a daily tablet, monitoring at home, and no journey at all. We say so regularly.

Urgency

How urgent is your case

Usually safe to plan travel
  • Chronic leukaemia, stable on treatment
  • Planned transplant with a stable patient in remission
  • Post-treatment follow-up
  • Second opinion sought on a bone marrow report
Needs local assessment before travel
  • Newly diagnosed acute leukaemia
  • Any fever with a low white cell count
  • Active bleeding
  • Very high white cell count with breathlessness or confusion
  • Severe anaemia requiring transfusion

We will tell you which column you are in

For newly diagnosed acute leukaemia, we will tell you to start treatment locally today and plan the rest afterwards. That advice costs us the case and it is the right advice.

Next step

What to send us

Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.

Most useful

  • Bone marrow aspirate and biopsy report
  • Flow cytometry report
  • Cytogenetics and molecular testing results
  • Recent full blood counts

Also helpful

  • HLA typing results for patient and siblings if done
  • Details of treatment given so far
  • Kidney and liver function
  • The patient's age and general condition
Send my reports for review See published cost ranges
Questions

Questions patients ask

Not immediately. Acute lymphoblastic leukaemia in children needs treatment within days, and induction chemotherapy is available in most of the countries our patients come from. Start there, urgently, and send us the bone marrow report at the same time. If a transplant becomes necessary later, that is when travel makes sense — and by then we will have planned it properly.

No, and this is a common misunderstanding. Many acute leukaemias, particularly in children, are cured with chemotherapy alone. Chronic myeloid leukaemia is usually controlled indefinitely with tablets. Transplant is reserved for high-risk disease, relapse, or disease no longer responding — the cytogenetics and response to initial treatment determine which applies.

Transplant is still very likely possible. Haploidentical transplant uses a half-matched donor — a parent, child or sibling who is not a full match — and has made transplant available to almost everyone who needs one. Matched unrelated donor registries are a further option. Send the HLA typing and we will tell you what routes exist.

In the great majority of cases, yes. Tyrosine kinase inhibitor tablets control the disease in most patients, are taken at home, and are inexpensive in generic form. Regular monitoring of the molecular response is needed. Transplant is now reserved for the minority who do not respond or who progress despite treatment.

Plan on three to four months in total. That covers pre-transplant assessment and donor workup, four to six weeks in hospital including a prolonged period in protective isolation, and a further period of close outpatient monitoring before it is safe to fly home. It is the longest stay of any treatment we arrange.

Because chemotherapy leaves the white cell count very low, and an infection that would be minor in a healthy person can become life-threatening within hours. Fever during or after chemotherapy is treated as an emergency requiring intravenous antibiotics the same day, wherever you are. Never wait to see whether it settles.

RelatedOn this site
Cancer treatment in IndiaRead → Bone marrow transplant in IndiaRead → LymphomaRead → Bone marrow transplant costRead → Medical visa guidesRead →
Contact

Send us your reports

Send the bone marrow report with flow cytometry and cytogenetics. If this is a new diagnosis of acute leukaemia, start treatment locally first and send the reports in parallel.

Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.

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