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Leukemia
The difference between chronic granulocytic leukemia and leukemia
Chronic granulocytic leukemia is a type of leukemia, which itself is a group of malignant clonal disorders of hematopoietic stem cells. In leukemia, the leukemic cells exhibit enhanced self-renewal, uncontrolled proliferation, and obstructed apoptosis, causing a halt at various stages of cell development. Leukemia is divided into acute leukemia and chronic leukemia. Acute leukemia includes acute lymphoblastic leukemia and acute myeloid leukemia, while chronic leukemia includes chronic lymphocytic leukemia and chronic granulocytic leukemia. The primary difference between acute and chronic leukemia is that the leukemic cells in acute leukemia mainly stall at the primitive and immature stages, whereas in chronic leukemia, the cells primarily remain at the mid-immature and late-immature stages.
What tests are done for leukemia?
Patients with leukemia need to be further classified to determine if it is acute leukemia or chronic leukemia, whether it is acute myeloid leukemia or acute lymphoblastic leukemia in the case of acute leukemia, and whether it is chronic myeloid leukemia or chronic lymphocytic leukemia in the case of chronic leukemia. Therefore, in addition to routine blood tests, leukemia patients also need to undergo bone marrow cytology, immunophenotyping, testing for 43 types of leukemia fusion genes, chromosome tests, etc., to further clarify the subtype of leukemia. After the subtype is clarified, a treatment plan is selected based on the specific type.
Can leukemia be cured?
Leukemia is a broad category of diseases. Some leukemia patients can achieve clinical cure through oral chemotherapy or intravenous chemotherapy, while others can only achieve cure through allogeneic hematopoietic stem cell transplantation. Among them, chronic granulocytic leukemia can be clinically cured through oral chemotherapy due to the availability of targeted drug treatments, resulting in a longer survival period. In the case of acute promyelocytic leukemia, the advent of drugs like retinoic acid and arsenic trioxide has enabled patients to achieve clinical cure through a combination of oral and intravenous chemotherapy. However, many other types of leukemia often require allogeneic hematopoietic stem cell transplantation to reach clinical cure.
Differentiation between Leukemoid Reaction and Leukemia
Leukemoid reactions and acute leukemia can both present with fever and elevated white blood cell counts, but there are clear differences between the two. Leukemoid reactions are often caused by severe bacterial or viral infections, with the main symptom being fever. Blood tests may show an increase in white blood cells, primarily neutrophils, and peripheral blood smear can reveal myelocytes and metamyelocytes. Leukemia can also involve an increase in white blood cells and fever when there is a concurrent infection, but blood tests will also show reductions in hemoglobin and platelets. Neutrophil alkaline phosphatase score is significantly elevated in patients with leukemoid reactions, while it is generally normal in patients with leukemia. A bone marrow examination can easily differentiate between leukemoid reactions and leukemia.
Symptoms of Chronic Myelogenous Leukemia
Most cases of chronic granulocytic leukemia are due to abnormal enlargement of the spleen, leading to abdominal distension and poor appetite. A small portion of chronic granulocytic leukemia cases show no obvious symptoms and are only discovered through routine physical examinations, finding an abnormal increase in white blood cells, leading to diagnosis and treatment in the hematology department. Common clinical symptoms of chronic granulocytic leukemia include an enlarged spleen. Additionally, some patients may also experience fatigue due to anemia, and a very few patients seek medical advice due to bleeding caused by a decrease in platelets.
Does leukemia cause vomiting?
Leukemia can cause vomiting. There are two reasons why leukemia patients experience vomiting: one is caused by the leukemia itself. If the white blood cell count in leukemia patients abnormally increases to more than 100×10^9/L, this condition is called hyperleukocytosis. In the state of hyperleukocytosis, the body is in a state of ischemia and hypoxia, which can manifest as dizziness, headache, and vomiting in the nervous system. The other reason is that during chemotherapy, the use of chemotherapy drugs can lead to gastrointestinal reactions such as nausea and vomiting.
How is leukemia treated?
Leukemia treatment currently mainly consists of three aspects: supportive care, chemotherapy, and transplantation. Supportive care refers to actively preventing and treating infections, as well as transfusing red blood cells and platelets in leukemia patients, who often suffer from repeated infections, anemia, and bleeding. Chemotherapy can be divided into oral chemotherapy and intravenous chemotherapy, depending on the specific type of leukemia. Transplantation can be divided into autologous hematopoietic stem cell transplantation and allogeneic hematopoietic stem cell transplantation. Autologous transplantation costs less and has fewer side effects but has a higher relapse rate. Allogeneic transplantation is more costly, has more severe side effects, but a lower relapse rate. Whether to undergo autologous or allogeneic hematopoietic stem cell transplantation depends on the specific type of disease and the patient's individual circumstances.
Is sternal pain leukemia?
There are many causes of chest pain, and it is not necessarily only leukemia. For young people or children, sometimes injuries such as those from car accidents, sleeping on the stomach, or accidentally bumping into chair backs or table corners can cause sternal pain. However, persistent sternal pain in children should be carefully examined for the possibility of blood disorders. Of course, this can be ruled out through chest CT scans, or, if necessary, a small sternal biopsy under local anesthesia to check for leukemia. But for adults, there are many other possible causes of chest pain, such as gastrointestinal ulcers, stomach ulcers, and duodenal ulcers which can radiate to the surrounding area of the sternum causing pain. Additionally, some anatomical organs behind the sternum such as heart diseases, coronary artery disease, and angina can also cause sternal pain. Thymomas, thymus cancer, an enlarged thyroid, and lymphoma can all lead to sternal pain. Other malignant tumors, like lung cancer, if involving the sternum can also cause this pain. Therefore, not all cases of sternal pain are definitely due to leukemia.
Does leukemia cause coughing?
Leukemia patients' coughing is not directly caused by the leukemia itself, but often due to pulmonary inflammation that commonly accompanies leukemia, leading to symptoms such as coughing, phlegm, and chest pain. Due to a reduced count of normal neutrophils, leukemia patients have low resistance and poor immunity, making them highly susceptible to secondary infections, particularly pulmonary infections. Following a pulmonary infection, whether bacterial, fungal, or viral, patients may experience symptoms including coughing, severe cases may involve coughing up phlegm, chest pain, and breathing difficulties.
What is acute leukemia?
Acute leukemia is a malignant clonal disease originating from hematopoietic stem progenitor cells. Normally, hematopoietic stem progenitor cells differentiate into white blood cells, which gradually mature into normal white blood cells. However, leukemia cells are primitive cells and immature cells, which means that the hematopoietic stem cells lose the ability to differentiate and mature. Additionally, they proliferate massively in the bone marrow while suppressing normal hematopoietic functions, and can widely infiltrate various organs such as the liver, spleen, and lymph nodes. Due to the suppression of bone marrow hematopoiesis, patients may exhibit clinical manifestations such as anemia, bleeding, and infections. Patients with acute leukemia often seek medical attention because of fever, fatigue, or bleeding from the skin and mucous membranes.