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Leukemia
Causes of Chronic Myeloid Leukemia
Chronic granulocytic leukemia, also known as chronic myeloid leukemia, is a myeloproliferative tumor originating from pluripotent stem cells. It is characterized by a specific chromosomal alteration, commonly referred to as the Philadelphia chromosome, which is formed by the translocation of chromosomes 9 and 22, resulting in the formation of the BCR-ABL fusion gene at the molecular level. Chronic granulocytic leukemia is a clonal disease originating from pluripotent stem cells. Due to a significant expansion of the progenitor cell pool, there is excessive proliferation of myeloid cells and increased granulocyte production. The slow clearance of granulocytes leads to the accumulation of granulocytes in the body, which is the main cause of the disease.
The Difference Between Acute Leukemia and Chronic Leukemia
The difference between acute and chronic leukemia lies in the maturity stage of the leukemia cells. Acute leukemia is characterized by more immature leukemia cells, while chronic leukemia cells tend to be more mature. Acute leukemia is further divided into acute myeloid leukemia and acute lymphoblastic leukemia. Among them, acute myeloid leukemia is subdivided into eight types, from M0 to M7. Chronic leukemia is divided into two main categories: chronic lymphocytic leukemia and chronic myeloid leukemia. As the name suggests, acute leukemia has a rapid onset and a shorter survival period, whereas chronic leukemia develops more slowly and has a longer life expectancy.
Chronic granulocytic leukemia etiology
Chronic granulocytic leukemia is a myeloproliferative tumor originating from multipotent stem cells. It is characterized by the translocation of chromosomes 9 and 22 forming the BCR/ABL fusion gene. The Philadelphia chromosome is a characteristic change in chronic granulocytic leukemia, first discovered and named in Philadelphia in 1960. Initially, it was observed as a deletion of the long arm of the primary chromosome in dividing blood cells of patients with this leukemia. Currently, studies have shown that abnormalities in the interaction between hematopoietic progenitor cells and the stroma might be central to treating the disease. Abnormal adhesion and anchoring characteristics of progenitor cells lead to disrupted cell maturation and proliferation. Chronic granulocytic cells do not adhere to stromal cells as normal cells do, particularly lacking integrin-mediated adhesion. Additionally, the expression of the adhesion molecule lymphocyte function-associated antigen 3 is also reduced in these cells. Therefore, the progression of the disease results from clonal changes. During the transformation of chronic granulocytic leukemia to acute myeloid leukemia, there is an increased rate of genetic mutations. Changes in gene expression during the progression involve various aspects, including nucleosome sugar metabolism, bone marrow myeloid differentiation, genomic instability of cell apoptosis genes, and processes related to DNA damage repair.
Is leukemia cancer?
Leukemia is a cancer of the blood system. Based on the maturity of the tumor cells, leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia is further divided into acute myeloid leukemia and acute lymphoblastic leukemia, while chronic leukemia is divided into chronic granulocytic leukemia and chronic lymphocytic leukemia. As the name suggests, acute leukemia has a rapid onset, a shorter survival period, and treatment is more challenging. Chronic leukemia, on the other hand, has a slower onset, a relatively longer survival period, and the treatment results are comparatively better.
Chronic Granulocytic Leukemia Classification
Chronic granulocytic leukemia is a myeloproliferative tumor originating from pluripotent stem cells, characterized by the presence of the Philadelphia chromosome or changes in the BCR/ABL fusion gene. Chronic granulocytic leukemia progresses through four stages: asymptomatic, chronic, accelerated, and blast crisis phases. Most patients are diagnosed after the onset of symptoms. Only a very few patients are diagnosed through routine physical examinations or other reasons when blood abnormalities are discovered. The earliest symptoms experienced during the chronic phase of the illness typically include fatigue, dizziness, and abdominal discomfort. The accelerated phase is a transitional stage before the blast crisis, marking a turning point where the disease worsens. It is often difficult to distinctly separate the accelerated phase from the blast crisis, and about 20%-25% of patients may enter the blast crisis phase directly without passing through the accelerated phase.
Symptoms of leukemia
The symptoms of leukemia can be categorized into four main types: infections, anemia, bleeding, and organ infiltration. Infections occur due to a decrease in neutrophils, leading to poor resistance of the body and can trigger infections in various parts, such as lung infections, gastrointestinal infections, urinary system infections, etc. Anemia is caused by the growth of leukemia cells, which leads to limited erythropoiesis in the bone marrow, resulting in symptoms such as dizziness, headache, fatigue, poor appetite, and decreased tolerance to activity. Bleeding is due to a significant reduction in platelets in leukemia patients, making spontaneous bleeding more likely, which can manifest as bleeding from the skin and mucous membranes, organ bleeding, etc. Tumor infiltration can lead to abnormalities in other organs.
Chronic granulocytic leukemia symptoms
The clinical symptoms of chronic myeloid leukemia can be divided into two phases: 1. During the chronic phase, the earliest subjective symptoms include fatigue, dizziness, and abdominal discomfort. Other symptoms may also appear such as general malaise, decreased endurance, and nausea. Some patients may exhibit signs of increased basal metabolism, such as sweating, weight loss, palpitations, and nervousness. As the disease progresses, patients may experience enlargement of the liver and spleen. An enlarged spleen can cause abdominal bloating, discomfort in the upper left abdomen, and a feeling of fullness after eating. In a few cases, bleeding may occur in the early stages. In female patients, excessive menstruation is common, and while bone pain and joint pain are less common at initial diagnosis, they can also occur. 2. During the accelerated phase, patients often exhibit unexplained low-grade fever, fatigue, lack of appetite, night sweats, and increased weight loss. These symptoms are accompanied by rapid enlargement of the spleen causing discomfort and fullness, sudden swelling of lymph nodes, clear sternal tenderness, and osteolytic changes in bones leading to bone pain. Anemia also progressively worsens. Once patients enter the blast crisis phase, they may show extramedullary infiltration symptoms such as skin nodules, testicular infiltration, abnormal penile erections, and the appearance of green tumors in the eye sockets, among other serious complications.
How is acute leukemia chemotherapeutically treated?
Acute leukemia is first divided into two main categories: one is acute myeloid leukemia, and the other is acute lymphoblastic leukemia. The chemotherapy regimens for these two types are different. Among them, acute myeloid leukemia is further divided into eight types from M0 to M7, among which type M3 can be treated with oral targeted chemotherapy drugs, while other types of acute myeloid leukemia require chemotherapy for treatment. The other main category is acute lymphoblastic leukemia, which also requires chemotherapy for treatment.
Is bleeding when brushing teeth leukemia?
Bleeding during brushing is not necessarily leukemia; it could also be due to gingivitis or periodontitis. Bleeding can occur around the teeth where there are irritants like soft plaque or dental plaque. These irritants chronically stimulate the gingival tissues, causing them to be in a congested state. A stimulus, such as brushing, can then lead to bleeding of the gums. This condition is a common early sign of gingivitis or periodontitis. After dental cleaning to remove these irritants, followed by rinsing and medicating the area around the gums, the condition of gingivitis can be improved. Therefore, if bleeding during brushing can be improved through dental cleaning and medication, it indicates that the bleeding is simply caused by gingivitis or periodontitis, and not leukemia.
What is leukemia?
Leukemia is a malignant tumor of the hematopoietic system that originates from hematopoietic stem/progenitor cells. It involves leukemia cells that have proliferative and survival advantages, proliferating and accumulating uncontrollably in the body, gradually replacing normal hematopoiesis to form pathological hematopoiesis. Furthermore, it invades other organs and systems, leading to symptoms such as anemia, bleeding, and infections, which eventually cause death. The incidence of leukemia is 4.8/100000-7.1/100000 in males and 3.2/100000-4.6/100000 in females, with significant variations in incidence, mortality rates, and distribution among different types of leukemia and various regions and ethnic groups. Early on, it was recognized that leukemia is not an inflammation, and the views that leukemia is caused by a lack of certain substances have been proven incorrect. Currently, it is understood that the causative factors of leukemia are related to infections, radiation, chemical agents, lifestyle, and genetics.