Is leukemia treatment free?

Written by He Li Fang
Hematology
Updated on September 19, 2024
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Leukemia is a type of malignant tumor originating from hematopoietic stem cells and progenitor cells in the myeloid hematopoietic system. Leukemia cells differentiate and organize at the early stages of different myeloid developments, exhibiting the morphological and immunophenotypic characteristics of myeloid development. The incidence of acute myeloid leukemia in the population is 2-4/100,000, with the median age of onset being sixty-four to seventy years, making it a disease of the elderly. The incidence increases with age, accounting for 70% of acute leukemias, and representing 55%-70% of infant, 17%-20% of childhood, and 80%-90% of adult acute leukemias. Regarding the medical insurance situation in China, some leukemia conditions are eligible for major illness assistance. All leukemia treatments can be reimbursed at a certain ratio under the national health insurance, although there is no free treatment for leukemia at present, unless one participates in relevant clinical trials, which could offer some compensation, and certain treatment drugs are provided free of charge.

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Written by He Li Fang
Hematology
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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.

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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.

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Hematology
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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.

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Written by Li Fang Fang
Hematology
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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.

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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.