Early symptoms of childhood leukemia

Written by Yan Xin Liang
Pediatrics
Updated on September 19, 2024
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Generally speaking, leukemia can manifest symptoms related to a decrease in all three blood cell lines. Changes in these three lines typically include an increase or decrease in white blood cells, a decrease in red blood cells leading to symptoms of anemia, and a reduction in platelets, resulting in symptoms of bleeding. Children with leukemia often experience recurrent fevers and are prone to infections, as well as bleeding gums. There may also be enlargement of the liver, spleen, and lymph nodes, along with pallor of the face and lips, which appear pale and bloodless.

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Written by Li Bao Hua
Dentistry
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Is bleeding gums leukemia?

Gum bleeding is not necessarily leukemia; it could also be gingivitis, periodontitis, or other diseases of the hematopoietic system. Gum bleeding is a common clinical symptom of gingivitis, caused by irritants like dental plaque and tartar around the teeth, keeping the gum tissue in a congested state. If persistent, this can lead to gum bleeding. This condition can be improved by dental cleaning, followed by medicated rinses around the teeth. If the situation does not improve, it may be due to periapical abscess caused by periapical inflammation of the tooth, which can also result in gum bleeding. In this case, root canal treatment is required, and once the inflammation in the root canal is controlled, the gum bleeding may alleviate on its own. If neither of these treatments is effective, it could be due to an underlying hematopoietic system disease, which would require further examination.

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Written by Li Fang Fang
Hematology
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How is leukemia diagnosed?

When a routine blood test suggests the possibility of leukemia, further diagnostic tests such as bone marrow aspiration, biopsy, and immunophenotyping are required to confirm the diagnosis. Leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia includes acute myeloid leukemia and acute lymphoblastic leukemia. Acute myeloid leukemia is further categorized into eight types, from M0 to M7. Acute lymphoblastic leukemia is divided into three subtypes: L1 to L3. Chronic leukemia can be divided into chronic myeloid leukemia and chronic lymphocytic leukemia.

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Written by Zhang Xiao Le
Hematology
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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.

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Written by Li Fang Fang
Hematology
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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.

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Written by He Li Fang
Hematology
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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.