chronic granulocytic leukemia platelets

Written by He Li Fang
Hematology
Updated on September 28, 2024
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Patients with chronic granulocytic leukemia have variations in blood platelets as seen in routine blood tests, which differ according to different stages of the disease. In the chronic phase, especially early on, platelet counts are mostly elevated or normal, with increases potentially exceeding 1000x10^9 per liter. The shape of the platelets is normal, but their function is often abnormal, with thrombus formation being rare. A minority of patients may experience a decrease in platelet count. As the disease progresses, routine blood tests can reveal significant decreases or increases in platelet counts along with the appearance of megakaryocytes. Additionally, some patients may also exhibit bone marrow fibrosis, characterized by an increase in reticular fibers or collagen fibers.

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Written by He Li Fang
Hematology
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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.

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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 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 Zhi Gong
Cardiothoracic Surgery
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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.

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Written by He Li Fang
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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.