How is acute leukemia chemotherapeutically treated?

Written by Li Fang Fang
Hematology
Updated on September 05, 2024
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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.

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Written by He Li Fang
Hematology
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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.

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Written by Li Fang Fang
Hematology
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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.

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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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chronic granulocytic leukemia platelets

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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chronic granulocytic leukemia course

The course of chronic granulocytic leukemia is relatively long, as it is a type of chronic leukemia. Its onset is gradual, and its natural course includes four stages: asymptomatic phase, chronic phase, accelerated phase, and blast crisis phase. Most patients seek medical attention and are diagnosed only after symptoms appear, with very few patients discovering blood abnormalities during physical examinations or blood tests conducted for other reasons. At this point, the spleen may already be mildly enlarged, or not enlarged at all. In the early stages of the disease, some patients may experience an absolute increase in basophilic granulocytes. When the white blood cell count is less than 20×10^9/L, there is a decrease in neutrophil alkaline phosphatase activity in peripheral blood, and this decreases further as the disease progresses. When the white blood cell count exceeds 40×10^9/L, the spleen can be felt below the ribs. Between 30 and 90×10^9/L, a range of related clinical symptoms may appear.