Symptoms of leukemia

Written by Li Fang Fang
Hematology
Updated on September 11, 2024
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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.

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Written by He Li Fang
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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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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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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.

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Written by He Li Fang
Hematology
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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.

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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.