What are the symptoms of leukemia?

Written by Li Fang Fang
Hematology
Updated on September 29, 2024
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The symptoms of leukemia mainly fall into four categories: infections, anemia, bleeding, and tumor infiltration. Infections occur because the proliferation of leukemia cells leads to a reduction in the patient's own granulocytes, lowering their resistance and possibly leading to various secondary infections such as respiratory, urinary system, and skin mucous membrane infections. Anemia is due to the proliferation of leukemia cells, which restricts normal erythropoiesis in the bone marrow, leading to symptoms in patients such as dizziness, headaches, fatigue, and decreased stamina. Bleeding occurs due to a decrease in platelets, posing a risk of spontaneous bleeding, which can include bleeding of the skin mucous membranes, organs, and even cerebral hemorrhage. Tumor infiltration by leukemia cells may manifest as tumor masses on the skin surface.

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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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Early symptoms of childhood leukemia

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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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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Written by Li Fang Fang
Hematology
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Does leukemia cause fever?

Leukemia patients do experience fever, which can be categorized into two main types: infectious fever and tumor fever. Infectious fever occurs due to the compromised resistance and lowered immunity of leukemia patients, potentially leading to various types of infections such as pulmonary infections, skin and mucous membrane infections, digestive system infections, urinary system infections, etc. Tumor fever, on the other hand, occurs in the late stages of leukemia and is caused by the abnormal proliferation of leukemia cells, leading to tumor-related fever. Typically, the temperature in tumor fever does not exceed 38 degrees Celsius, with early-stage fevers responding well to treatment, but late-stage fevers showing poorer responsiveness.

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Written by Li Fang Fang
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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.