The difference between chronic granulocytic leukemia and leukemia

Written by Zhang Xiao Le

Hematology

Updated on March 28, 2025

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Chronic granulocytic leukemia is a type of leukemia, which itself is a group of malignant clonal disorders of hematopoietic stem cells. In leukemia, the leukemic cells exhibit enhanced self-renewal, uncontrolled proliferation, and obstructed apoptosis, causing a halt at various stages of cell development. Leukemia is divided into acute leukemia and chronic leukemia. Acute leukemia includes acute lymphoblastic leukemia and acute myeloid leukemia, while chronic leukemia includes chronic lymphocytic leukemia and chronic granulocytic leukemia. The primary difference between acute and chronic leukemia is that the leukemic cells in acute leukemia mainly stall at the primitive and immature stages, whereas in chronic leukemia, the cells primarily remain at the mid-immature and late-immature stages.

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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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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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Does leukemia cause coughing?

Leukemia patients' coughing is not directly caused by the leukemia itself, but often due to pulmonary inflammation that commonly accompanies leukemia, leading to symptoms such as coughing, phlegm, and chest pain. Due to a reduced count of normal neutrophils, leukemia patients have low resistance and poor immunity, making them highly susceptible to secondary infections, particularly pulmonary infections. Following a pulmonary infection, whether bacterial, fungal, or viral, patients may experience symptoms including coughing, severe cases may involve coughing up phlegm, chest pain, and breathing difficulties.

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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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Symptoms of Chronic Myelogenous Leukemia

Most cases of chronic granulocytic leukemia are due to abnormal enlargement of the spleen, leading to abdominal distension and poor appetite. A small portion of chronic granulocytic leukemia cases show no obvious symptoms and are only discovered through routine physical examinations, finding an abnormal increase in white blood cells, leading to diagnosis and treatment in the hematology department. Common clinical symptoms of chronic granulocytic leukemia include an enlarged spleen. Additionally, some patients may also experience fatigue due to anemia, and a very few patients seek medical advice due to bleeding caused by a decrease in platelets.