What is acute leukemia?

Written by Zhang Xiao Le
Hematology
Updated on November 22, 2024
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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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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 He Li Fang
Hematology
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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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Is leukemia cancer?

Leukemia is a cancer of the blood system. Based on the maturity of the tumor cells, leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia is further divided into acute myeloid leukemia and acute lymphoblastic leukemia, while chronic leukemia is divided into chronic granulocytic leukemia and chronic lymphocytic leukemia. As the name suggests, acute leukemia has a rapid onset, a shorter survival period, and treatment is more challenging. Chronic leukemia, on the other hand, has a slower onset, a relatively longer survival period, and the treatment results are comparatively better.

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Written by Li Fang Fang
Hematology
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Can leukemia be cured?

Leukemia is a broad category of diseases. Some leukemia patients can achieve clinical cure through oral chemotherapy or intravenous chemotherapy, while others can only achieve cure through allogeneic hematopoietic stem cell transplantation. Among them, chronic granulocytic leukemia can be clinically cured through oral chemotherapy due to the availability of targeted drug treatments, resulting in a longer survival period. In the case of acute promyelocytic leukemia, the advent of drugs like retinoic acid and arsenic trioxide has enabled patients to achieve clinical cure through a combination of oral and intravenous chemotherapy. However, many other types of leukemia often require allogeneic hematopoietic stem cell transplantation to reach clinical cure.

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Written by Zhang Xiao Le
Hematology
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Differentiation between Leukemoid Reaction and Leukemia

Leukemoid reactions and acute leukemia can both present with fever and elevated white blood cell counts, but there are clear differences between the two. Leukemoid reactions are often caused by severe bacterial or viral infections, with the main symptom being fever. Blood tests may show an increase in white blood cells, primarily neutrophils, and peripheral blood smear can reveal myelocytes and metamyelocytes. Leukemia can also involve an increase in white blood cells and fever when there is a concurrent infection, but blood tests will also show reductions in hemoglobin and platelets. Neutrophil alkaline phosphatase score is significantly elevated in patients with leukemoid reactions, while it is generally normal in patients with leukemia. A bone marrow examination can easily differentiate between leukemoid reactions and leukemia.