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Leukemia
How is acute leukemia treated?
The treatment for acute leukemia is chemotherapy. Chemotherapy can be administered orally or intravenously, and the choice between oral or intravenous chemotherapy depends on the type of acute leukemia. For patients with acute leukemia, if chemotherapy alone can effectively control the disease or achieve a cure, then there is no need for allogeneic hematopoietic stem cell transplantation. However, if chemotherapy alone cannot control the disease, and the patient is considered at high risk and of suitable age, then allogeneic hematopoietic stem cell transplantation should be considered.
How to test for leukemia?
Patients with leukemia should first undergo a routine blood test. Some leukemia patients' routine blood tests may indicate leukemia, such as when white blood cell counts are abnormally high, exceeding 50*10^9/L, and can even reach more than 100*10^9/L, which highly suggests leukemia. At this point, bone marrow biopsy, bone marrow immunotyping, and chromosome tests are needed to further clarify the type of leukemia. In addition, risk stratification in leukemia patients is also necessary through genetic mutations and chromosome analysis.
Is chronic myeloid leukemia scary?
Chronic myeloid leukemia, though a type of leukemia, is not terrifying because there are targeted drugs available for it, namely tyrosine kinase inhibitors. These inhibitors have been developed into first, second, and third-generation products. Most cases of chronic granulocytic leukemia can achieve clinical remission after oral administration of tyrosine kinase inhibitors. Some patients might experience a blast crisis, acceleration phase, or relapse during treatment, but they can switch to higher-grade tyrosine kinase inhibitors or undergo allogeneic hematopoietic stem cell transplantation. Thus, chronic myeloid leukemia is no longer considered a frightening disease. (Please use medication under the guidance of a doctor.)
The difference between chronic granulocytic leukemia and leukemia
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.
What tests are done for leukemia?
Patients with leukemia need to be further classified to determine if it is acute leukemia or chronic leukemia, whether it is acute myeloid leukemia or acute lymphoblastic leukemia in the case of acute leukemia, and whether it is chronic myeloid leukemia or chronic lymphocytic leukemia in the case of chronic leukemia. Therefore, in addition to routine blood tests, leukemia patients also need to undergo bone marrow cytology, immunophenotyping, testing for 43 types of leukemia fusion genes, chromosome tests, etc., to further clarify the subtype of leukemia. After the subtype is clarified, a treatment plan is selected based on the specific type.
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.
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.
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.
Does leukemia cause vomiting?
Leukemia can cause vomiting. There are two reasons why leukemia patients experience vomiting: one is caused by the leukemia itself. If the white blood cell count in leukemia patients abnormally increases to more than 100×10^9/L, this condition is called hyperleukocytosis. In the state of hyperleukocytosis, the body is in a state of ischemia and hypoxia, which can manifest as dizziness, headache, and vomiting in the nervous system. The other reason is that during chemotherapy, the use of chemotherapy drugs can lead to gastrointestinal reactions such as nausea and vomiting.
How is leukemia treated?
Leukemia treatment currently mainly consists of three aspects: supportive care, chemotherapy, and transplantation. Supportive care refers to actively preventing and treating infections, as well as transfusing red blood cells and platelets in leukemia patients, who often suffer from repeated infections, anemia, and bleeding. Chemotherapy can be divided into oral chemotherapy and intravenous chemotherapy, depending on the specific type of leukemia. Transplantation can be divided into autologous hematopoietic stem cell transplantation and allogeneic hematopoietic stem cell transplantation. Autologous transplantation costs less and has fewer side effects but has a higher relapse rate. Allogeneic transplantation is more costly, has more severe side effects, but a lower relapse rate. Whether to undergo autologous or allogeneic hematopoietic stem cell transplantation depends on the specific type of disease and the patient's individual circumstances.