What is leukemia?

Written by He Li Fang
Hematology
Updated on September 03, 2024
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Leukemia is a malignant tumor of the hematopoietic system that originates from hematopoietic stem/progenitor cells. It involves leukemia cells that have proliferative and survival advantages, proliferating and accumulating uncontrollably in the body, gradually replacing normal hematopoiesis to form pathological hematopoiesis. Furthermore, it invades other organs and systems, leading to symptoms such as anemia, bleeding, and infections, which eventually cause death. The incidence of leukemia is 4.8/100000-7.1/100000 in males and 3.2/100000-4.6/100000 in females, with significant variations in incidence, mortality rates, and distribution among different types of leukemia and various regions and ethnic groups. Early on, it was recognized that leukemia is not an inflammation, and the views that leukemia is caused by a lack of certain substances have been proven incorrect. Currently, it is understood that the causative factors of leukemia are related to infections, radiation, chemical agents, lifestyle, and genetics.

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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.

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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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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.

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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.