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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Can leukemia cause toothache?

Leukemia, particularly acute leukemia, is characterized by leukemic cells losing their ability to differentiate and mature, remaining at various stages of cell development. This results in a significant reduction in mature, functional white blood cells. Consequently, patients with acute leukemia have extremely low immune function. Therefore, more than half of the patients initially present with fever as the primary symptom. Fever indicates infection, which can spread to multiple parts of the body, with oral inflammation, gingivitis, and pharyngitis being the most common. Thus, patients with acute leukemia who also have gingivitis may experience toothache.

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Is acute leukemia contagious?

Acute leukemia is not a contagious disease, so it is not transmissible. Acute leukemia is a malignant tumor disease of the hematopoietic system. The causes of this disease are still not very clear, however, some known inducers include exposure to radiation, contact with chemotherapy drugs, and contact with benzene-containing chemicals. The genetic factors of acute leukemia are also not significant, so children usually do not have a genetic predisposition if their parents suffer from acute leukemia.

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Symptoms of leukemia

The symptoms of leukemia can be categorized into four main types: infections, anemia, bleeding, and organ infiltration. Infections occur due to a decrease in neutrophils, leading to poor resistance of the body and can trigger infections in various parts, such as lung infections, gastrointestinal infections, urinary system infections, etc. Anemia is caused by the growth of leukemia cells, which leads to limited erythropoiesis in the bone marrow, resulting in symptoms such as dizziness, headache, fatigue, poor appetite, and decreased tolerance to activity. Bleeding is due to a significant reduction in platelets in leukemia patients, making spontaneous bleeding more likely, which can manifest as bleeding from the skin and mucous membranes, organ bleeding, etc. Tumor infiltration can lead to abnormalities in other organs.

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Hematology
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chronic granulocytic leukemia platelets

Patients with chronic granulocytic leukemia have variations in blood platelets as seen in routine blood tests, which differ according to different stages of the disease. In the chronic phase, especially early on, platelet counts are mostly elevated or normal, with increases potentially exceeding 1000x10^9 per liter. The shape of the platelets is normal, but their function is often abnormal, with thrombus formation being rare. A minority of patients may experience a decrease in platelet count. As the disease progresses, routine blood tests can reveal significant decreases or increases in platelet counts along with the appearance of megakaryocytes. Additionally, some patients may also exhibit bone marrow fibrosis, characterized by an increase in reticular fibers or collagen fibers.

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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.