Causes of Chronic Myeloid Leukemia

Written by He Li Fang
Hematology
Updated on September 19, 2024
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Chronic granulocytic leukemia, also known as chronic myeloid leukemia, is a myeloproliferative tumor originating from pluripotent stem cells. It is characterized by a specific chromosomal alteration, commonly referred to as the Philadelphia chromosome, which is formed by the translocation of chromosomes 9 and 22, resulting in the formation of the BCR-ABL fusion gene at the molecular level. Chronic granulocytic leukemia is a clonal disease originating from pluripotent stem cells. Due to a significant expansion of the progenitor cell pool, there is excessive proliferation of myeloid cells and increased granulocyte production. The slow clearance of granulocytes leads to the accumulation of granulocytes in the body, which is the main cause of the disease.

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Is bleeding gums leukemia?

Gum bleeding is not necessarily leukemia; it could also be gingivitis, periodontitis, or other diseases of the hematopoietic system. Gum bleeding is a common clinical symptom of gingivitis, caused by irritants like dental plaque and tartar around the teeth, keeping the gum tissue in a congested state. If persistent, this can lead to gum bleeding. This condition can be improved by dental cleaning, followed by medicated rinses around the teeth. If the situation does not improve, it may be due to periapical abscess caused by periapical inflammation of the tooth, which can also result in gum bleeding. In this case, root canal treatment is required, and once the inflammation in the root canal is controlled, the gum bleeding may alleviate on its own. If neither of these treatments is effective, it could be due to an underlying hematopoietic system disease, which would require further examination.

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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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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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How is leukemia diagnosed?

When a routine blood test suggests the possibility of leukemia, further diagnostic tests such as bone marrow aspiration, biopsy, and immunophenotyping are required to confirm the diagnosis. Leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia includes acute myeloid leukemia and acute lymphoblastic leukemia. Acute myeloid leukemia is further categorized into eight types, from M0 to M7. Acute lymphoblastic leukemia is divided into three subtypes: L1 to L3. Chronic leukemia can be divided into chronic myeloid leukemia and chronic lymphocytic leukemia.