Chronic Granulocytic Leukemia Classification

Written by He Li Fang
Hematology
Updated on September 12, 2024
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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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The difference between chronic granulocytic leukemia and leukemia.

Chronic granulocytic leukemia is a type of leukemia. Leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia is further divided into acute myeloid leukemia and acute lymphoblastic leukemia. Among these, acute myeloid leukemia can be divided into eight subtypes from M0 to M7, and acute lymphoblastic leukemia can be divided into three subtypes from L0 to L3. Chronic leukemia is further divided into chronic granulocytic leukemia and chronic lymphocytic leukemia. Therefore, chronic granulocytic leukemia is a subtype of leukemia.

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Written by Li Fang Fang
Hematology
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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 etiology

Chronic granulocytic leukemia is a myeloproliferative tumor originating from multipotent stem cells. It is characterized by the translocation of chromosomes 9 and 22 forming the BCR/ABL fusion gene. The Philadelphia chromosome is a characteristic change in chronic granulocytic leukemia, first discovered and named in Philadelphia in 1960. Initially, it was observed as a deletion of the long arm of the primary chromosome in dividing blood cells of patients with this leukemia. Currently, studies have shown that abnormalities in the interaction between hematopoietic progenitor cells and the stroma might be central to treating the disease. Abnormal adhesion and anchoring characteristics of progenitor cells lead to disrupted cell maturation and proliferation. Chronic granulocytic cells do not adhere to stromal cells as normal cells do, particularly lacking integrin-mediated adhesion. Additionally, the expression of the adhesion molecule lymphocyte function-associated antigen 3 is also reduced in these cells. Therefore, the progression of the disease results from clonal changes. During the transformation of chronic granulocytic leukemia to acute myeloid leukemia, there is an increased rate of genetic mutations. Changes in gene expression during the progression involve various aspects, including nucleosome sugar metabolism, bone marrow myeloid differentiation, genomic instability of cell apoptosis genes, and processes related to DNA damage repair.

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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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Written by Li Fang Fang
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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.