The difference between chronic granulocytic leukemia and leukemia

Written by Li Guo Bao
Hematology
Updated on September 20, 2024
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Leukemia is divided into acute leukemia and chronic leukemia. Acute leukemia is further categorized into acute lymphocytic leukemia and acute myeloid leukemia, while chronic leukemia is divided into chronic lymphocytic leukemia and chronic myeloid leukemia. Chronic myeloid leukemia, also known as chronic granulocytic leukemia, generally has a better prognosis compared to acute leukemia, with a higher cure rate and longer survival. Among these, chronic granulocytic leukemia has targeted treatment drugs such as imatinib and dasatinib.

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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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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.

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What is leukemia?

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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Hematology
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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.

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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.