How is acute leukemia chemotherapeutically treated?

Written by Li Fang Fang
Hematology
Updated on September 05, 2024
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Acute leukemia is first divided into two main categories: one is acute myeloid leukemia, and the other is acute lymphoblastic leukemia. The chemotherapy regimens for these two types are different. Among them, acute myeloid leukemia is further divided into eight types from M0 to M7, among which type M3 can be treated with oral targeted chemotherapy drugs, while other types of acute myeloid leukemia require chemotherapy for treatment. The other main category is acute lymphoblastic leukemia, which also requires chemotherapy for treatment.

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Written by He Li Fang
Hematology
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Chronic Granulocytic Leukemia Classification

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 Bao Hua
Dentistry
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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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Written by He Li Fang
Hematology
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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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Written by Zhang Xiao Le
Hematology
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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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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.