Is leukemia cancer?

Written by Li Fang Fang

Hematology

Updated on September 14, 2024

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Leukemia is a cancer of the blood system. Based on the maturity of the tumor cells, leukemia can be divided into acute leukemia and chronic leukemia. Acute leukemia is further divided into acute myeloid leukemia and acute lymphoblastic leukemia, while chronic leukemia is divided into chronic granulocytic leukemia and chronic lymphocytic leukemia. As the name suggests, acute leukemia has a rapid onset, a shorter survival period, and treatment is more challenging. Chronic leukemia, on the other hand, has a slower onset, a relatively longer survival period, and the treatment results are comparatively better.

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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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Hematology

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What tests are done for leukemia?

Patients with leukemia need to be further classified to determine if it is acute leukemia or chronic leukemia, whether it is acute myeloid leukemia or acute lymphoblastic leukemia in the case of acute leukemia, and whether it is chronic myeloid leukemia or chronic lymphocytic leukemia in the case of chronic leukemia. Therefore, in addition to routine blood tests, leukemia patients also need to undergo bone marrow cytology, immunophenotyping, testing for 43 types of leukemia fusion genes, chromosome tests, etc., to further clarify the subtype of leukemia. After the subtype is clarified, a treatment plan is selected based on the specific type.

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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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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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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.