How is leukemia diagnosed?

Written by Li Fang Fang
Hematology
Updated on September 22, 2024
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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.

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Written by Li Fang Fang
Hematology
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What are the symptoms of leukemia?

The symptoms of leukemia mainly fall into four categories: infections, anemia, bleeding, and tumor infiltration. Infections occur because the proliferation of leukemia cells leads to a reduction in the patient's own granulocytes, lowering their resistance and possibly leading to various secondary infections such as respiratory, urinary system, and skin mucous membrane infections. Anemia is due to the proliferation of leukemia cells, which restricts normal erythropoiesis in the bone marrow, leading to symptoms in patients such as dizziness, headaches, fatigue, and decreased stamina. Bleeding occurs due to a decrease in platelets, posing a risk of spontaneous bleeding, which can include bleeding of the skin mucous membranes, organs, and even cerebral hemorrhage. Tumor infiltration by leukemia cells may manifest as tumor masses on the skin surface.

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Written by He Li Fang
Hematology
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Causes of Chronic Myeloid Leukemia

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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The difference between chronic granulocytic leukemia and leukemia

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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Written by Li Fang Fang
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Symptoms of leukemia

The symptoms of leukemia can be categorized into four main types: infections, anemia, bleeding, and organ infiltration. Infections occur due to a decrease in neutrophils, leading to poor resistance of the body and can trigger infections in various parts, such as lung infections, gastrointestinal infections, urinary system infections, etc. Anemia is caused by the growth of leukemia cells, which leads to limited erythropoiesis in the bone marrow, resulting in symptoms such as dizziness, headache, fatigue, poor appetite, and decreased tolerance to activity. Bleeding is due to a significant reduction in platelets in leukemia patients, making spontaneous bleeding more likely, which can manifest as bleeding from the skin and mucous membranes, organ bleeding, etc. Tumor infiltration can lead to abnormalities in other organs.

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Written by He Li Fang
Hematology
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chronic granulocytic leukemia platelets

Patients with chronic granulocytic leukemia have variations in blood platelets as seen in routine blood tests, which differ according to different stages of the disease. In the chronic phase, especially early on, platelet counts are mostly elevated or normal, with increases potentially exceeding 1000x10^9 per liter. The shape of the platelets is normal, but their function is often abnormal, with thrombus formation being rare. A minority of patients may experience a decrease in platelet count. As the disease progresses, routine blood tests can reveal significant decreases or increases in platelet counts along with the appearance of megakaryocytes. Additionally, some patients may also exhibit bone marrow fibrosis, characterized by an increase in reticular fibers or collagen fibers.