What tests are done for leukemia?

Written by Li Fang Fang

Hematology

Updated on March 20, 2025

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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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Written by Li Guo Bao

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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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Hematology

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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

53sec

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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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Written by He Li Fang

Hematology

1min 56sec

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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 Li Fang Fang

Hematology

1min 3sec

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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.