Is chronic myeloid leukemia scary?

Written by Li Fang Fang
Hematology
Updated on April 08, 2025
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Chronic myeloid leukemia, though a type of leukemia, is not terrifying because there are targeted drugs available for it, namely tyrosine kinase inhibitors. These inhibitors have been developed into first, second, and third-generation products. Most cases of chronic granulocytic leukemia can achieve clinical remission after oral administration of tyrosine kinase inhibitors. Some patients might experience a blast crisis, acceleration phase, or relapse during treatment, but they can switch to higher-grade tyrosine kinase inhibitors or undergo allogeneic hematopoietic stem cell transplantation. Thus, chronic myeloid leukemia is no longer considered a frightening disease. (Please use medication under the guidance of a doctor.)

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Written by Li Fang Fang
Hematology
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Symptoms of Acute Leukemia

The common symptoms of acute leukemia include four main categories: infection, anemia, bleeding, and tumor infiltration. Symptoms of infection manifest as fever, cough, expectoration, chest pain, abdominal pain, diarrhea, frequent urination, urgent urination, painful urination, skin infections, and perianal infections. Anemia is characterized by dizziness, fatigue, poor appetite, and decreased endurance. Symptoms of reduced platelets mainly involve bleeding, which can manifest as bleeding of the skin and mucous membranes, organ bleeding, and even cerebral hemorrhage. Tumor infiltration can manifest as gingival hyperplasia and skin rashes among other swellings.

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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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Written by He Li Fang
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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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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.

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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.