What is acute leukemia?

Written by Zhang Xiao Le
Hematology
Updated on November 22, 2024
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Acute leukemia is a malignant clonal disease originating from hematopoietic stem progenitor cells. Normally, hematopoietic stem progenitor cells differentiate into white blood cells, which gradually mature into normal white blood cells. However, leukemia cells are primitive cells and immature cells, which means that the hematopoietic stem cells lose the ability to differentiate and mature. Additionally, they proliferate massively in the bone marrow while suppressing normal hematopoietic functions, and can widely infiltrate various organs such as the liver, spleen, and lymph nodes. Due to the suppression of bone marrow hematopoiesis, patients may exhibit clinical manifestations such as anemia, bleeding, and infections. Patients with acute leukemia often seek medical attention because of fever, fatigue, or bleeding from the skin and mucous membranes.

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Written by Li Fang Fang
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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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How to test for leukemia?

Patients with leukemia should first undergo a routine blood test. Some leukemia patients' routine blood tests may indicate leukemia, such as when white blood cell counts are abnormally high, exceeding 50*10^9/L, and can even reach more than 100*10^9/L, which highly suggests leukemia. At this point, bone marrow biopsy, bone marrow immunotyping, and chromosome tests are needed to further clarify the type of leukemia. In addition, risk stratification in leukemia patients is also necessary through genetic mutations and chromosome analysis.

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Is bleeding when brushing teeth leukemia?

Bleeding during brushing is not necessarily leukemia; it could also be due to gingivitis or periodontitis. Bleeding can occur around the teeth where there are irritants like soft plaque or dental plaque. These irritants chronically stimulate the gingival tissues, causing them to be in a congested state. A stimulus, such as brushing, can then lead to bleeding of the gums. This condition is a common early sign of gingivitis or periodontitis. After dental cleaning to remove these irritants, followed by rinsing and medicating the area around the gums, the condition of gingivitis can be improved. Therefore, if bleeding during brushing can be improved through dental cleaning and medication, it indicates that the bleeding is simply caused by gingivitis or periodontitis, and not leukemia.

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Written by Li Fang Fang
Hematology
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Is chronic myeloid leukemia scary?

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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How is acute leukemia chemotherapeutically treated?

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.