Leukemia Leukemia is a malignant clonal disease of hematopoietic stem cells, in which leukemia cells proliferate uncontrollably, exhibit differentiation disorders, and have inhibited apoptosis, leading to stagnation at various stages of cell development. In the bone marrow and other hematopoietic tissues, leukemia cells proliferate extensively, leading to suppression of normal hematopoiesis and infiltration of other organ tissues.

Leukemia is a malignant clonal disease of hematopoietic stem cells, characterized by uncontrolled proliferation of leukemia cells, differentiation disorders, and blocked apoptosis, leading to stagnation at various stages of cell development. In the bone marrow and other hematopoietic tissues, leukemia cells proliferate and accumulate in large numbers, suppressing normal hematopoiesis and infiltrating other organ tissues.

Viral Infections

Adult T-cell leukemia/lymphoma (ATL) can be caused by human T-cell lymphotropic virus type I (HTLV-I) following viral infection. Endogenous viruses latent in host cells may be activated under certain factors, leading to leukemia, or as exogenous viruses causing direct pathogenesis.

Immune Dysfunction

Individuals with certain immune dysfunctions, such as some autoimmune disease patients, have a higher risk of developing leukemia.

Physical Factors

Mainly ionizing radiation such as X-rays and gamma rays. Studies have shown that extensive and high-dose irradiation can lead to bone marrow suppression, decreased immune function, DNA mutation, breakage, and recombination, leading to leukemia.

Chemical Factors

Long-term exposure to benzene and benzene-containing organic solvents can cause leukemia. Ethyleneimine, a derivative of ethylene, has the ability to induce chromosomal aberrations and leukemia. Additionally, certain anti-tumor drugs (such as alkylating agents) can also lead to leukemia.

Genetic Factors

Having a family history of leukemia may increase the risk of the disease. Familial leukemia accounts for 0.7% of leukemia cases and is associated with genetic diseases such as Down syndrome, congenital aplastic anemia, Bloom syndrome, ataxia-telangiectasia, congenital immunoglobulin deficiency, etc.

Other Blood Disorders

Certain blood disorders may eventually develop into leukemia, such as myelodysplastic syndromes, chronic myeloproliferative disorders, lymphomas, multiple myeloma, etc.

Unhealthy Lifestyle Habits

Individuals with habits such as smoking, excessive drinking, drug abuse, and irregular sleep patterns are prone to developing leukemia.

Cancer Treatment

The incidence of leukemia is increased in other cancer patients undergoing chemotherapy and radiation therapy.

Early Symptoms

Acute leukemia may present with sudden high fever, resembling "flu-like" symptoms, or severe bleeding. Chronic leukemia generally progresses slowly, and patients may exhibit pallor, lymphadenopathy, splenomegaly, excessive menstrual bleeding, or difficulty in stopping bleeding after tooth extraction.

Acute Leukemia

Anemia

Most patients present with moderate to severe anemia at the time of diagnosis, while some acute leukemia patients may have a short course without anemia.

Fever and Infection

Fever is an early symptom in half of the patients, ranging from low-grade to over 39°C to 40°C. High fever often indicates secondary infection, which can occur in various parts of the body, such as the gums, perianal area, and lungs. Severe cases may lead to septicemia.

Bleeding

Around 40% of early patients experience bleeding, which can occur in various parts of the body, with skin ecchymosis, nosebleeds, gum bleeding, and excessive menstrual bleeding being common. Although rare, intracranial hemorrhage, gastrointestinal bleeding, and urogenital bleeding can have serious consequences.

Leukemia Cell Proliferation and Infiltration Manifestations

Lymphadenopathy and Splenomegaly: Lymphadenopathy is a prominent feature of lymphocytic leukemia, particularly in acute lymphocytic leukemia. Splenomegaly is more common in acute leukemia.

Bone and Joint Pain: Bone pain is a common sign of leukemia, often severe and located in the sternum, limbs, spine, and pelvis. Pain relief is often ineffective, and it is more common in children than adults.

Eyes: Some leukemias can cause exophthalmos, diplopia, or blindness.

Oral Cavity and Skin: Common in acute leukemia, presenting as gingival hyperplasia, swelling, or bleeding. Localized skin nodules may appear hardened and purplish-blue.

Central Nervous System: Can affect cerebrospinal fluid circulation, leading to increased intracranial pressure, resulting in headaches, nausea, vomiting, blurred vision, papilledema, and even seizures, coma, and other manifestations.

Testes: Often unilateral painless enlargement, with leukemia cell infiltration often found on biopsy.

Chronic Leukemia

Mainly divided into chronic myeloid leukemia and chronic lymphocytic leukemia.

The chronic phase of chronic myeloid leukemia generally lasts 1 to 4 years, with symptoms of fatigue, low-grade fever, excessive sweating or night sweats, and weight loss. Splenomegaly is the most prominent sign, with noticeable pain in the splenic area in the case of splenic infarction. When white blood cell count significantly increases, there may be congested and bleeding fundi. In the accelerated phase of the disease, there is often fever, weakness, progressive weight loss, bone pain, and gradually developing anemia and bleeding, which can last for several months to years. When chronic myeloid leukemia enters the blast crisis, the prognosis is poor, often leading to death within a few months.

Chronic lymphocytic leukemia has a slow onset, often with no apparent symptoms. Patients may initially experience fatigue, tiredness, followed by decreased appetite, weight loss, low-grade fever, and night sweats. 60% to 80% of patients have lymphadenopathy, mostly in the head and neck, clavicle, and other areas. More than half of the patients have mild to moderate splenomegaly, mild hepatomegaly, and other symptoms. In the late stage, patients may develop anemia, thrombocytopenia, and granulocytopenia, making them susceptible to infections.

Patients: Pay attention to nutritional supplementation, maintain water and electrolyte balance, and if necessary, receive parenteral nutrition. Leukemia patients have a lower immune system and should take precautions against infections, especially in oral, nasal, and perianal care.

Family Members: Provide the patient with high-protein, high-calorie, easily digestible foods. Pay attention to observing any abnormal signs or symptoms.

Maintain regular lifestyle, adequate sleep, moderate exercise, healthy diet, avoid overeating, and pay attention to food hygiene.

Be vigilant about post-transplant complications: These may include infections, bleeding, nausea, vomiting, and even graft rejection.

Avoid certain chemicals: Avoid exposure to certain chemical environments, such as benzene and related chemical products.

Quit smoking: Smoking increases the risk of acute myeloid leukemia and should be avoided.

Regular check-ups: For individuals with a family history of leukemia and a history of blood disorders, regular check-ups are recommended.