Overview of leukemia
本页汇编了我们与 leukemia有关的内容。有关诊断和治疗的更多信息，请按照下方链接参阅我们关于相关疾病和症状的 BMJ Best Practice 临床实践完整专题。
简介
相关疾病
Acute lymphoblastic leukemia | 访问我们的完整专题Acute lymphoblastic leukemia A malignant clonal disease that develops when a lymphoid progenitor cell becomes genetically altered through somatic changes and undergoes uncontrolled proliferation. This progressive clonal expansion eventually leads to acute lymphoblastic leukemia (ALL), characterized by early lymphoid precursor cells replacing the normal hematopoietic cells of the bone marrow and further infiltrating various body organs.[4][5] ALL can occur at any age, but more than one-half of all cases (52.7%) are diagnosed in those ages under 20 years.[6] B-ALL (arising from B lymphoid progenitors) accounts for approximately 75% of adult cases, with the remainder being predominantly T-ALL (arising from T lymphoid progenitors).[7] Most ALL patients have signs and symptoms related to cytopenias (e.g., fatigue, easy bruising) at presentation and diagnosis. Enlarged lymph nodes can be an initial presenting sign. Key diagnostic factors include young age (children age <5 years); presence of genetic disorders (e.g., trisomy 21); family history of ALL; personal history of malignancy; treatment with chemotherapy; exposure to radiation; smoking; and folate metabolism polymorphisms. |
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Chronic lymphocytic leukemia | 访问我们的完整专题Chronic lymphocytic leukemia Chronic lymphocytic leukemia (CLL) is the most common leukemia in the western world.[8][9] It represents 1% of all new cancer cases in the US.[10] CLL is an indolent lymphoproliferative disorder in which monoclonal B lymphocytes (≥5000 cells/microliter [≥5 x 10⁹/L]) are predominantly found in peripheral blood.[11] The exact cause of CLL is unclear, but it is thought to develop as a result of an accumulation of multiple genetic events affecting oncogenes and tumor suppressor genes, which leads to increased cell survival and resistance to apoptosis.[12] Key diagnostic factors include lymphadenopathy, hepatosplenomegaly, shortness of breath and fatigue. Most cases of CLL are diagnosed incidentally following a routine complete blood count (CBC) for an unrelated reason.[13] |
Acute myeloid leukemia | 访问我们的完整专题Acute myeloid leukemia A life-threatening hematologic malignancy caused by the clonal expansion of myeloid blasts in the bone marrow, peripheral blood or extramedullary tissues. Occurs predominantly in older adults.[2] In 2025, there will be an estimated 22,010 new cases of acute myeloid leukemia (AML) and 11,090 deaths related to AML in the US.[2] Risk factors include previous treatment with chemotherapy, a previous hematologic disorder (e.g., aplastic anemia, myelodysplastic syndrome), inherited genetic disorders (e.g., Bloom syndrome, Wiskott-Aldrich syndrome), and exposure to radiation, benzene, or alkylating agents. Pallor, ecchymoses, and petechiae are common findings. Diagnosis requires bone marrow aspirate and trephine biopsy analysis. |
Chronic myeloid leukemia | 访问我们的完整专题Chronic myeloid leukemia A malignant clonal disorder of the hematopoietic stem cell that results in marked myeloid hyperplasia of the bone marrow.[14] Incidence peaks between the ages of 65 and 74 years, but people of all ages can be affected.[2] Possible signs and symptoms include splenomegaly, dyspnea, abdominal discomfort, malaise, fever, and night sweats; approximately 50% of patients are asymptomatic.[15] All patients require bone marrow biopsy. Presence of Philadelphia chromosome and/or molecular demonstration of the BCR::ABL1 transcript confirms diagnosis. |
Blast crisis | Blast crisis refers to the transformation of chronic myeloid leukemia (CML) from the chronic or accelerated phase to the blast phase. Diagnosis is confirmed by the percentage of blast cells (≥20% [WHO criteria] or ≥30% [MD Anderson Cancer Center and the International Bone Marrow Transplant Registry criteria]) in the peripheral blood or bone marrow.[16][17][18][19] The Philadelphia chromosome is present in >95% of cases of CML and is a hallmark of this disease. Anemia, infections, abnormal/excessive bleeding, bone pain, or constitutional symptoms (night sweats, weight loss, fever) are common presenting complaints of blast-phase CML. History of CML and exposure to alkylating chemotherapeutic agents are risk factors for blast crisis. |
Hairy cell leukemia | vaya a nuestro tema completo sobre Hairy cell leukemia A relatively uncommon, indolent mature B-cell neoplasm. Hairy cell leukemia (HCL) is considered to be a type of non-Hodgkin lymphoma. Seen under the microscope, the leukemic cells have delicate cytoplasmic projections resembling hair ("hairy cells"). HCL is commonly characterized by symptoms of fatigue, a markedly enlarged spleen, and pancytopenia. To confirm the diagnosis, a bone marrow trephine biopsy and aspiration should be carried out for morphology assessment and immunophenotyping (using immunohistochemistry or flow cytometry).[20] |
Evaluation of pancytopenia | vaya a nuestro tema completo sobre Evaluation of pancytopenia Pancytopenia is a reduction in the number of red blood cells, and platelets, in the peripheral blood below the lower limits of the age-adjusted normal range for healthy people. The causes are diverse, and likely differ in children and adults. The presence of pancytopenia always warrants investigation by a hematologist. Leukemias may cause pancytopenia through decreased production, or increased destruction or sequestration, of blood cells. |
Evaluation of neutropenia | vaya a nuestro tema completo sobre Evaluation of neutropenia Neutrophils are essential components of the hematopoietic and immune system, and quantitative or qualitative abnormalities of neutrophils can result in life-threatening infection. Infections are the most common cause of neutropenia in adults, followed by drug-induced neutropenias. In children <2 years of age, primary autoimmune neutropenia is the most common cause. Absolute neutrophil count is generally used to grade neutropenia severity. |
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