Let's dig deeper into the topic of leukemia. So, in a simple sentence, leukemia is a type of blood cancer that specifically affects white blood cells. To be clear we have 3 types of blood cells. Red blood cells, white blood cells , and platelets. White blood cells help ourselves fight off foreign particles and bacteria. One of the cells of the WBC lineage is called lymphocytes. These lymphocytes build immunoglobulins that act as an antibody.
There are two types of leukemia based on how long it takes for the cells to spread. One is acute and the other is chronic. These two species have two further classifications respectively. One is acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL). Another is chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL).
What really happens in acute lymphoblastic leukemia is that there is a sudden overproliferation of WBCs and especially lymphocytes. As a result, the number of lymphocytes is only increased. Note also the wording for acute and chronic leukemia. Acute is both blastocytic leukemia and chronic is cellular leukemia. This means that in cases of acute leukemia, there will be blast cells. Blast cells are mostly immature cells that are unable to perform normal functions. So there will be an increased number of lymphocytes in the bloodstream but most of them are unable to defend the body against foreign particles and bacteria.
Take another note that all blood cells are created from stem cells in the bone marrow. Therefore, an increase in the number of one cell will decrease the production of the other cells. So in the blood picture of acute lymphoblastic leukemia that we see, the RBC count has decreased. With a decrease in the number of RBCs, there will be a decrease in hemoglobin, which will lead to anemia. We are also looking for thrombocytopenia. This is a low platelet count. And finally, we see that the number of white blood cells is usually 3-4 times higher than normal. On the contrary, in acute myelogenous leukemia, there will be an increase in the number of white blood cells other than lymphocytes.
What happens here is that the bone marrow stem cells will produce immature myeloblasts. Myeloblasts are mostly called granulosa cells when they become mature. Granulocytes are white blood cells that contain granules in their cytoplasm. There are three types of granulocytes. Neutrophils, eosinophils and basophils. Therefore, in acute myelogenous leukemia, there will be an increase in the number of immature neutrophils, eosinophils or perhaps basophils, and sometimes all of them. Similarly, for chronic myeloid leukemia, the myeloid cells that are immunized fail to maintain physiological functions as normal cells, leaving the body succumbing to various diseases.
Now let's talk about chronic leukemia
As the name suggests, they are chronic in nature which means they need a longer duration to reproduce. Also if you check the formulations, they are myeloid or lymphatic in nature. This means that it will produce more implanted cells. But as more mature cells are produced, the number of others decreases. But this type of cell grows slowly and is sometimes difficult to detect at first. We can confirm by observing the change in the morphology of the white blood cells. These types of chronic leukemias are usually uncommon in individuals. Chronic myeloid leukemia is most often caused by a switch between chromosome number 9 and 22. The very short chromosome 22 is called the Philadelphia chromosome. A patient with chronic myeloid leukemia has a 90% chance of acquiring the Philadelphia chromosome in the genotype.
Similarly for chronic leukemia, the increased number of white blood cells will eventually reduce the number of RBCs and platelets, resulting in uncontrollable bleeding, fever, weight loss, bone pain and so on. As the cells from the bone marrow multiply, myelodysplasia will occur which leads to severe bleeding. Bone pain.
Now let's move on to the topic of treatment and curability
Most often patients ask about the stage of leukemia. For your recognition, we stage the cancers to assess whether we go for palliative treatment or curative treatment. One staging includes whether or not cancer cells have metastasized to distant organs. If metastasis does occur, it will be an advanced stage cancer. Cancer cells usually spread in two ways, one is hematogenous or through the blood and the other is through the lymphatic system. Our leukemia is a cancer of the blood itself. So it's always an advanced stage. Whatever you do, if you don't treat it, you will die. But there is hope that acute leukemias respond very well to chemotherapy and patients often make a full recovery and lead happy lives.
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