leukemia

Leukemia

Leukemia is most common malignancy of children less than 15 years of age.

Leukemia is a cancer of blood forming cells in the bone marrow.

Leukemia is group of malignant disorders effecting the blood and blood forming tissues of the bone marrow, lymph system and spleen.

It is uncontrolled neoplastic proliferation of leucocyte precursors, result in uncontrolled growth of leukemic cells in bone marrow.

Etiology

Exact cause of leukemia is unknown.

1. Genetic factor (familial predisposition)

2. Chromosomal abnormalities/changes

3. Virus like Human Papilloma virus (HPV)

Epstein -Barr Virus (EBV)

4. Radiation and chemotherapy

5. Exposure to chemical and drugs; benzene

6. Near Nuclear bomb sites

7. Immunologic deficiencies

8. Smoking

9. Down syndrome and some inherited disease

Fanconi anemia; developing acute myeloid leukemia

10. Blood disorder

Classification of Leukemia

A. Acute leukemia

1. Acute lymphoid leukemia (80%); ALL

a. T cell

b. B cell

c. Pre B cell; precursors of B-lymphocytes

d. Null cell; large granular lymphocyte that develop inside bone marrow.

2. Acute myeloid leukemia (10-20%); AML (tissue of bone marrow)

a. Acute myeloblastic

b. Acute promyelocytic (increase immature WBC)

c. Acute myelomonocytic

d. Acute monocytic

e. Acute erythrocytic

 

B. Chronic leukemia

1. Chronic lymphoid leukemia (absent in children)

2. Chronic myeloid leukemia

Lympho; leukemia involve in lymphoid.

Myelo; leukemia of myeloid (bone marrow origin)

Blastic; leukemia involve in immature cells

Cytic; leukemia involve in mature cells

Pathophysiology

Uncontrolled proliferation of leucocyte precursors.

Infiltration and replacement of normal cell of bone marrow by leukemic cells and infiltration into organ.

Abnormal immature leucocytes circulate in bloods.

Destruction of normal cell occur due to competition for nutrients.

1. Bone marrow dysfunction

Decrease RBC; anaemia

Decrease WBC; infection

Neutropenia; low level of neutrophils 

Decrease Platelets; Hemorrhage

Sign and symptoms

Fever

Pallor

Fatigue

Anorexia

Hemorrhage

Bone and joint pain

2. Reticuloendothelial system

(Infiltration into organ)

Enlarged liver, lymph nodes and spleen

3. Central nervous system

Leukemic

Meningitis

4. Generalized hyper-metabolism 

Proliferating leukemic cell deprive all body cell nutrients.

Cellular starvation

Muscle wasting

Weight loss

Anorexia

Fatigue