Han Xiao, Hematology Medical Center, Second Affiliated Hospital of Army Medical University (Xinqiao Hospital)
Leukemia, commonly known as "blood cancer" by common people, is a malignant clonal disease originating from hematopoietic stem cells. According to the degree of differentiation of leukemia cells and the natural course of the disease, it can be divided into acute and chronic. According to the source of affected cells, it can be divided into myeloid and lymphoid lineages.
Acute leukemia is highly aggressive and progresses rapidly, and can often be life-threatening if not treated in time. With the continuous deepening of research on leukemia, its diagnosis and treatment have entered a new era of comprehensive evaluation, combining chemotherapy and targeted therapy, and the prognosis has improved significantly. Therefore, it is not as scary as imagined.
What situations require vigilance in diagnosing leukemia?
Because leukemia stem cells inhibit the growth of normal cells, blood tests often show an increase or decrease in white blood cells, and a decrease in red blood cells and platelets, which can cause infection, anemia, bleeding, and infiltration-related manifestations, such as fever, cough, dizziness, fatigue, bleeding, ecchymosis, Bone pain, gum hyperplasia, etc.
What tests are needed for diagnosis when the blood picture is abnormal?
Bone marrow aspiration is the gold standard for diagnosing leukemia. Because "blood cancer" is a hematological malignant tumor, there is no metastasis. Bone marrow fluid is extracted to complete comprehensive assessments such as morphology, immune typing, molecular genetics, cytogenetics, and gene sequencing for diagnosis and risk stratification.
Why do you get leukemia?
Like most cancers, the cause of acute leukemia is not yet fully understood. Only a small proportion of cases may have definite triggers. Related factors include ionizing radiation, exposure to organic solvents such as benzene, viral infection or immune dysfunction, genetic susceptibility, etc. .
What is the treatment for acute leukemia?
The goal of treatment is to destroy leukemia cells and restore the growth of healthy blood cells in the bone marrow, thereby achieving complete remission. Different treatment options are selected according to each person's disease type, general condition and risk stratification. Currently, common treatment options mainly include:
1. Chemotherapy: Chemotherapy is like spraying herbicides on the fields. While the weeds are removed, the crops may also be affected.
2. Hypomethylation therapy: This option can be chosen for elderly patients who cannot tolerate chemotherapy. The response rate of single drug is low, so it often needs to be used in combination or for maintenance treatment.
3. Targeted therapy: such as imatinib, orebatinib, bellintuzumab, etolizumab, venetoclax, FLT3 inhibitors, IDH1/2 inhibitors, etc.
4. Hematopoietic stem cell transplantation: It can effectively reduce the risk of recurrence of all acute leukemias. Therefore, after comprehensive evaluation by specialists, bridging transplantation is recommended for donors and patients with related conditions to consolidate the prevention of recurrence, improve survival, and improve prognosis.
5. Immunotherapy: such as CAR-T or CAR-NK cell therapy targeting CD19, CD22, CD123, CD33, CLL-1 and other antigens, PD1 inhibitors, lenalidomide, etc.
What should we pay attention to during treatment?
First of all, cleanliness is the most important thing to prevent infection, such as wearing a mask, rinsing your mouth frequently, keeping your mouth shut, and being careful with your bowel movements; secondly, observe yourself and report any discomfort to the medical staff in a timely manner; finally, maintain a calm and optimistic mood , the encouragement and companionship of family members are more important.
To sum up, with the continuous improvement of the understanding of the disease, leukemia is no longer an incurable disease. With active cooperation, strengthened care, and medical care working together, we will eventually defeat the disease!
■Expert comments——
As a topic, this article chose "blood cancer" leukemia, a disease that everyone is concerned about but not well understood, as a popular science content, which has a good popularization effect; in terms of content, it includes the causes, symptoms that need attention, how to diagnose, Treatment and care are comprehensive and detailed; the writing style is easy to understand and explains the profound things in simple terms, and the content output is well realized.
Wen Qin, Hematology Medical Center, Second Affiliated Hospital of Army Medical University (Xinqiao Hospital)