Acute Leukemia: What It Is, Types, and Main Symptoms

Acute leukemia is a cancer of the blood that begins in the bone marrow. It is based on a mutation of a blood stem cell whose descendants lose the ability to mature. Acute leukemias grow quickly and, without treatment, progress within a short time, whereas chronic leukemias develop slowly over years.

What acute leukemia is

Acute leukemia is a clonal disease that arises primarily in the bone marrow due to a mutation of a blood stem cell. The mutated cell produces descendants that have lost the ability to differentiate into mature cells; these blast cells displace normal hematopoiesis. No specific external causative factor has been identified for acute leukemias. The terms "acute" and "chronic" here refer to the rate of growth, not to progression from one to the other: acute leukemia does not turn into chronic leukemia. About 35 new cases per 1 million population are registered annually; the risk increases with age, and the disease most often occurs after age 60.

Acute myeloid (myeloblastic) leukemia

AML is a rare cancer of the blood and bone marrow; it is more common in older adults but also occurs in children. It is one of the two main forms of acute leukemia. This group includes several variants, including AML without maturation and with maturation, promyeloblastic, myelomonoblastic, monoblastic, erythroleukemia, and megakaryoblastic leukemia. The incidence of AML is roughly the same across all age groups, and men and women are affected at equal rates.

Acute lymphoblastic leukemia: B-cell and other forms

ALL is the second main type. Among lymphoblastic forms, pre-pre-B ALL, pre-B ALL, B-ALL, and T-ALL are distinguished. Acute lymphoblastic leukemia is the most common cancer in children, but it also occurs in adults. The incidence pattern depends on age: ALL more often develops in childhood and after age 40.

Rare forms: monocytic leukemia

Monoblastic (monocytic) leukemia is included in the list of AML variants.

Symptoms of acute leukemia

The clinical manifestations are the same for all variants and can be diverse; onset may be sudden or gradual, and there are no specific signs. A combination of bone marrow failure and signs of organ involvement is characteristic.

• Fatigue and signs of anemia
• Fever, night sweats, frequent infections due to immunodeficiency
• Easy bruising and bleeding, small red spots — petechiae
• Weight loss and loss of appetite
• Necrotizing gingivitis, tonsillitis, enlarged lymph nodes, spleen, and liver

The severity of the condition may be determined by intoxication, hemorrhagic syndrome, and respiratory failure due to compression of the airways by enlarged lymph nodes.

Diagnosis: blood test and bone marrow

Examination includes a physical examination, medical history, blood tests (complete blood count), and bone marrow testing — aspiration and biopsy with samples sent to the laboratory. Genetic tests to look for gene and chromosome changes complete the picture; when necessary, imaging and a lumbar puncture to examine cerebrospinal fluid are performed. In the bone marrow, blasts make up 10–20% of cells; in the blood and bone marrow, a "leukemic hiatus" has been described — the presence of only blast and mature cells without intermediate forms. The lineage of blasts is clarified using special cytochemical and immunohistochemical methods.

Suspicion of leukemia alone is not a reason to call an ambulance; 103 or 112 — for severe bleeding, marked respiratory failure, signs of sepsis, or a sudden deterioration of the condition.

This material is for reference: it describes general principles and does not replace a doctor's consultation — in case of suspicious symptoms or changes in test results, the decision is made by a hematologist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer