Leukemias are tumors of the bone marrow. In acute leukemias, the neoplastic cells are early hematopoietic cells (-blasts).
Description
In healthy individuals, the number of precursor (-blast) cells in the bone marrow stays at a normal range (since cells maturate and new -blast cells are formed).
- In acute leukemias, precursor cells (-blasts) lose the ability to maturate, and these cells start proliferating and pile up in the bone marrow
- This may affect hematopoiesis and cause cytopenia (cell number decrease in the blood) of other cell lineages (thrombocytopenia, anemia, leukopenia)
- The patient may present with symptoms that fit one of the cytopenia types (bleeding, hypoxia, or infections)
- Precursor cells usually reach the circulation
- They will seem polymorphic: larger, with and a big, pale nucleolus
- This may result in an increased count of the specific cell lineage
- Acute leukemias have a sudden onset, they can arise on their own or as a progression of chronic leukemia
- Progress quickly, but are curable
- Mostly affect younger patients.
Acute myeloid leukemias and myelodysplastic syndromes
Acute myeloid leukemias
In AML, we will see an increase in the number of myeloblasts.
- Presents within weeks or months with symptoms related to the cytopenia
- Fatigue
- Fever
- Spontaneous bleeding
- Opportunistic infections
- Appears mostly in adults (median age is 50)