Acute leukemia is a disease of the leukocytes and their precursors. It is characterized by the appearance of immature, abnormal cells in the bone marrow and peripheral blood and frequently in the liver, spleen, lymph nodes, and other parenchymatous organs.

The underlying pathophysiology consists of a maturational arrest of bone marrow cells in the earliest stages of development. The mechanism of this arrest is under study, but in many cases, it involves the activation of abnormal genes through chromosomal translocations and other genetic abnormalities.

The disease is more common in males than in females.

Causes of Acute Leukemia

The exact cause of acute leukemia is unknown; however, radiation (especially prolonged exposure), certain chemicals and drugs, viruses, genetic abnormalities, and chronic exposure to benzene are likely contributing factors.

In children, Down syndrome, ataxia, and telangiectasia may increase the risk, as may such congenital disorders as albinism and congenital immunodeficiency syndrome.

Although the pathogenesis isn't clearly understood, immature, nonfunctioning WBCs appear to accumulate first in the tissue where they originate (lymphocytes in lymph tissue, granulocytes in bone marrow). These immature WBCs then spill into the bloodstream. They then overwhelm the red blood cells and the platelets. From there, they infiltrate other tissues.

Signs & Symptoms of Acute Leukemia

Abnormal bleeding
Excessive bruising
Weakness
Prolonged or excessive bleeding, bruising easily
Infection and fever
Abdominal pain or "fullness"
Enlarged spleen, lymph nodes, and liver
Unintentional weight loss

Diagnostic Tests

Blood counts
Bruising (ecchymosis)
Low platelet count
Cell surface antigen studies (B-cell, leukemia/lymphoma panel)

Treatment

Treatment may include:

Bone marrow transplantation
Chemotherapy
Monoclonal antibodies (Mylotarg is used in conjunction with a chemotherapy drug)
Radiation therapy

Prevention Tips

Because the cause of most cases is unknown, prevention of most cases is not possible. Minimizing exposure to toxins, radiation, chemicals, etc. may reduce risk.

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