Leukemii

Leukemii, the plural form of leukemia in Romanian, refer to cancers arising from blood-forming tissues, most notably the bone marrow, which lead to the abnormal proliferation of white blood cells. In general, leukemia manifests as uncontrolled growth of immature or abnormal leukocytes that crowd out normal blood cells, impairing immunity, oxygen transport, and clotting.

Classification: Leukemias are commonly grouped as acute or chronic, and by lineage as lymphoblastic (ALL) or myeloid (AML). Acute leukemias progress rapidly and require urgent treatment, while chronic leukemias evolve more slowly. ALL is the most common form in children, AML is common in adults, CLL and CML occur mainly in older adults or with distinct features.

Causes and risk factors: Genetic abnormalities such as chromosomal translocations, prior chemotherapy or radiation, certain inherited syndromes, and exposure to benzene or other environmental factors can increase risk. Some leukemias arise de novo, others after a preceding hematologic disorder.

Clinical features: Symptoms include fatigue, pallor, frequent infections, fever, easy bruising or bleeding, night sweats, and weight loss. Physical findings may include enlarged lymph nodes, liver, or spleen.

Diagnosis: Evaluation starts with complete blood count and peripheral smear, followed by bone marrow biopsy to assess blast percentage. Cytogenetic and molecular tests identify genetic changes that guide prognosis and treatment.

Treatment: Management depends on subtype and patient factors. Standard approaches include chemotherapy, targeted therapies, immunotherapy, and hematopoietic stem cell transplantation. Supportive care with transfusions and antibiotics is common.

Prognosis and follow-up: Outcome varies widely; favorable genetics and good treatment response improve survival, while age and comorbidity can worsen prognosis. Regular monitoring is essential to detect relapse and manage complications.