What are the symptoms of lymphocytic leukemia?

Lymphoblastic leukemia can be divided into acute and chronic types. Acute lymphoblastic leukemia is a malignant hematological disease caused by the infinite proliferation of undifferentiated or poorly differentiated lymphocytes in hematopoietic tissues (especially bone marrow, spleen and lymph nodes).

Classification of acute lymphoblastic leukemia

1. According to cell size (FAB, China standard)

① The promyelocytic cells with L1are mainly small cells, and the large cells are less than 0.25 (25%).

②L2 promyelocytic cells are mainly large cells >: 0.25(25%).

③L3 cells are mainly large, with many cytoplasm and dark blue, and many vacuoles are honeycomb-shaped, which is called Birket type.

According to cell phenotype (WHO standard)

① precursor b-all: the cell morphology resembles L 1 or L2, and the immunophenotype is strain b: CD 19, CD22, CD79a, CD 10 positive, and TdT^+. accounts for 80% ~ 85% of the total.

② precursor T-ALL: the cell morphology is like L 1 or L2, and the immunophenotype is T-ray: CD3, CD7, CD4 and CD8 are positive, and TDT can also be positive, accounting for 15% ~ 20% of ALL.

Who classified L3 (BurKitt type) as a mature B-cell tumor.

Although the clinical manifestations of each type are different, they are basically the same. The breakdown is as follows:

1. Generally, except for T-ALL, the onset is relatively urgent and slow. In the early stage, it is often manifested as burnout, weakness or irritability, loss of appetite and occasional vomiting. There are also symptoms such as viral upper respiratory tract infection at first, or rash, and then weakness. Bone and joint pain is also a common symptom.

2. Progressive pallor appears in the early stage of anemia, especially in the skin and oral mucosa. With the aggravation of anemia, symptoms such as shortness of breath, weakness and fatigue will appear after exercise. Because of the acute onset of T-ALL, anemia was not serious at the time of diagnosis.

3, more than half of the fever has fever, and the heat type is uncertain. The main cause of fever is secondary infection.

4, bleeding About half of the patients have nosebleeds, gingival bleeding and skin purpura or ecchymosis, ecchymosis, and occasionally intracranial hemorrhage. The cause of bleeding is not only the abnormal quality and quantity of platelets, but also the invasive damage of leukemia cells to the blood vessel wall, which increases the permeability. DIC occasionally occurs in T-ALL, which may be caused by the release of thrombin, kinase and other substances from primitive T-ALL cells.

5. Symptoms caused by leukemia cells infiltrating organs About two-thirds of children have mild or moderate splenomegaly, and the liver is slightly swollen and soft. Lymph node enlargement is mostly mild, confined to the neck, submaxillary, armpit, groin and other places.