Leukemia classification: Difference between revisions
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{{Leukemia}} | {{Leukemia}} | ||
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==Classification== | ==Classification== | ||
Leukemia is clinically and pathologically subdivided into several large groups. The first division is between its ''[[Acute (medical)|acute]]'' and ''[[chronic (medicine)|chronic]]'' forms: | Leukemia is clinically and pathologically subdivided into several large groups. The first division is between its ''[[Acute (medical)|acute]]'' and ''[[chronic (medicine)|chronic]]'' forms: | ||
* ''[[Acute leukemia]]'' is characterized by the rapid increase of immature [[blood]] | * ''[[Acute leukemia]]'' is characterized by the rapid increase of immature [[Blood cell|blood cells]]. This crowding makes the [[bone marrow]] unable to produce healthy blood cells. Acute forms of leukemia can occur in children and young adults. In fact, it is a more common cause of death for children in the United States than any other type of malignant disease. Immediate treatment is required for acute leukemias due to the rapid progression and accumulation of the [[malignant]] cells, which then spill over into the bloodstream and spread to other organs of the body. [[Central nervous system]] (CNS) involvement is uncommon, but the disease can occasionally cause [[Nerve palsy|cranial nerve palsies]]. | ||
* ''[[Chronic leukemia]]'' is distinguished by the excessive build up of relatively mature, | * ''[[Chronic leukemia]]'' is distinguished by the excessive build up of relatively mature, abnormal blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal [[white blood cells]] in the blood. Chronic leukemia mostly occurs in older people but can theoretically occur in any age group. While acute leukemia must be treated immediately, chronic forms are sometimes monitored for a some time before treatment to ensure maximum effectiveness of therapy. | ||
Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or ''[[lymphocytic leukemia]]s'' and myeloid or ''[[myelogenous leukemia]]s'': | Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or ''[[lymphocytic leukemia]]s'' and myeloid or ''[[myelogenous leukemia]]s'': | ||
* In lymphoblastic or ''[[lymphocytic leukemia]]s'', the cancerous change takes place in a type of [[marrow]] cell that normally goes on to form [[lymphocyte]]s. | * In lymphoblastic or ''[[lymphocytic leukemia]]s'', the cancerous change takes place in a type of [[marrow]] cell that normally goes on to form [[lymphocyte]]s. | ||
* In myeloid or ''[[myelogenous leukemia]]s'', the cancerous change takes place in a [[myeloid cells|type of marrow cell]] that normally goes on to form red cells, | * In myeloid or ''[[myelogenous leukemia]]s'', the cancerous change takes place in a [[myeloid cells|type of marrow cell]] that normally goes on to form red cells, [[Platelet|platelets]], and certain types of white cells. | ||
Combining these two classifications provides a total of four main categories: | Combining these two classifications provides a total of four main categories: | ||
{| class="wikitable" | {| class="wikitable" | ||
|+Four | |+Four Major Kinds of Leukemia | ||
! Cell type !! Acute !! Chronic | ! Cell type !! Acute !! Chronic | ||
|- | |- | ||
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Within these main categories, there are typically several subcategories. Finally, [[hairy cell leukemia]] is usually considered to be outside of this classification scheme. | Within these main categories, there are typically several subcategories. Finally, [[hairy cell leukemia]] is usually considered to be outside of this classification scheme. | ||
* ''Acute lymphoblastic leukemia'' ([[Acute lymphocytic leukemia|ALL]]) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Standard treatments involve chemotherapy | * ''Acute lymphoblastic leukemia'' ([[Acute lymphocytic leukemia|ALL]]) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Standard treatments involve either chemotherapy or radiation. The survival rates vary by age: 85% in children and 50% in adults.<ref>[http://www.accessmedicine.com/content.aspx?aID=65842 Harrison's Principles of Internal Medicine, 16th Edition,] Chapter 97. Malignancies of Lymphoid Cells. Clinical Features, Treatment, and Prognosis of Specific Lymphoid Malignancies.</ref> | ||
* ''Chronic lymphocytic leukemia'' ([[Chronic lymphocytic leukemia|CLL]]) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of affected | * ''Chronic lymphocytic leukemia'' ([[Chronic lymphocytic leukemia|CLL]]) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of the affected individuals are men. The five-year survival rate is 75%.<ref>[http://seer.cancer.gov/statfacts/html/clyl.html Finding Cancer Statistics » Cancer Stat Fact Sheets »Chronic Lymphocytic Leukemia] National Cancer Institute</ref> It is incurable, but there are many effective treatments. | ||
* ''Acute myelogenous leukemia'' ([[Acute myelogenous leukemia|AML]]) occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%.<ref>{{cite journal |author=Colvin GA, Elfenbein GJ |title=The latest treatment advances for acute myelogenous leukemia |journal=Med Health R I |volume=86 |issue=8 |pages=243–6 |year=2003 |pmid=14582219 |doi=}}</ref> | * ''Acute myelogenous leukemia'' ([[Acute myelogenous leukemia|AML]]) occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%.<ref>{{cite journal |author=Colvin GA, Elfenbein GJ |title=The latest treatment advances for acute myelogenous leukemia |journal=Med Health R I |volume=86 |issue=8 |pages=243–6 |year=2003 |pmid=14582219 |doi=}}</ref> | ||
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* ''Chronic myelogenous leukemia'' ([[Chronic myelogenous leukemia|CML]]) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with [[imatinib]] (Gleevec) or other drugs. The five-year survival rate is 90%.<ref>[http://www.medscape.com/viewarticle/536049 Patients with Chronic Myelogenous Leukemia Continue to Do Well on Imatinib at 5-Year Follow-Up] Medscape Medical News 2006</ref><ref>[http://professional.cancerconsultants.com/conference_asco_2006.aspx?id=37519 Updated Results of Tyrosine Kinase Inhibitors in CML] ASCO 2006 Conference Summaries</ref> | * ''Chronic myelogenous leukemia'' ([[Chronic myelogenous leukemia|CML]]) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with [[imatinib]] (Gleevec) or other drugs. The five-year survival rate is 90%.<ref>[http://www.medscape.com/viewarticle/536049 Patients with Chronic Myelogenous Leukemia Continue to Do Well on Imatinib at 5-Year Follow-Up] Medscape Medical News 2006</ref><ref>[http://professional.cancerconsultants.com/conference_asco_2006.aspx?id=37519 Updated Results of Tyrosine Kinase Inhibitors in CML] ASCO 2006 Conference Summaries</ref> | ||
* ''Hairy cell leukemia'' ([[Hairy cell leukemia|HCL]]) is sometimes considered a subset of CLL | * ''Hairy cell leukemia'' ([[Hairy cell leukemia|HCL]]) is sometimes considered a subset of CLL but does not fit neatly into this pattern. About 80% of affected individuals are adult men. There are no reported cases in young children. HCL is incurable, but easily treatable. Survival is 96% to 100% at ten years.<ref name="pmid16245328">{{cite journal |author=Else M, Ruchlemer R, Osuji N, ''et al'' |title=Long remissions in hairy cell leukemia with purine analogs: a report of 219 patients with a median follow-up of 12.5 years |journal=[[Cancer]] |volume=104 |issue=11 |pages=2442–8 |year=2005 |pmid=16245328 |doi=10.1002/cncr.21447}}</ref> | ||
==References== | ==References== | ||
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Latest revision as of 22:30, 29 July 2020
|
Leukemia Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Classification
Leukemia is clinically and pathologically subdivided into several large groups. The first division is between its acute and chronic forms:
- Acute leukemia is characterized by the rapid increase of immature blood cells. This crowding makes the bone marrow unable to produce healthy blood cells. Acute forms of leukemia can occur in children and young adults. In fact, it is a more common cause of death for children in the United States than any other type of malignant disease. Immediate treatment is required for acute leukemias due to the rapid progression and accumulation of the malignant cells, which then spill over into the bloodstream and spread to other organs of the body. Central nervous system (CNS) involvement is uncommon, but the disease can occasionally cause cranial nerve palsies.
- Chronic leukemia is distinguished by the excessive build up of relatively mature, abnormal blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal white blood cells in the blood. Chronic leukemia mostly occurs in older people but can theoretically occur in any age group. While acute leukemia must be treated immediately, chronic forms are sometimes monitored for a some time before treatment to ensure maximum effectiveness of therapy.
Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias:
- In lymphoblastic or lymphocytic leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form lymphocytes.
- In myeloid or myelogenous leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form red cells, platelets, and certain types of white cells.
Combining these two classifications provides a total of four main categories:
| Cell type | Acute | Chronic |
|---|---|---|
| Lymphocytic leukemia (or "lymphoblastic") |
Acute lymphoblastic leukemia (ALL) | Chronic lymphocytic leukemia (CLL) |
| Myelogenous leukemia (also "myeloid" or "nonlymphocytic") |
Acute myelogenous leukemia (AML) | Chronic myelogenous leukemia (CML) |
Within these main categories, there are typically several subcategories. Finally, hairy cell leukemia is usually considered to be outside of this classification scheme.
- Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Standard treatments involve either chemotherapy or radiation. The survival rates vary by age: 85% in children and 50% in adults.[1]
- Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of the affected individuals are men. The five-year survival rate is 75%.[2] It is incurable, but there are many effective treatments.
- Acute myelogenous leukemia (AML) occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%.[3]
- Chronic myelogenous leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with imatinib (Gleevec) or other drugs. The five-year survival rate is 90%.[4][5]
- Hairy cell leukemia (HCL) is sometimes considered a subset of CLL but does not fit neatly into this pattern. About 80% of affected individuals are adult men. There are no reported cases in young children. HCL is incurable, but easily treatable. Survival is 96% to 100% at ten years.[6]
References
- ↑ Harrison's Principles of Internal Medicine, 16th Edition, Chapter 97. Malignancies of Lymphoid Cells. Clinical Features, Treatment, and Prognosis of Specific Lymphoid Malignancies.
- ↑ Finding Cancer Statistics » Cancer Stat Fact Sheets »Chronic Lymphocytic Leukemia National Cancer Institute
- ↑ Colvin GA, Elfenbein GJ (2003). "The latest treatment advances for acute myelogenous leukemia". Med Health R I. 86 (8): 243–6. PMID 14582219.
- ↑ Patients with Chronic Myelogenous Leukemia Continue to Do Well on Imatinib at 5-Year Follow-Up Medscape Medical News 2006
- ↑ Updated Results of Tyrosine Kinase Inhibitors in CML ASCO 2006 Conference Summaries
- ↑ Else M, Ruchlemer R, Osuji N; et al. (2005). "Long remissions in hairy cell leukemia with purine analogs: a report of 219 patients with a median follow-up of 12.5 years". Cancer. 104 (11): 2442–8. doi:10.1002/cncr.21447. PMID 16245328.