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Acute leukaemia - characteristics and treatment

Leukaemia is a disease of the reticuloendothelial system and is characterised by the uncontrolled proliferation of leucocytes. Accumulation of these abnormal white cells results in bone marrow failure, peripheral blood involvement and infiltration of organs. Advances in the treatment of acute leukaemia have improved the chance of cure from almost zero to between 25 and 80 per cent, depending on the patient’s age and type of leukaemia.

By Raj Nijjar

Aetiology

In most cases, the aetiology of leukaemia is not fully understood. Like other cancers, it is thought to result from a combination of factors as shown in Table 1, p100.

Classification

In leukaemia, the normal process of haemopoiesis (production of blood cells) is altered (see Figure 1, p100).

The main classification is into acute and chronic leukaemia. In acute leukaemia, the normal bone marrow is replaced by a malignant clone of immature blast cells. Based on morphology, cytochemistry and immunology, acute leukaemia is subdivided into:

  • Acute myeloid leukaemia (AML), which involves the myeloid lineages (ie, cells from which such cells as neutrophils, eosinophils, monocytes, basophils are derived)
  • Acute lymphoblastic leukaemia (ALL), in which the abnormal proliferation is in the lymphoid progenitor cells (ie, immature lymphocytes)

Both AML and ALL are further subdivided: AML into eight variants and ALL into three variants, according to the French-American- British (FAB) scheme (see Table 2, p101).

On the basis of surface antigen expression, ALL is divided in to T-cell lineage and B-cell lineage (see Table 3, p101).

Download the attached PDF to read the full article.

Citation: Hospital Pharmacist URI: 10976725

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