Definition of Leukemia Disease:

Leukemia are the disease in which abnormal proliferation of haemopoietic cells cause progressively increasing infiltration of the bone marrow and other tissues such as lymph node, liver & spleen. It is a disease of abnormal proliferation and maturation of bone marrow which interferes with the production of normal RBCs, WBCs and platelets.

Classification or Types of Leukemia Disease:

Clinical classification of Leukemia Disease:

1. According to Clinical course of disease:

a) Acute,

b) Chronic.

2. According to Types & degree of differentiation of the cell population or cell line predominantly involved.

a) Myeloid,

b) Lymphoid.

It may be explained as –

Acute leukaemia:

• Acute lymphobastic leukaemia (ALL),
• Acute myeloblastic leukaemia (AMI.)

Chronic Leukemia:

• Chronic lympliocytic Leukemia (CLL),
• Chronic mylocytic /granulocytic Leukemia (CGL or CML).

FAB classification: (French, American, British):

1. Acute lymphobastic leukaemia (ALL):

• L1 – small homogenous lymphoblast,
• L2 – heterogenous lymphoblast,
• L3 – large homogenous lymphoblast.

2. Acute myeloblastic leukaemia (AML):

• MO – Myeloblastic leukaemia with minimal differentiation,
• MI – Myeloblastic leukaemia without maturation,
• M2 – Myeloblastic leukaemia with maturation,
• M3 – Hypergranular promyelocytic leukaemia,
• M4 – Myelomonocytic leukaemia,
• M5 -Monocytic leukaemia,
• M6 – Eroythrocytic leukaemia,
• M7-Megakaryoblastic leukaemia.

WHO Classification Of Acute Leukemia:

• Acute myeloblastic leukaemia with recurrent genetic abnormalities,
• Acute myeloblastic leukaemia with multilincage dysplasia,
• Acute myeloblastic leukaemia & myelodysplastic syndrome,
• Acute myeloblastic leukacmia not otherwise specified,
• Acute lymphobastic leukaemia.

Etiology or Causes or Risk Factors of Leukemia:

1. Chromosomal abnormalities.

2. Ionizing radiation –

• X-ray radiation,
• Radiotherapy,
• Atom bomb.

3. Chemicals:

4. Virus-

• HTLV-1 (human T cell lymphotrophic virus type-1).

5. Genetic factor-

• Identical twin of patient with leukemia,
• Down syndrome,
• Blooms syndrome,
• Fanconi’s anaemias.

6. Immunological:

• Immune deficiency states (e.g. hypogammaglobulinaemia).

Clinical Features or Sign and Symptoms of Acute Leukemia:

Symptoms of Acute Leukemia:

1. Feature of anaemia:

• Weakness, fatigue, lassitude, effort intolerance, dyspnòea on exertion.
• Pallor, palpitation, anorexia.

2. Feature of leucopenia:

• Fever,
• Malaise,
• Sore throat,
• Chills,
• Ulceration of mouth & pharynx,
• Sweating,
• Chronic skin infection,
• Recurrent chest infection,
• Pneumonia, diarrhoea, UTI, otitis media, cellulitis.

3. Feature of thrombocytopenia (Mainly by purpuric spot):

• Echymosis,
• Patechiac,
• Epistaxis,
• Bleeding from gum, alimentary tract,
• Sub-conjunctival hge, fundal hge, hacmatemesis, maclena,
• Menorrhagia,
• Hematuria,
• Joint swelling & joint pain, bone pain.

4. General- Fatigue, weight loss, bone pain, cough, Headache or diaphoresis.

Signs of Acute Leukemia:

• Appearance-toxic & ill looking.
• Anaemia-Present
• Pulse – rapid.
• Temp – raised.
• Lymph node – moderately enlarged, non-tender, discrete, tree from skin & underlying structure.
• Bony tenderness.
• Skin (Evidence of bleeding) – Ecchymosis, purpura & Patechiac
• Testicular enlargement.

Clinical Features or Sign and Symptoms of Chronic Leukemia:

Symptoms of Chronic Leukemia:

• Asymptomatic (25%),
• Shortness of breath due to anaemia,
• Abdominal pain & discomfort,
• Tiredness, fatigue, pale, lethargy,
• Weight loss,
• Fever & night sweat,
• Anorexia, nausca, vomiting,
• Headache due to hyperleukocytosis,
• Brusing & bleeding episode (Terminal stage).

Signs of Chronic Leukemia:

• Anaemia – early,
• Spleenomegaly – huge (90%),
• Hepatomegaly (50%),
• Bony tenderness- present,
• A friction rub in splenic infarction,
• Lymphadenopathy unusual,
• Retinal hge due to leukocytosis.

More questions related to this article:

1. What do you mean by leukemia?
2. What is leukemia?
3. Define leukemia.
4. Write down the classification of leukemia.
5. Give the WHO classification of acute leukemia.
6. Write down the etiology of leukemia.
7. Write down the causes of leukemia.
8. Write down the risk factors of leukemia.
9. What are the clinical features of acute leukemia?
10. Write down the clinical features of chronic leukemia.
11. State the treatment of acute leukemia.
12. Describe the nursing management of leukemia
13. Write down the nursing management of a child with anemia.

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “[email protected]”

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