Patient's question:
The examination for leukemia actually involves checking chromosomes and genes—is this necessary? Why is it done?Doctor's answer:
Hello: Leukemia is a malignant disease of hematopoietic tissue, also known as "blood cancer." Leukemia is a type of malignant clonal disease of hematopoietic stem cells. Hemoglobin and platelet counts are reduced. The total white blood cell count varies, generally ranging from 20.0 to 50.0×10^9/L, with some cases exceeding 100×10^9/L or falling below 10.0×10^9/L. In more than half of the patients, a large number (sometimes as high as 90%) of abnormal primitive white blood cells are observed in the peripheral blood. Blood cell chemical staining methods can determine the type of acute leukemia. Approximately 45% of cases have chromosomal abnormalities, including monosomy, hypervariation, and various marker chromosomes. Bone marrow shows active proliferation, significantly active or extremely active, primarily composed of leukemia cells. If primitive cells account for more than 6% in the bone marrow, it is considered suspicious; a diagnosis is more certain if primitive cells exceed 30%; and a definitive diagnosis can be made if primitive cells plus early (immature) cells account for 50% or more. In the entire bone marrow, red blood cell and megakaryocyte counts are highly reduced. When blood and bone marrow findings are insufficient to confirm acute leukemia, lymph node puncture fluid smears and specific skin lesion imprint smears can be used to identify corresponding leukemia cells, and pathological imprint smears are helpful for diagnosis.