Discuss the classification of the leukaemias and how this can be used Essay

Discuss the classification of the leukaemias and how this can be used to help treat this group of disorders. Use specific types - Essay Example After they immigrate into the peripheral blood, through circulation, they infiltrate into other tissues (Wu, 2010). There are several types of leukemia and based on the lineage of cell that is involved, they can be classified as lymphocytic or myeloid. They can further classified as acute or chronic based on the natural history of the disease. Thus, there are basically, four common types of leukemia and they are (Wu, 2010): 1. Acute lymphocytic (or lymphoblastic) leukemia (ALL) 2. Acute myeloid (or myelogenous) leukemia (AML) 3. Chronic lymphocytic (or lymphoblastic) leukemia (CLL) 4. Chronic myeloid (or myelogenous) leukemia (CML) This classification of leukemias is very important from treatment point of view, because; presentation, treatment and prognosis for each group is different. Acute leukemias: ALL and AML ALL and AML share many clinical features and hence they are discussed under the same heading. The presentation of these leukemias is abrupt and within 3 months of onset of malignant changes in the bone marrow and lymphoid tissue. Clinical features of these leukemias is mainly related to malfunctioning of the malignant cells, pancytopenia and leukostasis. Leukostasis is a condition in which the microcirculation in the tissues can get occluded by leukemic blast cells. It mainly occurs when the blast cells counts exceed 100 x 109 per liter.. Decrease in red blood cell counts leads to anemia which manifests as pallor, dysnea on mild exertion and easy fatiguibility. When there is thrombocytopenia or decreased number of circulating platelets, the patient presents as easy bruisability, petechiae and excessive bleeding. More often than not, bleeding is seen from oral mucosa, especially gums and gastrointestinal bleeding. The latter manifests as hematochezia, malena or hematemesis. In girls who are menstruating severe blood loss can occur. When coagulation defects are also concomitant, bleeding is severe warranting hospitalization and blood transfusion. Sponta neous bleeding can also occur in the lungs, central nervous system and other organs. Decrease in the macrophage and granulocyte count can cause increased risk of infection,, especially of the perirectal tissues, skin, gingival tissue, gastrointestinal tract, urinary tract and lungs. Pathogens which frequently contribute to infections in these patients are gram positive cocci, gram negative bacilli and candida species (Wiernik, 2003). Infiltration of lymphnodes, liver and spleen by leukemic cells leads to lymphadenopathy, hepatomegaly and splenomegaly. Organ infiltration is seen more commonly in ALL than in AML. In advanced stages, even other organs can also get infiltrated wtih malignant cells leading to abdominal fullness, nausea, early satiety and loss of appetite. In those with T-cell variant ALL, anterior abdominal mass can be there. Testicular involvement can also occur in ALL. Soft tissue masses of leukemic cells, also known as chloromas can occur in any location in the body. More than 50 percent of patients with acute leukemia present with bone tenderness due to expanding malignant cell mass. Enlargement of the lymph nodes near ureters can cause ureteric obstruction. Other complications include pyelonephritis, nephropathy and renal hemorrhage. Infiltration of leukemic cells into the subarachnoid space may present as leukemic