Question

Distinguish between acute leukemia and chronic leukemia in the following ways:

1) Number of blasts, Level of Maturity, # of Cell Lines involved

2) Stage of maturity where chromosmal/genetic damage has occured

3) Disease progression

4) Prognosis

Answer 1

1) The percentage of blasts in the bone marrow or blood is particularly important. Having at least 20% blasts in the marrow or blood is generally required for a diagnosis of AML. (In normal bone marrow, the blast count is 5% or less, while the blood usually doesn't contain any blasts.
In the blast phase, there are 20% or more blasts in the blood or bone marrow, and it is difficult to control the number of white blood cells. The CML cells often have additional genetic changes as well. HL60 (human promyelocytic leukemia cell line)
PML, or a cancer of the blood forming tissue viz. the bone marrow, is caused due to a non-inherited (or somatic) mutation in the PML gene. The disease is characterized by an accumulation of immature white blood cells(promyelocytes) in the bone marrow.
2) Most cancers are staged based on the size and spread of tumors. However, because leukemia already occurs in the developing blood cells in the bone marrow, leukemia staging is a little bit different. The stages of leukemia are often characterized by blood cell counts and the accumulation of leukemia cells in other organs, like the liver or spleen. Making an educated treatment decision begins with the stage, or progression, of the disease. The stage of leukemia is one of the most important factors in evaluating treatment options. Factors affecting leukemia staging and prognosis include:

White blood cell or platelet count Age (advanced age may negatively affect prognosis)History of prior blood disorders Chromosome mutations or abnormalities Bone damage Enlarged liver or spleen.
3) Cancer cells can spread from where they start to other parts of the body. Unlike other types of cancer, leukemia does not usually form solid tumours in other organs in the body.
4) Long term survival of leukemia varies greatly, depending upon multiple factors, including type of leukemia and age of the patient. ALL: In general, the disease goes into remission in nearly all children who have it. More than four out of five children live at least five years. Theprognosis for adults is not as good.