The incidence of leukemia in China is about 3 to 4 per 100,000. Leukemia ranks sixth (male) and eighth (female) in the mortality rate due to malignant neoplasms, but is the first among children and adults under 35 years of age. Among them, acute leukemia is the more common malignant disease of the hematological system, with an incidence of about 4/100,000. The excessive proliferation of leukemic stem cells interferes with the work of normal blood-forming cells in the bone marrow, which reduces the bone marrow’s ability to produce other blood cells. Leukemia cells can spread to the lymph nodes, spleen, liver, central nervous system, and other organs. Causes of leukemia 1, viruses: such as human T-lymphotropic virus type I, EBV (DNA tumor virus), HIV (AIDS) virus, etc. 2.Ionizing radiation: including X-rays, γ-rays, ionizing radiation, etc. 3, chemical factors: years of exposure to benzene and organic solvents containing benzene, such as gasoline and rubber, are associated with the development of leukemia. For example, the incidence of early shoemaking workers (exposure to glue containing benzene) is 3 to 20 times higher than the normal population. Some drugs can damage blood cells to cause leukemia, such as chloramphenicol, Protaxon, etc. 4, genetic factors: monozygotic twins, such as one person with leukemia, the incidence of the other person is 20%, in addition to congenital aplastic anemia, congenital gammaglobulin deficiency, etc., the incidence of leukemia will be increased. 5. Other blood disorders: certain blood disorders may eventually develop into leukemia, such as myelodysplastic syndrome, lymphoma, multiple myeloma, etc. Common types of leukemia 1. Acute leukemia includes acute myeloid leukemia (AML). 2.Acute lymphoblastic leukemia (ALL). Common symptoms of leukemia 1. Anemia: It is a common symptom appearing in the early stage, manifested as severe progressive anemia, all of which will show symptoms such as pale skin, dizziness and weakness, swelling and shortness of breath after activity. 2. Fever: (50% to 84% of the cases have fever as the first symptom. (1) Fever in leukemia itself: usually does not exceed 38℃ and antibiotic treatment is ineffective. (2) Infection: Due to the reduced immunity of the body of leukemia patients, it often leads to various infections, and the temperature can be as high as 39 to 41℃, which is the main cause of death. Common infections include upper respiratory tract infection, pharyngitis, tonsillitis, stomatitis, pain, pneumonia, urinary tract infection and sepsis, with stomatitis being the most common. 3, bleeding: due to thrombocytopenia and vascular infiltration by abnormal infantile cells often lead to bleeding. The bleeding sites can be all over the body, with bleeding from the skin, gums, oral cavity and nasal mucosa being the most common, followed by bleeding from the gastrointestinal tract, urinary tract, uterus and respiratory tract. 4.Liver and spleen enlargement: most common, especially in acute lymphoblastic leukemia. 5. Lymph node enlargement: mostly confined to the neck, axillae and groin. The swelling of lymph nodes throughout the body is most common in acute lymphocytic leukemia, which can reach 80% at the time of initial diagnosis. Mediastinal lymph node enlargement is more common in pediatric acute lymphocytic leukemia. 6. Skeletal manifestations: mostly seen in acute lymphoblastic leukemia. Patients often have percussion pain and pressure pain at the lower end of the sternum, aching or hidden pain in the joints of the limbs, and joint swelling in severe cases, and some patients can cause osteoporosis, osteolytic destruction, or even pathological fractures. Examination and diagnosis of leukemia 1. Clinical symptoms: acute hyperthermia, progressive anemia or significant bleeding, peripheral pain and weakness. 2.Physical examination: bleeding spots on the skin, sternal pressure pain, enlarged lymph nodes, liver and spleen. 3.Laboratory examination: routine blood tests reveal that white blood cells are always significantly increased (or decreased), and primitive or infantile cells may appear. Bone marrow aspiration reveals primitive cells ≥ 20%. Other tests include cytochemical staining of bone marrow smear, flow cytology and chromosome and fusion gene detection. The characteristic treatment of leukemia The treatment strategy for patients with acute myeloid leukemia is: 1. A regimen consisting of cytarabine + anthracycline or anthraquinone chemotherapeutic agents is the standard remission-inducing regimen for the vast majority of patients of all ages with acute myeloid leukemia. 2. Younger patients may benefit from multiple courses of intense consolidation therapy. 3. Patients with cytogenetic abnormalities in the intermediate or high risk groups require allogeneic hematopoietic stem cell transplantation. Acute promyelocytic leukemia, also known as AML-M3 type, is one of the more specific types of acute myeloid leukemia. There is a basic convergence of opinion on the treatment of acute promyelocytic leukemia, namely: induction therapy with retinoic acid and anthracycline-based chemotherapy; the efficacy of acute lymphoblastic leukemia in children in China has approached the international level; acute lymphoblastic leukemia in adults lymphoblastic leukemia treatment advocates induction remission therapy with DOLP regimen, and allogeneic hematopoietic stem cell transplantation remains the only means for patients to obtain a cure.