How does chronic granulocytic leukemia occur?
Chronic granulocytic leukemia, or chronic granulocyte, is caused by a mutation in the DNA of a stem cell in the bone marrow that causes the patient to carry a gene that is not present in normal humans – the BCR-ABL fusion gene – and this gene causes the malignant proliferation of a large number of abnormal blood cells, ultimately leading to the development of chronic granulocytic leukemia.
Who are the people at risk for chronic granulocytic leukemia?
It is now generally accepted that chronic granulocytic leukemia is caused by the interaction of environmental factors with the genetic material of the cells, and its high-risk groups include.
1, people who are often exposed to ionizing radiation
2.People who are often exposed to paints, hair dyes and other chemicals
3.Patients taking cytotoxic drugs
4.Patients with viral infections
5.Patients with such diseases in their families
What are the clinical manifestations of chronic granulocytic leukemia?
Chronic granulocytic leukemia has no obvious symptoms in the early stage, and is often detected during health checkups or visits to the doctor for other diseases. However, some non-specific clinical manifestations may occur, such as fatigue, weight loss, anemia, night sweats, fever, and hepatosplenomegaly.
What are the goals of treatment for chronic granulocytic leukemia?
To reduce the number of mutated genes in the patient’s body as much as possible, prevent disease progression, prolong the patient’s life span, improve quality of life, and cure the disease.
What are the dangers of residual disease?
As we can see from the definition of chronic granulocytic leukemia, chronic granulocytic leukemia is caused by very small lesions, and even small residual disease can have serious consequences for the patient. Tiny disease residues, if left unattended, can be like the collapse of a thousand-mile dike into an anthill, eventually leading to relapse or further deterioration of CML, making treatment more difficult and seriously threatening the lives of patients.
So, what methods are usually used in clinical practice to detect disease residues?
Cytogenetic testing and PCR testing are both commonly used in clinical practice to detect disease residues, with cytogenetic testing requiring a bone marrow aspiration to collect a sample, while PCR testing can be performed by simply drawing peripheral blood. PCR testing is a molecular biology technique that amplifies a specific DNA fragment, as shown in the figure, a DNA strand is turned into two after one PCR cycle, after which The 2n amplification is performed until a detectable level is reached, which shows that the presence of a target gene can be detected by PCR.
Why can PCR detect microscopic disease residues?
The presence of a small amount of BCR-ABL fusion gene can be easily detected by PCR by amplifying it millions of times.
We can compare PCR testing to a loudspeaker that amplifies a very small sound so that we can easily hear it.
Previous testing techniques can only see relatively large substances and tend to miss tiny disease residues, while PCR technology is like a super microscope that can see more clearly. The PCR test is simple to perform, requiring only peripheral blood sampling and no need for bone marrow aspiration. Because of the simplicity and sensitivity of PCR testing and the ease of standardization of test results, regular PCR testing has been used internationally as a standard monitoring tool for CML treatment, helping to monitor early remission or progression of the disease.
How to do PCR monitoring in a standardized way?
The test should be performed once before the start of treatment; every 3 months thereafter; the treatment plan should be adjusted according to the results of each test to keep the disease residual under 0.1%; and every 6 months thereafter.
For easier and simpler monitoring of the effect of slow-grain therapy, regular PCR monitoring should be chosen!