What are the Key Differences between Aplastic Anemia and Acute Leukemia?

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Differences between Aplastic Anemia and Acute Leukemia

Blood problems pose a significant threat to physical health, and there are various types of blood issues in clinical medicine. Among them, the incidence rates of aplastic anemia and acute leukemia are relatively high. However, due to the similarity of symptoms between these two blood diseases, many people tend to confuse them. Let's understand the main differences between aplastic anemia and acute leukemia.

1. Causes of the two diseases: Aplastic anemia occurs due to fatty bone marrow that impairs hematopoiesis, resulting in a decrease in hematopoietic stem cells and a subsequent reduction in normal blood cells differentiated from them. This leads to symptoms such as anemia, leukopenia, and thrombocytopenia. Bone marrow aspiration reveals decreased granulation, grade 4-5 bone marrow hyperplasia, inactive bone marrow proliferation, and absolutely no abnormal blast cells in the bone marrow smear. In contrast, acute leukemia arises from the mutation of hematopoietic stem cells under certain conditions, which prevents their maturation and normal apoptosis, leading to the accumulation of large numbers of primitive cells. The accumulation of primitive cells in the bone marrow cavity results in a lack of mature blood cells, causing anemia and thrombocytopenia, but leukocytosis is generally observed in acute leukemia patients. Bone marrow aspiration in acute leukemia patients shows normal bone marrow granulation, grade 1 bone marrow hyperplasia, extremely active bone marrow, and numerous morphologically abnormal blast cells visible in the bone marrow smear and peripheral blood.

2. Manifestations of the two diseases: Aplastic anemia is characterized by poor bone marrow hyperplasia, while acute leukemia is characterized by excessive bone marrow activity. Aplastic anemia can be divided into congenital and acquired types. The latter, which is more commonly referred to, can be further classified into idiopathic aplastic anemia with unknown causes and secondary aplastic anemia caused by chemical, physical, biological, and other factors. The causes of secondary aplastic anemia include drugs, chemical toxins, ionizing radiation such as X-rays and radionuclides, severe infections, autoimmune diseases, etc. The pathogenesis of aplastic anemia is complex and has not been fully elucidated, often resulting from the interaction of multiple factors. The clinical manifestations of aplastic anemia mainly include anemia, bleeding, and infection. Acute leukemia occurs when the differentiation of primitive cells in the bone marrow stalls at a certain stage due to chromosomal mutations and environmental factors, leading to the proliferation of a large number of morphologically abnormal cells (leukemia cells). This disrupts normal hematopoiesis, resulting in the accumulation of abnormal white blood cells and the decrease of normal cells. The diagnostic criterion is the presence of abnormal blast cells in peripheral blood and bone marrow.