Infectious complications (respiratory infections, bacterial sepsis) rarely develop in the onset of the disease, but have important practical and prognostic significance. Complications of various etiologies (bacterial, viral, fungal) usually occur during treatment, most often with the development of agranulocytosis and are one of the main causes of deaths.
Neuroleukemia in most cases manifests with a meningeal symptom complex or a picture of an intracerebral tumor (nausea, vomiting, headache), isolated lesion of cranial nerves is much less common (nn oculomotorius, facialis).
Clinical signs do not allow to reliably differentiate acute myeloblastic leukemia (AML) and acute lymphoblastic leukemia (ALL) without performing cytochemical and immunological studies of blast cells. However, some symptoms are more likely to occur in certain types of acute leukemia (OL).
Acute myeloid leukemias are characterized by more vivid symptoms: patients usually have intoxication, anemic, and hemorrhagic syndromes, often with severe infectious complications. 90% of patients with ALI develop syndrome of DIC. Acute monocytic, rarely myelomonocytic leukemia more often than other variants of AML are accompanied by hypertrophic gingivitis, lymphadenopathy, the appearance of leukemides on the skin and high leukocytosis.
In acute erythromyelosis, the anemic syndrome, macrocytosis and peripheral blood normocytosis are leading. Acute megakaryoblastic leukemia is usually characterized by pronounced myelofibrosis, which makes it difficult to obtain bone marrow aspirate and serves as a basis for performing bone marrow trephine biopsy to verify the diagnosis.
Acute lymphoblastic leukemias are characterized by more scarce clinical manifestations: intoxication, anemic and hemorrhagic syndromes are less pronounced, and infectious complications occur less frequently. At the same time, in patients with acute lymphoblastic leukemia (ALL), ossalgia, lymphadenopathy (including an increase in mediastinum), hepatosplenomegaly and neuroleukemia are significantly more common.