The most significant moments of pathogenesis
1. In most cases, acute leukemia (OL) develops from cells committed in the direction of myeloid or lymphopoiesis, fewer cell lines are involved. This explains the diversity of the clinical course and response to therapy for different types of blast cells that make up the tumor clone.
2. For acute leukemia, tumor progression is characteristic: as the disease progresses, clones of leukemic cells with new properties (morphological, cytochemical, immunological, etc.) appear, which explains the development of resistance to previously effective treatment.
3. The development of most clinical manifestations and laboratory data (anemia, hemorrhagic syndrome, fever) is due to the “crowding out” of normal hemopoietic tissue with a leukemic clone.
4. As the acute leukemia progresses (more rarely, from the onset of the disease), blast cells metastasize beyond the blood-forming organs. This leads to the development of specific (blast) infiltration of internal organs, lymphatic tissue, skin, mucous membranes, and may be accompanied by functional failure of various internal organs, organomegaly, lymphadenopathy, hyperplastic gingivitis, skin leukemides, etc. In some cases, acute leukemia (often – acute lymphoblastic leukemia (ALL)) blast cells metastasize to the central nervous system, which leads to the development of neuroleukemia.
5. The proliferation of blast cells and their death are accompanied by the development of intoxication syndrome and metabolic disorders that occur in most patients.