Leukemia's Impact on the Circulatory System
Leukemia disrupts hematopoiesis and circulatory function through:
1. Bone Marrow Failure
- Leukemic blast infiltration → crowd out normal precursors.
- Anemia: ↓ RBCs → fatigue, dyspnea, tachycardia.
- Thrombocytopenia: ↓ Platelets → petechiae, ecchymosis, mucosal bleeding, intracranial hemorrhage risk.
- Neutropenia: ↓ Functional neutrophils → severe infection risk (despite high total WBC).
2. Leukostasis (Hyperleukocytosis >100k/µL)
- Sludging in microvasculature → hypoxia, hemorrhage (CNS, lungs).
- Medical emergency: leukapheresis + hydroxyurea + hydration.
3. Infiltration
- Organomegaly (hepatosplenomegaly, lymphadenopathy).
- CNS leukemia (meningeal).
- Testicular, skin, gingival, orbital.
4. Coagulopathy
- DIC (especially APL/M3): consumption of factors, fibrinolysis.
- Acquired von Willebrand syndrome.
5. Cardiac
- Anthracycline cardiomyopathy (treatment-related).
- Leukemic infiltration → arrhythmia, HF.
- Infective endocarditis (neutropenia, central lines).
Treatment Effects
Chemotherapy → myelosuppression, mucositis, VTE risk, cardiotoxicity. Transfusion support, growth factors, prophylaxis essential.
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