LEUKEMIA: CLINICAL MANIFESTATIONS, DIAGNOSIS, AND THERAPEUTIC OPPORTUNITIES

Abstract

Leukemia is a complex group of malignant disorders characterized by the uncontrolled proliferation of abnormal white blood cells originating in the bone marrow and infiltrating the peripheral blood and other tissues. This hematological malignancy can affect individuals of all ages, from infants to the elderly, and remains one of the most studied yet challenging cancers to treat. The clinical presentation of leukemia varies widely depending on the subtype acute or chronic, lymphoid or myeloid and the degree of bone marrow involvement. Common symptoms include fatigue, recurrent infections, unexplained bruising or bleeding, bone pain, and lymphadenopathy. Advances in modern diagnostic techniques, including complete blood count analysis, bone marrow biopsy, cytogenetic and molecular testing, have significantly improved the early detection and classification of leukemia. Genetic profiling and the identification of chromosomal abnormalities such as the Philadelphia chromosome or mutations in genes like FLT3, NPM1, and TP53 have deepened the understanding of the disease’s pathogenesis. These diagnostic developments have also paved the way for targeted and personalized therapies. Traditional treatment approaches - chemotherapy, radiation therapy, and hematopoietic stem cell transplantation - have been supplemented by novel targeted therapies, immunotherapy, and molecular inhibitors, dramatically improving survival rates in many patients. Drugs such as tyrosine kinase inhibitors TKIs, monoclonal antibodies, and CAR-T cell therapy have revolutionized the management of both acute and chronic forms of leukemia. Nevertheless, treatment resistance, relapse, and therapy-induced toxicity continue to pose major clinical challenges. This article explores the pathophysiological mechanisms of leukemia, its diverse clinical features, diagnostic advancements, and current treatment strategies, while emphasizing the potential of emerging research in genetics and immunology to transform future therapeutic approaches. Through a detailed examination of epidemiological trends, molecular insights, and therapeutic innovations, the paper aims to provide a comprehensive understanding of leukemia and highlight ongoing efforts to achieve more effective, less toxic, and personalized treatment outcomes.