Comparative Characteristics of Blood and Bone Marrow Indicators in Patients with Acute and Chronic Leukemia

Abstract

Leukemias, representing malignant neoplasms of the hematopoietic system, are distinguished in hematological practice by high mortality rates and complex clinical trajectories. The pathogenesis of acute and chronic leukemias involves mutations occurring at divergent stages of bone marrow cellular differentiation, precipitating profound discrepancies in peripheral blood profiles and myelogram parameters. This study aims to conduct a comparative analysis of the morphological indices of blood and bone marrow in patients with acute and chronic leukemia, determining their correlation with disease severity. Utilizing a prospective observational design, the clinico-laboratory data of 154 patients (82 with acute and 72 with chronic leukemia) were systematically evaluated over a 24-month monitoring period. Initial diagnostic phases incorporated peripheral blood analysis via automated hematology analyzers, alongside morphological, cytochemical, and flow cytometric evaluations of sternal puncture aspirates. Cox proportional hazards regression models and ANOVA revealed that bone marrow blast infiltration in acute leukemias averaged 68.4 ± 14.2%, manifesting with severe suppression of normal hematopoiesis (erythroid lineage reduction to 4.2 ± 1.1%). Conversely, chronic leukemias exhibited hyperplasia of bone marrow cellular elements, preserving all maturation stages of the myeloid lineage (leukemoid hiatus absence). Peripheral thrombocytopenia (20.5 ± 5.4 x10^9/L) and anemia (Hb 68.4 ± 8.2 g/L) were strictly characteristic of acute forms, independently amplifying the risk of early hemorrhagic complications by a factor of 3.4 (p < 0.001). Systemic evaluation of the cross-correlational dynamics between bone marrow and peripheral blood indices facilitates the early stratification of high-risk patient phenotypes, optimizing targeted polychemotherapy regimens.