Under acute leukemia (leukemia)
understand the rapidly progressive malignant disease, with
which mutated white blood cells are concentrated in the bone marrow and
bloodstream. The basis of the disease is a pathological change.
hematopoietic hemocytoblasts. Initially, the tumor grows in
bone marrow, and then affects other organs and tissues. Pathology not
has age restrictions, but is most often found in
adults.
Etiology of the disease
In modern medical science the study of neoplastic
pathologies of the hematopoietic system plays an important role. Despite
numerous clinical studies, exact reason
the occurrence of this form of cancer has not yet been identified.
It is known for certain that the development of leukemia
circumstances creating preconditions and favorable conditions for
mutations of cellular structures. To such mutagenic factors
include:
Ionizing radiation. After atomic
bombing of Japanese cities during the Second World War
the number of citizens who have had acute leukemia,
increased many times. And the people who were directly
near the epicenter, fell sick 50 times more often than those who were behind
danger zone limit.- Carcinogenic substances. These may be industrial chemicals.
compounds or metabolites of potent pharmaceuticals
drugs. There is evidence of an inducing effect.
carcinogens on the development of oncological process. - Genetic predisposition. Нередко причиной leukemia
becomes bad heredity. The risk of getting leukemia is much
higher in those whose relatives suffered from hematopoietic cancer
system. It is believed that the disease itself is not inherited, but
propensity to change the genetic material. - Viruses. In expert circles, the popular theory is that some
non-cellular infectious agents that invade human DNA
transform healthy cells into cancer cells. - Race, geographical area of residence.
Statistics indicate that Caucasians are more
prone to acute leukemia.
Classification of pathology
According to the generally accepted international classification used
in hematology, acute leukemias differentiate according to
morphology of malignant cells. In this regard, distinguish
two main forms of the disease:
Lymphoblastic. Carcinogenic process
affecting the blood system and characterized
uncontrolled growth of immature lymphoid cells.
Malignant pathology affects the bone marrow, lymphatic
nodes, spleen, thymus and other functional
organs.- Myeloblastic. Причиной острого leukemia становится пролиферация
unformed blood cells and bone marrow. In the analysis of the patient
there is a decreased level of leukocytes, platelets and
red blood cells. Infiltration of tissues by malignant cells
occurs on the background of ulcerative necrotic and hemorrhagic
complications. As a rule, death comes from a sudden
cerebral hemorrhage or aggravated gastrointestinal
bleeding.
A more detailed classification of acute leukemia has been developed,
taking into account the cytological specificity of hemocytoblasts. Accurate
установка вида leukemia требуется врачам для выработки
therapeutic strategy and projection for the patient.
Symptomatic picture
In most cases, the onset of the disease
goes unnoticed. The person feels quite healthy right up
to the maximum distribution of leukemic cells throughout the organs
кроветворной system. Первые симптомы острого leukemia могут
manifest in the form of any infectious disease.
Due to a sharp decline in platelet levels often develops.
hemophilia. The patient complains of fatigue, general malaise,
shortness of breath, increased heartbeat, aches in the bones. Acute phase
oncological process manifests a significant increase
body temperature. Often joins pneumonia,
accompanied by prolonged dry cough and wheezing in the lungs. Everyone has it
четвертого больного встречается менингит с соответствующими
clinical manifestations.
As a result of treatment with cytostatics, cases of
necrotic lesions of the mucous membranes of the digestive
tract. At first, the patient suffers from a weak abdominal distention.
cavities, rumbling and stool disorders, after which
unbearable pain in the stomach, speaking of the presence of erosion or
ulcers.
In the late stages of the disease, the skin is covered slightly.
rising above the surface stained brown or red
colors – the so-called leukemides, which are sources
leukemia infiltration. The liver grows in size and
becomes painful at palpation. Due to renal
insufficiency problems with urination. For
лимфобластного leukemia свойственно увеличение лимфатических узлов и
spleen.
Clinical stages
Clonal malignant pathology usually occurs in
several stages. Acute leukemia begins with suppression
hematopoietic function, pronounced hemorrhagic syndrome and
complications of infectious genesis. Debut disease is different
erased symptoms, and the diagnosis is established randomly.
From the moment of mutation of the first stem cell until the discovery of obvious
симптомов leukemia проходит минимум месяц. In clinical
course of pathology distinguish the following stages:
Initial. In this period
suspecting the disease is almost impossible. White blood counts
Taurus changes slightly, immature forms appear
leukocytes, anemia develops.- Unfolded. At this stage, the person is faced with the true
symptoms of leukemia caused by inhibition of hematopoiesis and
the formation of a huge number of blasts in peripheral blood.
A person’s health is sharply deteriorating, but at the same time absent
pronounced morphological changes from the circulating
in the bloodstream of blood vessels. - Remission. Stage, which is characterized by positive dynamics
against the backdrop of ongoing therapeutic interventions. In peripheral blood not
blast cells are detected. Partial suppression occurs
foci of leukemic infiltration, clinical signs
нейроleukemia не наблюдаются. 
Relapse Stage when activated
growth of immature cells in the bone marrow, isolated
extramedullary lesions, including soft infiltration
tissues.- Terminal. At this stage, cytostatic therapy is powerless.
in front of a far-reaching cancer process. Течение leukemia
complicated by granulocytopenia and thrombocytopenia. Aggressive growth
neoplasm adversely affects the work of all vital
bodies, which ultimately leads to death.
Diagnostic measures
Diagnostics is designed to solve several important problems: first,
establish the fact of the presence of oncology in a patient, and secondly –
choose therapeutic tactics with regard to molecular genetic
особенностей острого leukemia. For подтверждения диагноза
A number of studies are being conducted:
Blood chemistry.
The change in the number and type of liquid shaped elements
connective tissue indirectly indicates leukemia.- The study of bone marrow. Bone marrow punctate study for
establish the final diagnosis and assess the effectiveness of
therapy. - Immunophenotyping. Special immunological method
диагностики, позволяющий определить, с какой формой leukemia
have to deal with. - Cytogenetic study. Allows you to identify chromosomal
damages whose presence helps determine the type of leukemia and
evaluate the aggressiveness of the malignant process. - Fine needle biopsy of the lymph nodes. Fabric is being taken
lymph node for detailed histological analysis. 
Spinal puncture. During
performing the procedure, the needle is inserted into the spinal canal in
lumbar spine. The resulting fluid sample is examined.
to detect cancer cells.- X-ray. X-rays can be seen
malignant lesions localized in the joints and
bones. - CT scan. Innovative diagnostic method
allowing to assess the condition of almost any organ. - Magnetic resonance imaging. Detailed image
soft tissue structures are produced using strong magnets and
radio waves. Non-invasive instrumental method is especially justified.
for examination of the spinal cord and brain. - Ultrasound procedure. It gives an opportunity to assess the state
lymph nodes and blood-forming organs (liver and
spleen). - Scanning the lymphatic and bone systems. Radioactive
the drug, administered by the intravenous method, accumulates in
lymph nodes and bones, so you can distinguish oncological
process from banal inflammation.
Therapeutic strategy
Say goodbye to this insidious disease once and for all.
кроветворной системы удается лишь единицам, но лечение leukemia
must continue throughout life. The choice of therapeutic
tactics and medication drugs the doctor carries out taking into account
forms of pathology and individual characteristics of the organism
the patient.
Multicomponent chemotherapy
Under chemotherapy
involve the use of medicinal substances that fight
with cancer cells. High-tech medical care
carried out in several successive stages – induction,
consolidation and supportive treatment. Tumor
the disease does not immediately recede. Those cancer cells that
remain, continue to multiply. Intensive care can
continue until the pathological process
will stop progressing, and sometimes it takes about two
years old.
The induction stage is considered successful if it occurs.
tissue repair, no bone marrow puncture
malignant cells, and blood counts have returned to normal.
To minimize the risk of infectious complications, induction
pass in a hospital setting under strict medical supervision
staff.
Usually, several cytostatic drugs are administered at once.
drugs. Most common in oncology practice
got Vincristine and Asparaginase. In some cases, apply
Daunorubicin or Methotrexate.
Consolidation phase during which
eliminated remaining in the body of tumor cells, it is considered
more intense. In order to avoid resistance to a specific
cytostatics patient prescribed a combination of chemotherapeutic
drugs.
If hemoblastosis is in remission, proceed to
maintenance chemotherapy. In addition to antiblastoma
means prednisolone and dexamethasone are prescribed.
Although chemotherapy is aimed at alleviating the condition
cancer patient, it is extremely negative for the body
general, as it causes severe intoxication. Used
drugs disrupt the functioning of all internal organs.
The patient must be mentally prepared for the fact that he will lose hair,
will constantly experience nausea. To timely detect adverse
effects and monitor the results of treatment, the patient should
be tested regularly.
Bone marrow transplantation
People suffering from leukemia require a soft transplant
tissue of the inner cavity of the bones, since only it contains
hematopoietic stem cells that are precursors
blood corpuscles. Transplantation that is done in this way
sick, must be necessarily allogeneic. In other words, in
The transplant involves only a genetically compatible donor.
The key condition for such an operation is complete
remission. It is important that the bone marrow cavity be filled.
extremely healthy cells.
Before conducting invasive manipulations of the patient in compulsory
order is subject to conditioning – immunosuppressive
treatment, the purpose of which is to destroy the remaining cancer
cells and suppressing the immune response that is necessary for
prevention of alien biomaterial rejection. Straight
contraindications for transplantation are the following
circumstances:
- severe pathologies of vital organs
organism; - infectious diseases in the acute phase;
- non-treatment relapsed leukemia;
- advanced age.
Adjuvant treatments
Last role in relieving negative symptoms of leukemia
given concomitant therapy, which is prescribed, given
current state of man. The patient most often additionally
prescribe antibacterial drugs and various
detoxification products.
In addition, if indicated, the patient may be referred
on prophylactic brain irradiation. For warning
neurological complications are helpful
эндолюмбальное введение цитостатических drugs. Success
treatment depends largely on proper patient care. Such
people need to be protected from colds, creating for him
living conditions as close as possible to sterile.
Survival prognosis
The chances of recovery in children are much higher than in adults.
This is explained by the fact that the young body is more susceptible to
drugs. You can not discount the fact that
patients of venerable age is a mass of concomitant
chronic diseases that prevent the full
chemotherapy.
On top of that, adults are often pulled to the last
appeal to the doctor, missing the moment when the pathological process
can still be reversed. Admittedly, to solve problems with
the health of their children parents are more responsive.
The prognosis of survival in this disease is affected
following factors:
- age category of the patient;
- leukemia form;
- cytogenetic features of the pathology;
- the body’s response to cytotoxic drugs.
In the absence of adequate anticancer treatment
life expectancy of the patient rarely exceeds 12 months.
Chemotherapy makes it possible to achieve a five-year survival rate.
approximately every second patient. With myeloblastic form
leukemia to achieve stable remission is much more difficult. Only 10−15%
such patients live more than a year. After transplantation
hematopoietic stem cell remission lasting 5 years
occurs in 60–70% of patients. In general, the prognosis of acute
lymphoblastic leukemia is more favorable than with
myeloblastic.
Hearing a terrible diagnosis, you should not immediately panic and
hands down prematurely. Modern medicine does not stand on
place, every day there are new methods of treatment
oncological diseases that give patients hope for
recovery. Leukemia is not a sentence, so it’s important how you can
soon throw all your strength to fight the disease, and then maybe
she will retreat.
