Update: October 2018
Leukemia is a cancer that is
a type of cancer of the blood or bone marrow characterized by
патологическим увеличением количества лейкоцитов (белых cell) в
blood. About 90% of leukemia is diagnosed in adult patients. AT
In 2000, the diagnosis of leukemia worldwide was confirmed
approximately 256,000 patients. Of these, from the disease (and
its complications) died 209,000.
About every 4 minutes in the US, leukemia is confirmed in
очередного the patient. AT данный момент в США проживает более 1
a million people suffering from some form of blood cancer, including
числе leukemia Have людей старше 50 лет значительно возрастает частота
incidence of chronic lymphoblastic and acute myeloblastic
leukemia. Старше 65 лет – хроническим миелобластным leukemia.
Europeans remain the most susceptible to the disease (13.6 per
100 000 population). The lowest incidence of leukemia
It is celebrated among Asians and Pacific Islanders (7.4 per
100,000), as well as among American Indians and representatives
Alaska’s indigenous nationalities (7.3 per 100,000).
Leukemia in children
Leukemia is the most common form of cancer in children and adolescents.
occupying in frequency, in different countries, one of the three leading
positions. Approximately 75% of children’s leukemias are acute.
lymphoblastic leukemia. This form is more often diagnosed in children
age from 2 to 4 years. Boys are sick more often.
Acute myeloblastic leukemia takes up most of the remaining
25%. This type is common in a wider age range.
but its detection rate increases slightly in the first 2 years.
life as well as adolescents.
AT период с 2006 по 2010 годы частота развития острого
lymphoblastic leukemia among teenagers 15-19 years old exceeded twice
частоту острого миелобластного leukemia AT то же время, в возрастной
group from 25 to 29 years, the incidence of acute myeloblastic
leukemia was 57% higher than lymphoblastic.
Haveстановить конкретную причину развития лейкоза до сих пор не
succeeded. There is some association of the disease with chromosomal
anomalies. AT частности, у всех больных хроническим миелобластным
leukemia and in some patients with the acute form of this disease in
leukocytes and bone marrow pathological is detected
�”Philadelphia chromosome”. This pathology belongs to the category
acquired. It is not innate and not transmitted from
parents to children.
An association with acute myeloid leukemia of such
- Down syndrome;
- Bloom syndrome;
- Anemia Fanconi;
- Синдром ATискотта-Олдрича и другие иммунодефицитные
Risk factors for leukemia are:
- Radiation. People exposed to high doses of radiation
have an increased risk of developing various forms of leukemia. AT данный
The moment is a series of studies designed to determine the degree
X-ray effects (X-ray examination and
computed tomogram) for the development of leukemia;
- Smoking increases the risk of developing acute myeloblastic
- Petrol. Prolonged exposure to gasoline vapor increases the risk
развития хронического или острого миелобластного leukemia;
- Chemotherapy. Cancer patients receiving treatment
special anti-cancer drugs have an increased risk
развития острого миелобластного или лимфобластного leukemia;
- Myelodysplastic syndrome and other hematological
The presence of one or even several factors not listed
означает, что человек заболеет leukemia. Have большинства таких людей
never characteristic of leukemia
Symptoms лейкоза варьируют в зависимости от типа и течения
diseases. Leukemia is classified into 4 main groups:
- Acute Myeloblastic Leukemia
- Chronic myeloblastic leukemia
- Acute lymphoblastic leukemia
- Chronic lymphoblastic leukemia
In addition, the course of leukemia depends largely on such factors
as the age of the patient and the cause that led to the disease.
Symptoms common to all types of leukemia are:
- Frequent infectious diseases
- Cold, fever
- Loss of appetite, exhaustion, weight loss
- Abdominal pain
- Haveвеличение лимфатических узлов
- General malaise
- Frequent pain in bones and joints
Early symptoms of leukemia
The first symptoms of leukemia are non-specific and may not
perceived as a serious disease.
The onset of leukemia usually resembles a cold. In addition to the symptoms
listed above, the patient notes the appearance of a rash in the form
small red spots on the skin and an enlarged liver or spleen.
Usually this is enough to seek help from a doctor.
Characteristic additional symptoms for leukemia at this stage
are anemia and excessive sweating.
Symptoms лейкоза у детей
When diagnosing acute leukemia symptoms in children
appear as neurological disorders (drowsiness,
lethargy, loss of appetite, lack of body weight), after which
child’s condition is abrupt characteristic deteriorates and develops
picture of the disease.
If children with leukemia are suspected, symptoms may appear in
- Loss of appetite
- Weight loss for no apparent reason.
- Uncontrolled seizures accompanied by skin manifestations.
In some cases, there is an increase in the liver and spleen,
which is externally manifested by bulging and thickening of the abdomen.
Children with leukemia are more susceptible to various
infectious diseases, while the use of antibacterial
drugs may not lead to improvement in the patient.
Such patients are more difficult to tolerate even minor scratches and
cuts. Blood coagulates much longer than healthy
human, which leads to frequent bleeding.
If a child with leukemia has pain in the joints and
bones, this may indicate the spread of cancer cells in
these areas of the body.
Symptoms of leukemia in adults
Symptoms of leukemia in adults схожи с описанными выше симптомами у
children Leukemia begins with flu-like manifestations. Sick
prone to frequent infectious diseases, fever appears,
Frequent infections are the result of dysfunction.
leukocytes. Abnormal immune cells produced in large
are inactive and are not able to adequately deal with
viruses and bacteria entering the body. The accumulation of such
cells in the red bone marrow cause a decrease in production
platelet count. As a result, their lack leads to increased
bleeding and the appearance of subcutaneous hemorrhages (petechial
Symptoms of acute lymphoblastic leukemia at an early stage
manifested in the form of SARS (general malaise, weakness, fever). AT
further, there are characteristic signs of cancer
diseases. The pain in the bones and joints gradually increases and
становится более выраженной, чем у children There is a worsening
appetite, weight loss and abdominal pain due to an increase in
liver and spleen. The patient has enlarged lymph nodes. Their
palpation can be painful. Also increases bleeding
from the places of injuries and cuts.
Symptoms of leukemia develop depending on the place of accumulation
abnormal cells. As leukemia progresses
brain symptoms characterized by blurred vision, vomiting
and vestibular disorders. All patients develop shortness of breath,
Symptoms of acute leukemia include:
- Decreased muscle tone, inability to control movements
AT зависимости от поражаемого органа отмечаются признаки
lesions of the digestive system, kidneys, lungs, heart and genital
Difference in acute leukemia is rapid development.
симптомов и, как следствие, быстрая диагностика diseases. Have
in patients with chronic leukemia, symptoms appear only in late
stages, which leads to late diagnosis. Based on
personal experience and on numerous studies, researchers
found out that abnormal leukocytes are found in the blood
patients already 6 years before the development of clinical manifestations
Chronic leukemia symptoms develop
gradually, which makes the disease unlike other types
cancer. The initial signs of chronic leukemia are:
- Frequent infectious diseases (reduction of
gamma globulins responsible for maintaining the immune system
leads to the development of its failure and makes it impossible
resistance to pathogens)
- Bleeding, difficult to stop bleeding (due to
reduce the number of healthy platelets)
- Haveвеличение селезенки
- Feeling of pain in the stomach, rapid saturation
- Unreasonable weight loss
Have больных хроническим миелобластным лейкозом клинические
manifestations develop at later stages. Among them emit
(in addition to those described above):
- ATысокий уровень лейкоцитов в крови и костном мозге
- Excessive sweating, especially at night
- Headache fever
- Paleness of the skin
The only early sign of chronic lymphoblastic
Leukemia is an elevated level of lymphocytes in the blood. As
disease progression, patients report worsening
well-being and swollen lymph nodes.
In the transition to later stages to the symptoms described
joins anemia. Due to the insufficient number produced
antibodies to pathogens risk of developing infectious
The complications are greatly enhanced. This stage is also characterized
augmentation and sensation of pain in the region of the spleen.
Pathologically high levels of white blood cells can lead to
development of visual impairment (retinal haemorrhage),
�Tinnitus, the appearance of neurological changes,
prolonged erection (priapism) and the development of stroke.
Treatment лейкоза должно проводиться только в специализированных
centers by a doctor who has the appropriate certificate. If you run
these rules are not possible, the attending physician should
be sure to discuss and draw up a treatment plan with such
ATыбор плана лечения зависит от типа лейкоза, возраста пациента,
the presence of abnormal leukocytes in the cerebrospinal fluid, and
also from previous treatment.
The main treatments for leukemia include:
- Biological treatment
- Radiation therapy
- Bone marrow transplantation (stem cells)
If the disease is diagnosed in advanced stages, and
the patient has an enlarged spleen, an additional method
treatment is the removal of the spleen.
Treatment больных острым лейкозом необходимо начинать
immediately. The goal of therapy is to achieve remission. AT последующем,
after the disappearance of the clinical manifestations of the disease, the patient
continues to receive prophylactic treatment. This is called
Patients with asymptomatic chronic leukemia may not need
immediate treatment. Such patients are prescribed observation and
careful monitoring of the condition. Treatment начинают при появлении или
ухудшении симптомов diseases.
AT настоящее время проводится ряд крупных клинических
research on the use of new methods and drugs for the treatment of
leukemia At the request of the patient, he can take part in
research. For more information, consult
with the attending physician.
AT дополнение к основному курсу пациенту может понадобиться прием
analgesics and other symptomatic treatment to combat
manifestations of the disease, side effects of chemotherapy or
normalization of the emotional state.
Chemotherapy- наиболее распространенный метод лечения leukemia
It involves the use of drugs to suppress
роста или разрушения измененных раковых leukocytes. AT зависимости
the type of leukemia single or multi-component is assigned to the patient
ATведение препаратов может производиться различными методами, в
including directly into the spinal canal. It may
carried out in two ways:
- Spinal puncture (administration of the drug through
special needle in the lower, lumbar, part of the spinal
- Ommaya Reservoir is a special catheter installed in
spinal canal, the end of which is displayed and strengthened on
scalp. It allows multiple
administration of drugs without the need for repeated punctures
Chemotherapy проводится в виде циклических курсов: между курсами
treatment necessarily present recovery pauses.
Chemotherapy is allowed on an outpatient basis or at home (in
depending on the type and methods of drug administration).
A new word in the treatment of leukemia – directed therapy is
the method by which only an impact is made
abnormal cells without harming healthy tissue
organism. The first approved method of targeted therapy received
This method involves the stimulation of natural protective
mechanisms to fight cancer. AT зависимости от типа лейкоза
- Monoclonal antibodies (associated with pathological
leukocytes in the blood and bone marrow and cause their death)
- Interferon (a natural drug that inhibits the growth of cancer
Radiation therapy (радиотерапия)
This is a method based on the use of high-frequency
radiation exposure for cancer cells. AT ходе
irradiation special device sends beams through the spleen,
the brain and other parts of the body where leukemoid cells accumulate.
Some patients receive whole-body radiation. Usually total
Radiation is performed before bone marrow transplantation.
Stem cell transplant
Stem cell transplant позволяет проводить лечение
higher doses of chemotherapy or enhanced radiotherapy.
After both the pathological and the normal were destroyed
cells transplanted to healthy bone cells
brain. AT дальнейшем пациенту переливают стволовые клетки через
a catheter inserted into a large vein (in the neck or in the area
chest). New, healthy cells are developed from transplanted cells.
Among the methods of transplantation emit:
- Bone marrow transplantation
- Peripheral blood stem cell transplant
- Umbilical cord blood transfusion (for children without suitable
In addition to donor own cells can be used.
the patient. Before treatment, stem cells are collected.
from the patient’s bone marrow. After a chemo or
radiotherapy cells are thawed and transplanted back
to the patient.
Side effects of treatment
|Chemotherapy||A side effect of chemotherapy is damage to:
|Biological methods||Biological methods могут вызывать гриппоподобные симптомы,
|Radiotherapy||The consequences of radiotherapy are: feeling tired,
redness, dry skin.
|Stem cell transplantation||The most severe complication is the reaction
�Graft-versus-host. This condition occurs in patients
donor stem cells. It manifests itself sharp
irreversible damage to various organs, including the liver, skin
and gastrointestinal tract. The effectiveness of the treatment of this
state does not exceed 10-15%.
The remaining effects depend on the area of exposure.
Both leukemia itself and its treatment can cause various
serious health problems. To control these manifestations and
improve the quality of life of patients appointed supportive
therapy. It includes the use of:
- Antibacterial drugs
- Antianemic treatment
- Blood transfusions
- Dental treatment
- Special nutrition
AT целом, пятилетняя выживаемость увеличилась в четыре раза по
compared with the figures of 1960 (from 14% to 59.2%). Five year old
Leukemic survival is:
- Acute lymphoblastic leukemia – 68.8%
- Chronic lymphoblastic leukemia – 83.1%
- Acute myeloblastic leukemia – 24.9%
- Chronic myeloblastic leukemia – 58.6%
Five year old выживаемость детей с острым лимфобластным лейкозом
is over 85% and continues to rise every year. Now
It is believed that children who have had leukemia and have achieved recovery,
have a positive prognosis, since the probability of a relapse is
the type of cancer after such a period of time approaches zero.
Five year old выживаемость детей с острым миелобластным лейкозом
also continues to rise gradually, and at the moment
Survival rates of patients with chronic leukemia less
reliable, as some patients live with such a diagnosis in
for a long time. Five year old выживаемость при данном
the type of leukemia is, according to various data, from 60% to 80%.
Haveчитывая недавнее появление новых лекарств для лечения лейкоза, в
subsequent years, survival rates will increase significantly, but
There are currently no reliable data to support this.
Автор: Коробов Никита Александрович врач-анестезиолог