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Leukemia (leukemia, blood cancer) – what is it

Human blood is a liquid medium consisting of plasma and cells suspended in it: leukocytes, erythrocytes and platelets. Each type of formed elements performs a specific function: leukocytes are responsible for fighting various infectious agents, red blood cells transport oxygen from the lungs to all organs and tissues of the body, and platelets promote blood clotting.

Most of these cells are formed in bone marrow tissues, which are concentrated inside the pelvic bones and in the ribs, in a much smaller volume – in the long tubular bones of the limbs and in the vertebrae. Bone marrow is the only human tissue that contains an accumulation of immature stem cells without a given specialization.

It is here that hemopoiesis, or the gradual formation of new cells to replace spent their life cycle.

When normal cell formation is disrupted, a huge number of abnormal or immature leukocytes are released into the bloodstream.. They cannot perform their protective functions.

In addition, unlike normal elements, the modified ones are not eliminated at the right time, but continue to circulate in organs and tissues, gradually replacing the healthy ones. There is no tangible or visible tumor in case of leukemia, oncological structures are scattered throughout the body by blood flow.

The exact causes of leukemia are unknown, but a negative impact on this process of the polluted environment, an accelerated rhythm of life and constant stresses is assumed.

Leukemia subject to people of any age, among childhood cancers, leukemia occurs in 30% of cases. The greatest number of episodes of the disease is detected in children in the fourth year of life.

Despite a comprehensive study of the pathological process, it was not possible to reliably determine the cause of leukemia. Identified predisposing factors, the influence of which can provoke the development of the disease.

Causes of leukemia:

As a rule, the development of hemoblastosis is not provoked by only one factor. In the pathological process, a chain of events plays a role that activates an oncogene or affects the formation of a mutated cell.

Often there is a complex of negative influences, although there are cases of sudden and causeless, at first glance, the development of pathology.

CLASSIFICATION

The classification of blood cancer by type of disease:

  • Acute leukemia – many immature oncological blasts are revealed in the blood, which do not perform protective functions, the symptoms develop rapidly, the disease is prone to rapid progression.
  • Chronic – for a long time is in a latent state, but the detected cancer cells cope with the task of maintaining vital activity. This phenomenon is due to the fact that the blood cells that are already fully formed or are at the last stage of development are involved in the process. Such conditions are usually detected by random blood examination during routine checkups.

Acute leukemia can not turn into chronic and, conversely, chronic does not have the propensity to go into acute form. Chronic leukemia is characterized by periods of exacerbations, and the blood test pattern resembles the acute form of the disease.

Classification according to the degree of differentiation of altered cells:

  • lymphoblastic – found when mutations of lymphoid cells, characteristic of childhood;
  • granulocyte (myeloblastic) – changes affect granulocyte leukocytes, adults are more likely to get sick.

Depending on the type of cells affected by the pathology:

  • Chronic lymphocytic leukemia – in violation of the maturation and division of leukocytes.
  • Chronic myelocytic leukemia indicates a violation of the maturation and division of leukocytes, erythrocytes and platelets.
  • Acute lymphoblastic leukemia is a severe violation of the maturation and division of leukocytes.
  • Acute myeloblastic leukemia is a disorder in the maturation and division of leukocytes, erythrocytes and platelets. The disease proceeds rapidly and with a severe clinical picture.

The initial stage of leukemia may seem like a cold, but later on its signs acquire distinctive features.

Common signs of an initial stage of leukemia:

Symptoms of various types of leukemia:

  • Chronic lymphocytic leukemia. The disease is characterized by a slow course, progresses for a long time – over several months or years. Often diagnosed in the elderly, and in children in rare cases. After the accumulation of cancer cells, there is an increase in the lymph nodes, pain on the right under the rib, bleeding from the nose, jaundice of the sclera, and bleeding of the gums.
  • Chronic myelocytic leukemia characteristic of people from 30 to 50 years, often in males. Patients quickly increases the feeling of fatigue and decreases working capacity. Before the appearance of pronounced signs of leukemia can take from 2-3 to 10 years. These symptoms are: dyspnea at rest and with minor exertion, nausea, vomiting, fever, enlarged spleen and liver, migraines, dizziness, and sometimes loss of orientation in space.
  • Acute lymphoblastic leukemia often diagnosed in children from 1 to 6 years. There is intoxication on the principle of an infectious viral disease, an increase in lymph nodes, shortness of breath, bleeding into the retina of the eye, low hemoglobin values, and an enlarged liver and spleen. One third of boys show fluid accumulation in the testicles.
  • Acute Myeloblastic Leukemia appears at different ages, but more often in older people after 60 years. Patients complain of dizziness, weakness, fatigue, recurrent headaches, and increased sweating at night. A steady soreness appears in the bone tissue of the leg joints. In addition, pain occurs along the spinal line and osteoporosis. These symptoms provoke a change in the gait of a person. Sometimes an increase in the spleen and liver is detected. Lymph nodes can reach 5 cm in diameter and form conglomerates after adhesion of tissues. All these symptoms develop against the background of common signs of leukemia.

DIAGNOSTICS

Leukemia can be suspected by symptoms, but it is necessary to identify leukemia and make an accurate diagnosis based on blood test results. To clarify the various data using additional research methods.

Diagnostic methods:

  • Clinical blood test. Usually with this pathology there is an extremely high number of leukocytes, hemoglobin indices are reduced, thrombocytopenia is observed.
  • Aspiration bone marrow tissue with local anesthesia of the pelvic bone or sternum. To do this, a small needle is sampled through a puncture with a thick needle and sent for cytology.
  • Biopsy, in which, in addition to bone marrow tissue, a bone area is taken. As a result of studying the tissue, the type of tumor, the severity and volume of the lesion are determined. Aspiration and biopsy are not mutually exclusive, but are complementary methods of examination.
  • Puncture of cerebrospinal fluid allows you to detect the spread of cancer cells in the organs of the central nervous system. To do this, a needle is inserted between the lower back vertebrae for collecting liquor.
  • Cytogenetics (genetic analysis of blood cells) for the presence of chromosomal abnormalities to clarify the type of leukemia.

With leukemia chemotherapy is the basis of treatment. In addition, bone marrow transplantation is used.

Hematologists rely on regulated treatment regimens for certain forms of the disease that are constantly being improved. But an individual approach, as in the treatment of other diseases, is not practiced with leukemia – all doctor’s prescriptions follow a well-defined program.

Correction of therapy may be associated with the general condition of the patient and comorbidities.

What you need to know about chemotherapy:

  • Chemotherapy implies drug use, able to destroy cancer cells or interfere with their reproduction. Assign one drug or multiple.
  • The course of treatment may be carried out in an outpatient clinic or in specialized hospitals. It depends on the complexity of the diagnosis, side effects of drugs and the patient’s condition. Therapy includes several consecutive courses of potent drugs with breaks of 2-4 weeks.
  • High doses of chemotherapy with acute forms of leukemia help the body quickly get rid of leukemic cells. Treatment should begin immediately after confirmation of the diagnosis. From this will directly depend on the outcome of the disease.

The goal of subsequent therapy is to maintain treatment with the appointment of the same doses of cytostatics. The last stage is considered as prophylaxis to maintain the achieved result and to prolong remission.

In the treatment of certain types of cancer is applied exposure to radioactive isotopes for the purpose of prevention, treatment and preparation for bone marrow transplantation.

Donor transplantation or autotransplantation of one’s own bone marrow is performed in cases when the signs of leukemia persist after a course of chemotherapy. This operation helps to restore hemopoiesis, which has a positive effect on the work of the immune system.

All types of blood cancer respond differently to treatment, some are relatively easy to treat, while others do not always respond positively to the measures taken.

COMPLICATIONS

The most common complication of leukemia is infectious lesions of various origins that attack a weakened body of a patient with leukemia.

Acute forms of leukemia can provoke development of sepsis and hemorrhage in the brain. Without proper treatment, cancer of the blood is fatal.

Possible effects of chemotherapy:

  • hair loss;
  • bleeding;
  • nausea;
  • infertility.

PREVENTION

Primary prevention measures:

  • healthy lifestyle;
  • prophylactic blood tests;
  • prevention of risk factors;
  • supervision of children with the burdened heredity;
  • rehabilitation of foci of infection;
  • immunity strengthening.

Secondary prevention measures:

  • conducting effective anti-relapse therapy;
  • regular visits to the hematologist;
  • monitoring blood counts;
  • a ban on changing climatic conditions after a course of treatment;
  • restriction of physiotherapy procedures;
  • prophylactic vaccination according to the vaccination schedule.

FORECAST FOR RECOVERY

The prognosis for leukemia depends on the timing of the diagnosis, the patient’s age, the type of affected cells, the prevalence of pathological processes and the response to therapy.

Often with leukemia adverse prognosis in men, children over ten years and older people. Late detection of blood cancer with a significant increase in the number of leukocytes reduces the chances of long-term remission.

Children from 2 to 10 years old can achieve long-term remission with proper treatment.

Acute leukemias are characterized by rapid development and in the absence of proper treatment, they end in death. With adequate treatment of leukemia, about 50% of patients survive, but there are forms of the disease with recovery rates of 90–95% and 3-5%.

In the latter case, the doctors are doing everything possible, but only a bone marrow transplant is an effective means of saving these patients.

Methemoglobinemia is a blood disorder in which the patient has an increased content of methemoglobin (more than 1.5%) – oxidized hemoglobin. AT.

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