Leukemia is a malignant clonal disease of the hematopoietic system. It is also known as blood cancer. It should be noted that leukemia includes a whole group of diseases that differ in causes and conditions of occurrence. It is difficult to consider this topic completely, because it is specific and multifaceted, but its main aspects should be studied. So now we will talk about the classification of the disease, symptoms and treatment.
Acute leukemia: causes and symptoms
This is a form of the disease, which is characterized by rapid development and active accumulation of altered leukocytes in the brain and blood.
Before we turn to the consideration of the symptoms of acute leukemia, it should be noted that it is of two types - granulocytic (myeloid) and lymphoblastic. Each of them will be discussed separately.
The reasons why this disease occurs are still not fully understood. According to one version, its formation is provoked by genetic disorders,radiation exposure, immune system problems, and ingestion of chemicals that suppress hematopoiesis.
Whatever the cause, the hematopoietic cell mutates. This gives rise to the development of a tumor clone.
Common symptoms of acute leukemia include:
- Dramatic weight loss not related to exercise or diet.
- General deterioration of well-being. The man seems to be getting weaker every day. He also feels extremely tired, even if he didn't exert himself.
- Drowsy and unwilling to do anything.
- Heaviness in the abdomen, especially in the left side under the ribs, that occurs after eating any calorie content.
- Prone to infectious diseases.
- Excessive sweating.
- Sudden loss of appetite.
- Increased body temperature.
Rarely, in early-stage leukemia, symptoms may include shortness of breath, pale skin, bruising, cramps, and bone pain.
Lymphoblastic leukemia
In simple terms, a person suffering from these diseases develops a tumor in the bone marrow. Due to the fact that it is affected, the lymphocytes do not have time to develop enough to begin to fully fulfill their protective functions.
In this disease, in 85% of cases, B-lymphocytes, which provide human humoral immunity, suffer.
Clinical symptoms of lymphoblastic leukemia include:
- Intoxication syndrome. Manifested in a sharp weight loss, fever, malaise and weakness. May be accompanied by protozoal, fungal, viral or bacterial infection.
- Hyperplastic syndrome. Its presence is indicated by an increase in all peripheral lymph nodes. The size of the spleen and liver also change. As a result, a person often has a stomach ache.
- Feeling of aching bones and pain. It occurs due to leukemic infiltration and an increase in the bone marrow that occurs under the influence of a tumor.
- Anemic syndrome. Its presence can be recognized by pallor, bleeding of the mucous membranes and oral cavity, tachycardia and weakness resulting from intoxication and anemia.
- Hemorrhagic syndrome. It manifests itself in petechiae (small hemorrhages in the skin) and ecchymosis (dark blue bruising). You may vomit blood and black, semi-liquid stools (melena).
- Respiratory disorders.
- Swelling of the optic nerve and retinal hemorrhage.
In boys, the presence of this disease is also often indicated by initial enlargement of the testicles.
This is an extremely dangerous disease. Immunity is greatly reduced, and because of this, any damage to the skin becomes a focus of infection. Often there are panaritiums and paronychia (purulent inflammation).
Diagnosis and prognosis of lymphoblastic leukemia
In addition to interviewing and examining the patient, diagnostics involves the donation of peripheral blood for analysis and a smear of bone marrow punctate for a myelogram.
These procedures are required. According to the composition of the blooddetect thrombocytopenia (low platelets), anemia (low hemoglobin), increased erythrocyte sedimentation rate, and changes in white blood cell count.
Myelogram allows you to determine the inhibition of platelet, neutrophil, and erythroid germ.
Also, the examination program includes the following procedures:
- Lumbar puncture. The patient is injected with a needle at the lumbar level into the subarachnoid space of the spinal cord. This is necessary to exclude the presence of neuroleukemia.
- Chest X-ray. Helps determine if mediastinal lymph nodes are enlarged.
- Ultrasound of the abdominal organs. It can be used to assess the condition of the lymph nodes and parenchymal organs.
- Biochemical blood test. Helps to identify if there are disorders in the functioning of the kidneys and liver.
If the symptoms of leukemia are confirmed by tests, the doctor prescribes treatment. The basis of therapy is chemotherapy.
First, the person undergoes intensive treatment. The duration is usually about six months. The goal is to achieve remission, which manifests itself in the normalization of hematopoiesis and the elimination of blasts. Then, maintenance therapy is prescribed, which helps to slow down or completely stop the further development of the disease. This stage lasts for about two years.
All forecasts, like treatment, are individual. The condition of the patient and the level of risk are taken into account. If treatment fails, bone grafting may be considered.brain.
The average five-year adult survival rate is 35-40%. In children - 80-85%.
Myeloid leukemia
This disease is also known as acute granulocytic leukemia. It manifests itself in the uncontrolled growth of immature blood cells. They accumulate in the bone marrow, internal organs and in peripheral blood, as a result of which the work of all body systems is disrupted.
What are the symptoms of this type of acute leukemia in adults:
- Temperature from 38° to 40°.
- Severe headache.
- Subcutaneous hemorrhages and bruises appearing out of nowhere.
- Bleeding and sore gums.
- Uterine, gastrointestinal and nosebleeds.
- Feeling short of breath even with low physical activity.
- High heart rate.
- Rapid exhaustion of the lungs, kidneys and heart.
- Appearance of bronchitis, tonsillitis, necrotic stomatitis, paraproctitis, pneumonia.
Reduced blue-red spots on the skin, joint pain and swollen lymph nodes.
Diagnosis and prognosis of myeloid leukemia
As in the case of the previous disease (and any other too), a person must definitely donate blood for analysis. Symptoms of leukemia in adults can only be confirmed by its laboratory examination by specialists.
With this disease, there is a decrease in the level of reticulocytes and erythrocytes. Leukocyte counts fluctuate, and significantly– from 0, 1109/l to 100, 0109/l. Platelets are reduced, their level is less than 130, 0109/l.
The absence of basophils (leukocytes that destroy foreign agents in the body) and eosinophils (sources of destructive enzymes) in the blood is also recorded. Even with this disease, the erythrocyte sedimentation rate is increased (more than 15 mm / h).
Therapy prescribed by a doctor is aimed at destroying the leukemic clone. The patient is placed in special conditions, characterized by increased sterility. A high protein diet is also prescribed. Every product consumed by humans is heat treated.
This is about the treatment and symptoms of acute leukemia. Prognosis in adults is mixed. This disease, like therapy, is a huge burden on the body. And the older the person, the sadder the forecast.
Unfortunately, 60% of older patients relapse within three years after the end of therapy, which lasts an average of 2-3 years. Five-year survival varies from 4 to 46%.
Chronic lymphocytic leukemia
This disease is considered one of the most common among those that affect the hematopoietic system. In 30-35% of people who noticed symptoms of leukemia in themselves, it was the chronic form that was diagnosed. Every year, out of 100,000 people, 3-4 get it.
Chronic leukemia progresses very slowly. Atypical cells appearing among lymphocytes do not immediatelymanifest. Most often, the disease is detected in the later stages, when they become more than normal. At an early stage, there are practically no symptoms of blood leukemia. In adults, it can be detected at the first stage only if a general routine blood test is performed. Because an increased number of white blood cells cannot go unnoticed.
It should be noted that there is a predisposition to this disease. Scientists still cannot determine the exact set of genes that are damaged in it. But, according to statistics, in those families where at least one person suffered from chronic leukemia, the risk of the disease in his relatives increases by 7 times.
As mentioned earlier, development is asymptomatic. In the later stages, all of the above manifestations begin to become noticeable. One of the most serious consequences is manifested in autoimmune complications. They can lead to a hemolytic crisis and life-threatening bleeding.
Chronic leukemia diagnosis
As a rule, the process of detecting a disease is not difficult. Difficulties arise only in the differential diagnosis of leukemia along with other tumors of a lymphoproliferative nature.
A blood test helps to detect the presence of prolymphocytes and lymphoblasts. If you do it systematically, you can fix the growing lymphocytosis.
Biochemical analysis allows you to determine the presence of abnormalities. In the early stages, they are absent, but then hypogammaglobulinemia appears (low levels of immunoglobulins inblood) and hypoproteinemia (abnormally low plasma protein levels). If a patient has liver infiltration, abnormal liver tests may also occur.
By means of a myelogram, the amount of lymphocytes in the bone marrow punctate is revealed. In the early stages, it is relatively low (about 50%). But with the development of the disease, the indicator can reach up to 98%.
In addition to the above, the diagnosis, carried out after the detection of symptoms of blood leukemia, includes immunophenotyping. This procedure involves characterization of cells using probes or monoclonal antibodies. This allows you to determine their functional state and type. During the procedure, antigens CD23, CD19 and CD5 are often detected. Sometimes it is possible to detect B-cell markers CD79b and CD20.
Is it possible to treat a chronic disease?
Unfortunately not. Even if symptoms were detected at an early stage. In adults, the prognosis of chronic leukemia cannot be called positive - it is an incurable disease. However, if the diagnosis is established in a timely manner, and the doctor chooses the right therapy, the patient's quality of life can be improved.
In the initial stages, the patient is not prescribed any medication, he is simply under the supervision of a hematologist. Medications can be prescribed only with a significant progression of the disease, the appearance of complications and a deterioration in the person's well-being.
Life expectancy with acute leukemia, about the symptoms and diagnosis of whichmentioned above, depends on a lot of factors. These include the age and sex of the patient, the timeliness of the start of therapy and its effectiveness. Duration can vary from a few months to tens of years.
So far, no cases of complete, permanent remission have been identified. But many patients manage to partially recover. At the same time, it turns out to reduce the number of lymphocytes by 50%, reduce the size of the lymph nodes and spleen, and increase the levels of neutrophils, hemoglobin and platelets by 50%.
Acute promyelocytic leukemia
Another type of disease that cannot be left unsaid. A specific symptom of adult leukemia in this case is an abnormal accumulation of promyelocytes - cells that are larger than the notorious myeloblasts. In most cases, this disease occurs in young people - not older than 40 years.
The disease progresses quickly. The main symptom of leukemia in adults is bleeding, which occurs even with minor skin lesions, followed by bruising.
In principle, this disease is characterized by all the previously mentioned manifestations. Of the specific symptoms, DIC can be noted, which manifests itself in a violation of blood clotting, which occurs due to the massive release of thromboplastic substances from the tissues.
After confirming the symptoms of leukemia, treatment begins. It is carried out with the participation of doctors of various profiles, as well as with the help of transfusion and laboratory services. First, as a rule, fresh frozen plasma of cryoprecipitate and platelet concentrate are administered. ATRA therapy may be given until the diagnosis is confirmed. This is a combined treatment aimed at rearranging the gene. Then chemotherapy is prescribed.
Usually the course lasts 2 years. If there is no result, arsenic trioxide may be prescribed.
On average, life expectancy in 70% of cases reaches 12 years without exacerbations. To date, promyelocytic leukemia is one of the most curable malignant pathologies.
Acute megakaryoblastic leukemia
Much has been said above about the various types of disease. Finally, it is worth noting the symptoms and prognosis of acute leukemia of the megakaryoblastic type.
The presence of this disease is indicated by the presence in the blood and bone marrow of cells with a strongly stained nucleus, which also have filamentous outgrowths and a narrow cytoplasm. Also, the analysis often reveals fragments of the nuclei of malformed megakaryocytes.
Most often this type of leukemia occurs in children with Down syndrome.
Diagnosis of this disease presents a certain difficulty, since the clinical picture does not have any specific features. It is also difficult to carry out treatment, especially cytostatic therapy, which is necessary in this case. Therefore, the most effective way is a bone marrow transplant.
Complete remission and an increase in life expectancy is observed most often in children. For adults, the forecasts are less positive.
Therapy
Treatment of leukemia of any kind includes the following procedures:
- Radiation therapy. Influences malignant tumors. Promotes the removal of the cells of which they are composed.
- Chemical therapy. A catheter is installed in the region of the spinal canal, through which powerful drugs are introduced into the body that affect the tumor.
- Bone marrow transplant. It is offered to the patient only if a relapse has occurred. But first, the surgeon removes the cancer cells. And only then they are replaced with new ones.
- Taking antibiotics to fix the result.
Also, in addition to the above, it is important to follow a balanced diet enriched with vitamins, minerals and useful macro- and microelements. Strict bed rest is also necessary, as he althy sleep is a faithful assistant in the normalization of body functions.
The most important thing is not to delay going to the oncologist when you find alarming symptoms. The sooner the diagnosis is established and treatment is prescribed, the more positive the prognosis will be.
