How to identify leukemia: symptoms of leukemia and its manifestations. Chronic myeloblastic leukemia. Acute leukemia: general tests

With leukemia, the process of ripening and dividing properly of blood cells located in bone marrow. Immature, pathologically developing, white blood cells fill the blood. The lifespan of healthy cells is short. They die after a certain amount of time, while diseased leukocytes continue their path in a circle. The normal existence of the body becomes impossible.

To determine the presence of a disease, along with nonspecific symptoms, take into account the following analyses:

1. A routine general blood test for leukemia can detect the disease even before characteristic symptoms appear.
2. Blood chemistry.
3. Subsequently, bone marrow is taken for analysis, lymph node biopsy, ultrasound, MRI are performed, and radiation diagnostic methods are used.

Blood parameters in the analysis for leukemia

At acute illness leukemia cells metastasize in a very short time. Young cells become the basis of the cellular substrate.

A chronic disease, on the contrary, develops over a long period of time and is asymptomatic. Healthy cells are replaced by cancerous blasts within for long years. But a blood test can determine that the disease is beginning its destructive work.

In adults

Recently, people over 60 years of age have become more likely to become ill with leukemia. But now 57% of adult patients are diagnosed with myeloblastic acute leukemia. Moreover, acute myeloid leukemia affects people of productive, flourishing age - 30-50 years. Ecology weakens the immune system. Let's look at blood parameters for leukemia in adults.

A general blood test for leukemia shows:

• a sharp decline erythrocytes up to 1-1.5x1012/l;
• the number of reticulocytes gradually but steadily decreases. It reaches 10-27%;
• the erythrocyte sedimentation rate increases;
• the number of leukocytes can be either low - 0.1x109/l, or high - 00-300x109/l, depending on the nature of the cancer;
• at the same time, the number of platelets decreases significantly;
• In chronic leukemia, there are no transitional cells in the blood. Only unripe young ones and a few mature ones;
• neither basophils nor eosinophils are detected in the blood of patients;
• as the disease develops, the hemoglobin level decreases to 20 g/l.

IMPORTANT. You need to donate blood for a general analysis at least once a year. The study of many indicators allows us to determine the onset of leukemia when there are no other symptoms.

In blood serum at biochemical analysis an increase in level is visible:

• urea;
• uric acid;
• gamma globulins;
• bilorubin.

The activity of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) also increases.

At the same time, the levels of glucose, albumin and fibrinogen decrease.

Immunological tests reveal genetic damage in 92% of patients.

In children

Children suffer from acute lymphoblastic leukemia more often than adults. The disease manifests itself in three to four year old children.

Chronic leukemia in a child begins asymptomatically. Sometimes it can be detected by a general blood test. As in adults, a blood test for leukemia in children is characterized by:

• decrease in the number of red blood cells;
• a decrease in reticulocytes that occurs gradually;
• increase in ESR;
• noticeable anemia;
• change in the number of leukocytes (from a minimum to an increased level);
• decrease in platelet count.

These blood changes indicate the possible presence of leukemia. Examinations of the child make it possible to identify the onset of the disease and radically cure it.

How is leukemia determined?

The first symptoms of leukemia in adults are not noticeable from the very beginning of the disease.

However, here are the signs:

• weakness;
• severe fatigue;
• frequent infectious diseases;
• loss of appetite;
• joint pain;
• bleeding from the nose, gums;
• anemic shortness of breath;
• hemophilia.

With myelo- and monoblastic leukemia, the temperature often rises. The size of the spleen and kidneys increases, while the liver cannot be palpated.

At lymphoblastic leukemia inguinal and axillary lymph nodes. Sometimes one of the testicles increases in size. Even if there is no pain, you should urgently do a blood test. Often swollen lymph nodes are accompanied by a dry cough and shortness of breath.

In a quarter of cases, leukemic meningitis is diagnosed. Its signs: vomiting, weakness, headache, convulsions, inadequate perception of reality, irritability, seizures, fainting. Deterioration of hearing and vision is possible. In the cerebrospinal fluid, the rates of cytosis and blast cells increase.

The skin turns red or brown when late stages leukemia.

Causes of leukemia

Reasons causing this dangerous disease quite a lot:

1. Infections that provoke cell changes.
2. Heredity. Leukemia is often observed in relatives of the next generation or a generation later.
3. Blood cells can be modified by chemical toxins.
4. Some drugs, when the dosage is exceeded, cause a leukemic effect.
5. Radiation exposure can also damage chromosomes.

Do not despair if you or your family have been diagnosed. The diagnosis is very serious, but the earlier treatment is started, the greater the chances of recovery. It is necessary to be observed by a specialist and persistently carry out all prescribed procedures.

• Acute leukemia– these are rapidly progressive diseases that develop as a result of impaired maturation of blood cells (white cells, leukocytes) in the bone marrow, cloning of their precursors (immature (blast) cells), the formation of a tumor from them and its growth in the bone marrow, with possible further metastasis ( spread of tumor cells through the blood or lymph into healthy organs).
• Chronic leukemia differ from acute ones in that the disease lasts for a long time for years, pathological production of precursor cells and mature leukocytes occurs, disrupting the formation of other cell lines (erythrocyte line and platelet). A tumor is formed from mature and young blood cells.

Anatomy and physiology of bone marrow

Red blood cells- these are red blood cells, contain hemoglobin, oxygen is fixed on it, with the help of which the cells of the body are nourished. With a lack of red blood cells, insufficient saturation of the body's cells and tissues with oxygen occurs, resulting in various clinical symptoms.

Leukocytes these include: lymphocytes, monocytes, neutrophils, eosinophils, basophils. They are white blood cells, they play a role in protecting the body and developing immunity. Their deficiency causes a decrease in immunity and the development of various infectious diseases.
Platelets are blood platelets, which are involved in the formation of a blood clot. Lack of platelets leads to various bleedings.
More about types blood cells read in a separate article by following the link.

Causes of leukemia, risk factors

• Ionizing radiation: radiologists are exposed, after the atomic bombing, radiation therapy, ultraviolet radiation;
• Chemical carcinogens: toluene, found in paints and varnishes; pesticides are used in agriculture; arsenic is found in metallurgy; some medications, for example: Chloramphenicol and others;
• Some types of viruses: HTLV (T - human lymphotropic virus);
• Household factors: car exhausts, additives in various food products, smoking;
• Hereditary predisposition to cancer;
• Mechanical tissue damage.

Symptoms of various types of leukemia

1. For acute leukemia There are 4 clinical syndromes:

• Anemic syndrome: develops due to a lack of red blood cell production, many or some symptoms may be present. Manifests itself in the form of fatigue, pale skin and sclera, dizziness, nausea, rapid heartbeat, brittle nails, hair loss, pathological perception of smell;
• Hemorrhagic syndrome: develops as a result of a lack of platelets. Manifests the following symptoms: first, bleeding from the gums, bruising, hemorrhages in the mucous membranes (tongue and others) or in the skin, in the form of small dots or spots. Subsequently, as leukemia progresses, massive bleeding develops, as a result DIC syndrome(disseminated intravascular coagulation);
• Syndrome of infectious complications with symptoms of intoxication: develops as a result of a lack of leukocytes and with a subsequent decrease in immunity, an increase in body temperature up to 39 0 C, nausea, vomiting, loss of appetite, sudden weight loss, headache, general weakness. The patient develops various infections: influenza, pneumonia, pyelonephritis, abscesses, and others;
• Metastases - Through the blood or lymph flow, tumor cells enter healthy organs, disrupting their structure, functions and increasing their size. First of all, metastases reach The lymph nodes, spleen, liver, and then to other organs.

Diagnosis of leukemia

• Decrease in hemoglobin level (normal 120g/l);
• Decrease in the level of red blood cells (normal 3.5-5.5 * 10 12 / l);
• Low platelets(norm 150-400*10 9 /l);
• Reticulocytes (young red blood cells) level decreases or are absent (normal 02-1%);
• Blast (young) cells >20% in acute leukemia, and in chronic leukemia it may be less (the norm is up to 5%);
• The number of leukocytes changes: in 15% of patients with acute leukemia it increases to >100*10 9 /l, other patients may have a moderate increase or even a decrease. The norm of leukocytes is (4-9*10 9 /l);
• Decrease in the number of neutrophils (normal 45-70%);
• Absence of band leukocytes, eosinophils and basophils;
• Increase in ESR(norm 2-12mm/h).

1. Blood chemistry: nonspecific method, indicates changes in indicators as a result of damage to the liver and kidneys:

• Increased level of lactate dehydrogenase (normal 250 U/l);
• High ASAT (norm up to 39 U/l);
• High urea (normal 7.5 mmol/l);
• Increased uric acid (normal up to 400 µmol/l);
• Increase in bilirubin ˃20 µmol/l;
• Decrease in fibrinogen
• Decrease in total protein
• Decreased glucose ˂ 3.5 mmol/l.

1. Myelogram (bone marrow puncture analysis): is the method of choice for confirming acute leukemia

• Blasts (young cells) >30%;
• Low level erythrocytes, leukocytes, platelets.

1. Trephine biopsy ( histological examination iliac bone biopsy): does not allow an accurate diagnosis, but only determines the proliferation of tumor cells, displacing normal cells.
2. Cytochemical study of bone marrow punctate: detects specific blast enzymes (reaction to peroxidase, lipids, glycogen, nonspecific esterase), determines the variant of acute leukemia.
3. Immunological research method: identifies specific surface antigens on cells, determines the variant of acute leukemia.
4. Ultrasound internal organs: a nonspecific method that detects enlarged liver, spleen and other internal organs with metastases of tumor cells.
5. X-ray chest: is a nonspecific met, detects the presence of inflammation in the lungs when an infection is attached and enlarged lymph nodes.

Treatment of leukemia

Drug treatment

1. Polychemotherapy, used for antitumor effects:

1. Transfusion therapy: red blood cell mass, platelet mass, isotonic solutions, for the purpose of correcting severe anemic syndrome, hemorrhagic syndrome and detoxification;
2. General restorative therapy:

• used to strengthen the immune system. Duovit 1 tablet 1 time per day.
• Iron supplements, to correct iron deficiency. Sorbifer 1 tablet 2 times a day.
• Immunomodulators increase the body's reactivity. Timalin, intramuscularly 10-20 mg once a day, 5 days, T-activin, intramuscularly 100 mcg once a day, 5 days;

1. Hormone therapy: Prednisolone at a dose of 50 g per day.
2. Antibiotics wide range actions prescribed for the treatment of associated infections. Imipenem 1-2 g per day.
3. Radiotherapy used to treat chronic leukemia. Irradiation of an enlarged spleen and lymph nodes.

Surgery

Traditional methods of treatment

An infusion of crushed pine needles, dry onion skin, rose hips, mix all ingredients, add water, and bring to a boil. Leave for a day, strain and drink instead of water.

Drink juices from red beets, pomegranates, and carrots. Eat pumpkin.

Infusion of chestnut flowers: take 1 tablespoon of chestnut flowers, pour 200 g of water into them, boil and leave to infuse for several hours. Drink one sip at a time, you need to drink 1 liter per day.
A decoction of blueberry leaves and fruits is good for strengthening the body. Approximately 1 liter of boiling water, pour 5 tablespoons of blueberry leaves and fruits, leave for several hours, drink everything in one day, take for about 3 months.

An oncological process characterized by the formation of mutated cells in the bone marrow and their subsequent release into the bloodstream - leukemia. It is almost impossible to prevent the development of pathology. However, timely diagnosis leukemia allows for effective therapeutic measures, which greatly prolongs a person’s life and ability to work.

What it is: types and forms

Leukemia is a specific type of cancer process. Its main manifestation is the appearance of mutated cells in the blood, with their uncontrolled division and gradual displacement of healthy elements.

The oncological process begins with a violation of DNA integrity - atypia appears in one bone marrow cell. Then the negative process spreads, and a whole series of atypical structures is formed - blood leukemia. Previously it was also called leukemia.

At the earliest stages of its appearance, pathology may in no way make itself felt. Only a highly qualified specialist can detect the first signs.

It is customary to distinguish between two main forms of leukemia – chronic and acute. Both require early diagnosis and appropriate treatment. With late treatment or lack of proper medical care, the risk of death is high.

Experts distinguish the following types of pathology:

1. lymphoblastic acute leukemia: more often found in pediatric patients and in adolescence, progresses quickly, requires immediate comprehensive treatment;
2. acute myeloid leukemia - the predominance of pathologically immature blood elements, characteristic of the adult category of patients, is characterized by high susceptibility of patients to various infections;
3. a chronic variant of the course of lymphoblastic leukemia - an excess of mature leukocytes is observed in the bloodstream, often found in the elderly category of patients, among whom men predominate;
4. chronic form of myeloid leukemia - characterized by slow progression, clinical manifestations are absent for many years.

Other types of blood cancer can be detected, but much less frequently. For any type of cancer, a number of diagnostic studies are necessary to make an adequate diagnosis of leukemia.

How to recognize acute leukemia

A presumptive diagnosis is formed by a specialist when a person first seeks medical help - the complaints presented are carefully taken into account, and a physical examination is performed.

Recognize pathology by early stage very difficult - manifestations and symptoms are minimal, a person may not pay attention to them at all, attributing them to other negative conditions, for example, overwork, vitamin deficiency. Only previously uncharacteristic weakness, drowsiness, and increased sweating during the night's rest may be present.

A general blood test may show moderate increase in ESR, mild anemia.

Diagnosing blood cancer at the time of advanced symptoms is not difficult. The patient presents many complaints - bleeding gums and subcutaneous pinpoint bruises, as well as various other bleedings, difficulty stopping bleeding even from a small scratch.

The pathological condition is quite explainable by a significant decrease in the number of platelets in the bloodstream - atypical cells block their appearance and development.

Increased susceptibility to infectious lesions - ordinary tonsillitis is accompanied by ulcerative-necrotic complications, and acute respiratory infections end in severe pneumonia due to the fact that protective cells - leukocytes - mutate and are destroyed. As a result, a person finds himself completely unprotected against aggressive infectious agents.

Visually you can determine increased dryness and pallor of the skin, as well as fragility of the nail plates and hair. All this is a manifestation of anemia, which is necessarily present in leukemia. Among the complaints, the patient points to persistent dizziness, certain changes in olfactory and taste perceptions, and presyncope.

As blood cancer progresses, diagnosis becomes even easier - mutated cells quickly multiply and spread throughout the body. First of all, the spleen, liver, as well as lymph nodes and bones are attacked aggressively. The pain syndrome increases.

How to recognize chronic leukemia

Identify pathology in its chronic version development can be difficult - nothing bothers a person for years. The production of mutated cells occurs in small portions. The activity of healthy cells is disrupted little by little, unnoticed by the patient’s well-being.

At an early stage, adequate diagnosis of leukemia of this form does not exist. They are often detected during preventive medical examinations or when a person seeks advice on another matter.

Changes in the blood formula should be alarming - the presence large quantity immature elements against the background of a reduced volume of platelets and red blood cells. A comprehensive examination and consultation with a hematologist and oncologist is required.

Laboratory diagnostics

To diagnose blood pathology, a number of laboratory tests are required:

• detailed general blood test - can show an increase in leukocytes and ESR parameters, with simultaneous insufficiency of platelet and erythrocyte mass;
• cytogenetic analysis - allows specialists to establish the presence of atypical chromosomes, clarify the type of oncological process; for this purpose, cells are taken directly from the bone marrow, as well as the bloodstream and lymph nodes, for example, in the chronic version of myeloid leukemia, Philadelphia chromosomes are detected;
• a study based on the reaction of specific antibodies with antigens - immunophenotyping, allows you to distinguish between chronic or acute lymphoblastic blood cancer with the myeloid form of pathology: by the special label acquired by the mutated elements after placing the antigen in the solution;
• Using a thin long needle, a test such as a bone marrow puncture is carried out - from areas that are least covered muscle fibers, as a rule, from the sternum: in this case, chronic leukemia is detected in the patient or an acute form, identify by morphological characteristics and cytogenetic type, as well as to which chemotherapy drugs the disease is susceptible;
• the ratio of atypical and healthy elements in the bloodstream will be shown by a myelogram - the presence of leukemia will be indicated by an increase in the volume of blast cells over 5%, up to total damage by them;
• Cytochemical analysis for leukemia diagnosis is extremely necessary, especially for the acute form of the disease, it allows you to isolate specific enzymes, for example, the acute lymphoblastic variant is characterized by the presence of a positive PAS reaction to glycogen while simultaneously negative to lipids.

The above-described laboratory tests are usually carried out in specialized cancer hospitals. Required amount Diagnostic procedures are determined by the doctor individually for each person.

Instrumental diagnostics

Whatever form of leukemia is suggested by a specialist, in addition to laboratory diagnostic methods, instrumental ones are necessarily recommended:

• The most informative at the moment is recognized CT scan– with its help, the localization of the pathological focus, its prevalence, and the presence of distant metastases, for example, in the lymph nodes, penis, and spleen are revealed.
• Radiography is a publicly available and inexpensive research method, carried out when the patient complains of a persistent, untreatable cough, sometimes with bloody streaks in the sputum produced. Allows you to exclude other pathologies, for example, tuberculosis.
• If it is necessary to carry out differential diagnostics, MRI can be prescribed - it helps to detect the cause of unknown deterioration in well-being: numbness of the limbs, dizziness, visual disturbances. The pathological process can spread to the brain and internal organs, with the formation of a tumor focus in them.
• IN in doubtful cases a biopsy is performed - a detected or absent sign of cell atypia in the organs.

Each of the above instrumental methods is important for making an adequate diagnosis. In each situation, the specialist determines the optimal number of them to carry out.

Differential diagnosis

At acute types leukemia, there is a significant increase in the number of leukocytes in the bloodstream. Similar condition must be differentiated from reactive variants of leukocytosis.

Excessive neutrophilic leukocytosis with significant rejuvenation of the composition shaped elements, for example, accompanies severe infectious lesions– meningococcal pathology. However, blast elements are not detected. No atypia is detected in the bone marrow biomaterial.

Leukemoid modifications of the neutrophil type with or without leukocytosis are formed in various malignancies - hepatocellular cancer, small cell sarcoma of the pulmonary structures or nephroblastoma.

High quality differential diagnosis difficult if there is no cancerous focus available for biopsy - the elements of metastases of these neoplasms to the bone marrow will have a pronounced morphological similarity to leukemic blasts. Diagnosis relies more on clinical manifestations and information from other diagnostic procedures.

If you suspect Infectious mononucleosis In the clinical picture, there is a clear similarity of symptoms with acute leukemia - pharyngitis, fever, enlarged lymph nodes, hepato- and splenomegaly, as well as various hemorrhagic rashes.

IN laboratory research There is moderate leukocytosis, maximum lymphocytosis with the presence of blast-transformed lymphocytes, and even with T-cell markers. However, anemia and thrombocytopenia are not detected, or they are minimally expressed.

With infectious lymphocytosis, differential diagnosis consists of identifying mature, full-fledged lymphocytes; they are easily distinguishable from lymphoblasts.

Difficulties may arise for specialists in differentiating the acute form of leukemia with manifestations of hypersplenism, various options granulocytopenia, thrombocytopenia, as well as aplastic anemia. In some cases, a medical consultation is required with the involvement of highly qualified oncological and hematological specialists.

When medical attention is needed

For the diagnosis of leukemia to be highly effective, a person must contact a specialist at the earliest stage of identifying abnormalities in his or her health:

• persistent, previously unobserved weakness, dizziness;
• noticeable decrease in performance;
• unexplained myalgia, arthralgia;
• frequent hemorrhagic rashes on the skin, even if the person did not hit or fall;
• detection of bleeding gums when brushing teeth, even after treatment by a dentist;
• disturbance in the quality of night rest, excessive sweating, anxiety.

Leukemia detected in a timely manner when seeking medical help and treated is the key to good health and high working capacity.

Acute leukemia, or acute leukemia, are pathological processes in which excessive proliferation of bone marrow cells occurs, while they do not have time to differentiate. And as you know, undifferentiated cells cannot perform the functions assigned to them. If appropriate chemotherapy treatment is not carried out, then uncontrolled reproduction leads to the fact that these cells completely replace normal ones, and not only of this germ.

The symptoms of leukemia are determined by two main factors. It's about about the following:

• the severity of the pathological process due to the inhibition of normal hematopoiesis;
• infiltration of various organs by undifferentiated hematopoietic cells, which leads to dysfunction of one or another affected organ.

The onset of the disease is associated with the appearance nonspecific signs, which complicate the process of diagnosing hemoblastoses (leukemia is a type of them). Therefore, if the following clinical signs appear, you must immediately consult a doctor for qualified help, which includes a thorough examination in order to clarify the diagnosis and prescribe appropriate treatment.

The first clinical manifestations of leukemia may be:

• causeless increase in body temperature;
• unmotivated weakness;
• increased bleeding;
• expressed and sudden feeling physical exhaustion etc.

In a person suffering from leukemia, the disease may begin with: long time temperature remains slightly elevated ( low-grade fever), bleeding gums and easy education bruises when exposed to a traumatic factor, and also develop various infectious diseases which often recur. This significantly disrupts the immune system, leading to the progression of hematological malignancies. As a result, a vicious circle is closed, supporting a steady deterioration of the pathological process.

Also, the appearance of uterine bleeding of varying intensity (metrorrhagia), which cannot be explained by other reasons, should alert you to acute leukemia. Another suspicious sign is long-term, unstoppable bleeding after various dental operations.

Why do the main clinical signs appear?

Fever and hemorrhagic manifestations are two main signs that, with a high degree of probability, when combined, may indicate acute leukemia. Their appearance is associated with various pathogenetic mechanisms.

An increase in temperature can have two origins. On the one hand, it can be explained by the frequent occurrence of various infections, including those caused by opportunistic microorganisms. A decrease in the number of mature leukocytes in the blood leads to a significant decrease in immunity. IN in this case the use of antibiotics (taking into account the sensitivity of microorganisms) allows to achieve a decrease in body temperature. However, sometimes they turn out to be ineffective. As a rule, this indicates another way of increasing the temperature. It is associated with the release of pyrogenic substances by tumor cells. They have a direct impact on the thermoregulation center, leading to a change in its set point.

Hemorrhagic syndrome is associated with toxic damage to platelets, which become functionally inferior and therefore cannot help stop bleeding. The proliferation of cells in the bone marrow, which are the source of tumor growth, also leads to the development of thrombocytopenia, that is, a decrease in the level of platelets in the blood. As the disease progresses to pathological process The liver is also involved, where the synthesis of the main coagulation factors occurs. Therefore, increased bleeding of various tissues has a combined origin.

Other clinical signs of the disease

Signs of leukemia are also determined by other clinical manifestations. Usually they do not appear in the early stages, but as the disease progresses. pathological changes. These manifestations include:

• the appearance of pain in the bone area, which is associated with an increase in the tumor mass, leading to infiltration of bone tissue;
• refusal of food or a significant decrease in appetite, explained by the development of intoxication against the background of a malignant process;
• weight decreases and the volume of muscle tissue decreases significantly, which is explained by increasing catabolic processes (this is due to the increased proliferation of tumor cells, which require the presence of a large number nutrients and energy), etc.

It should also be taken into account that the appearance of certain symptoms depends on the histological structure of the tumor cells. Thus, hemoblastoses from the white blood germ manifest differently compared to hemoblastoses from the red blood germ. Let us consider in more detail the clinical manifestations depending on the type of hemoblastosis.

Leukemia from monocytic cells is primarily manifested by the development of leukemic infiltration of the gums. This leads to their swelling and redness, which creates the preconditions for the development of ulceration, which will be a risk factor for infection oral cavity. Non-lymphoblastic leukemias lead to the formation of leukemides in various organs and tissues, especially in the skin. Leukemides are foci of tumor cell deposition. As a rule, they appear green in appearance. This color is due to the presence of myeloperoxidase, an enzyme involved in metabolic processes. Lymphoblastic leukemia can manifest as enlarged liver and lymph nodes. Myeloid leukemia can lead to the development of thrombosis in various organs with impaired microcirculation in them. Against this background, infarctions of the heart, lungs, liver and other organs develop.

Thus, against the background of leukemic damage to internal organs, disturbances in the respiratory, cardiovascular, nervous, urinary systems, etc. may occur.

Differential diagnostic signs of leukemia

The appearance of the clinical signs listed above is a reason for a thorough examination of the patient. The purpose of such diagnostics is to exclude leukemia or detect it as early as possible. early stage. For this purpose they are used additional methods research.

The most common is a general clinical blood test, which allows you to identify one or another type of hemoblastosis. This analysis determines the increase in the number of cells of a particular germ, as well as increased content blast cells (precursors). It should be taken into account that damage to earlier blood cell precursors leads to the appearance of a larger type of tumor cells. Thus, when the myeloid precursor is damaged, the tumor process is manifested by an increase in the number of red blood cells and platelets. In some cases, only one type of cell may be affected, for example, only white blood cells or lymphocytes.

The definitive diagnosis can be made by bone marrow biopsy. I will definitely examine the resulting material under a microscope, which will allow us to identify the specific type of leukemia. And these data are necessary for carrying out differentiated chemotherapy treatment, since different cells have different sensitivities to drugs.
In conclusion, it should be noted that acute leukemia belongs to the group of hemoblastoses, that is, oncological processes of the hematopoietic system. The initial clinical signs are determined by the loss of those functions that are controlled by this type of cell. However, the process gradually progresses, so all the functions assigned to the blood system suffer. In addition, any organ can be involved in the pathological process, since all organs have their own blood supply system.

They develop very quickly. The sick person clearly feels them. Chronic leukemia is expressed to a much lesser extent, and at the beginning of the disease it may not manifest itself in any way.

The existence of leukemia can be suspected by the following manifestations:

• fatigue, weakness;
• weight loss, lack of appetite;
• bleeding gums;
• body aches;
• chills and heat, as well as other signs characteristic of colds;
• frequent infections;
• enlarged lymph nodes, liver, spleen;
• petechiae (bleeding under the skin);
• profuse sweating, especially during sleep.

Diagnostics

To diagnose leukemia, the doctor prescribes tests and examinations such as:

• general blood analysis. The most common method for detecting leukemia. With leukemia, the level of leukocytes is increased, platelets and hemoglobin are decreased. When acute lymphoblastic leukemia exists, an increased number of leukocytes is detected in the blood, over 10.0 x 10 9 / l, in rare cases 100 x 10 9 / l. In acute myeloid leukemia, the number of leukocytes exceeds 10.0 x 10 9 /l. At the same time, new, unusual cell forms appear in the blood. Leukocyte level in chronic myelocytic leukemia over 10.0 x 10 9 /l, in the last stages of the disease it can reach 200–500.0 x 10 9 /l. initial stages chronic lymphocytic leukemia reveals an increase in leukocytes and lymphocytes;
• bone marrow aspiration makes it possible to analyze its cells. They are mainly located in the central part of the bones. To perform aspiration, the doctor punctures the bone to reach areas of the bone marrow. Next, the cells are sent to the laboratory for detailed study;
• bone marrow biopsy is in the following way cell research. For a biopsy, the doctor removes a small piece of bone with bone marrow. The acquired material is studied in detail using a microscope;
• Sometimes, for a detailed examination, it may be necessary to carry out these two procedures. Thanks to aspiration and biopsy, it is possible not only to confirm the diagnosis of leukemia, but also to establish the type of disease (which cells of the patient’s body are involved in the pathological course);
• genetic testing is a study of the chromosomes of diseased blood cells. Thanks to this method, the type of leukemia is diagnosed;
• cerebrospinal fluid puncture is carried out in order to detect the likely spread of pathological cells to the central nervous system. This process is carried out under local anesthesia. Acquired cerebrospinal fluid is examined for the presence cancer cells;
• additional examination is performed to determine the extent of spread of the disease to other organs.

Kinds

There are 5 various classifications leukemia. One of the main criteria for differentiation is the nature of the disease.

In accordance with this classification, there are acute and chronic leukemias:

• acute leukemia. It is characterized by a very rapid movement through the body of leukocytes, no longer able to carry out their functions;
• chronic form of leukemia. In the first stages of the disease, the affected cells can still carry out their functions, which leads to asymptomatic leukemia. Therefore, chronic leukemia is mainly detected during a routine examination.

The number of abnormal cells then increases and symptoms such as enlarged lymph nodes and frequent occurrence various infections.

The difference between chronic leukemia and acute leukemia is that in patients chronic form symptoms appear only on later stages, and this causes delayed diagnosis. Acute form Leukemia is characterized by the rapid development of the disease and rapid diagnosis.

Another classification is based on the type of affected blood cells:

• chronic lymphocytic leukemia. Lymphoid cells are affected. The disease proceeds slowly and develops over a long period of time. Most often it appears in people over 50 years old; this form is rare in children;
• chronic myeloblastic leukemia. The disorder affects myeloid cells. The disease is mainly characteristic of older people;
• acute lymphoblastic leukemia. The disorder concerns lymphoid cells. The disease is characterized by rapid progression and mainly develops in children 2–4 years old. Acute lymphoblastic leukemia is especially dangerous in children under one year of age, since the child’s body is still too weak to resist the disease;
• acute myeloid leukemia. Myeloid cancer cells spread quite quickly at any age.

Treatment

Currently, the most effective treatment for leukemia is chemotherapy. Its task is to destroy cancer cells. Each type of leukemia is treated with appropriate medications.

Chemotherapy for acute leukemia consists of simultaneous administration several drugs with antitumor effects:

• drugs that are used to treat acute lymphoblastic leukemia: Vincristine, Daunorubicin, L-asparaginase or Pegasparaginase, Methotrexate, Prednisone and Cyclophosphamide;
• drugs for chemotherapy of acute myeloid leukemia: Daunorubicin, Idarubicin, Mitoxantrone and Cytosine Arabinose.

Chemotherapy for chronic leukemia may consist of one or more medicines, For example:

• combination 1 – Vincristine, Prednisone and Cyclophosphamide;
• combination 2 – “Alemtuzumab”, “Busulfan”, “Hydroxycarbamin”, “Hydroxyurea”, “Rituximab”, “Fludarabine”, “Chlorambucil” and “Cytarabine”.

Must be carried out under close medical supervision.

Forecast

The prognosis depends on the type of disease, the person’s health status and age:

• with acute lymphoblastic leukemia, about 80% of children and 50–60% of adults completely recover. Relatively good indicators are associated with the rapid development of medicine. Just 50 years ago, patients had no chance of full recovery;
• for acute myeloid leukemia, the possibility of recovery ranges from 10 to 80% and is determined by age, health status, type of molecular abnormalities and stage of the disease. Sick children and young people have a high chance of having no changes outside the bone marrow and positive results after chemotherapy. In young patients, intensive chemotherapy contributes to almost 40% of recovery, and combined with bone marrow transplantation - about 60%. In elderly patients, everything is much more complicated - only 10% of them live more than 5 years. This is due to more severe molecular and cytogenetic disorders, as well as deteriorating health;
• chronic myeloid leukemia is a very serious illness and his prognosis is disappointing. The only way, giving the opportunity full recovery, - bone marrow transplantation, preferably from a relative. In this case, about 80% of patients recover. Result drug treatment depends on the drug used;
• chronic lymphocytic leukemia. Without treatment, 1/3 of people can live up to 20 years. But it happens that the disease is aggressive and leads to death.

Despite the relatively mild course of the disease, it is difficult to achieve complete recovery. About 50% of patients live 10 years after treatment. The most common causes of death are infections (pneumonia, sepsis), bleeding, and general destruction of the body.

In all cases, a detailed prognosis is provided by the doctor, based on the appearance genetic disorders, development of the disease, age, general state health and gender.

Leukemia, also known as leukemia, leukemia - group oncological diseases hematopoietic systems that begin in the bone marrow when it produces altered leukocytes (leukemia cells). Cancer cells have a detrimental effect on healthy cells through the toxins they secrete. The hematopoietic function is impaired, a deficiency of important...

Leukemia – malignant disease, affecting the human hematopoietic system. The primary tumor can be localized in areas of bone marrow accumulation: the oncological process leads to the gradual replacement of healthy cells with pathogenic elements. As a result of this process, patients gradually change...

Acute leukemia This is a type of blood cancer, a dangerous cancer, which is sometimes also called leukemia. Leukemia occurs from undifferentiated (immature) cells in the bone marrow or blood cells. A tumor is usually formed in areas where the bone marrow is localized:...

Leukemia is a disease in which malignant changes occur in the composition of the blood. At the same time, it is saturated with blasts - abnormal cells that divide and absorb healthy cells. The reasons for their occurrence have not been fully studied by science, but most likely they are associated with mutations of leukocytes in bone tissue...

Acute myeloid leukemia (abbreviated as AML) is a disease that belongs to myeloid leukemia and develops due to the malignant growth of myeloblasts. Causes The exact causes of the disease are unknown, but most doctors associate the disease with the appearance of DNA defects in bone marrow cells....

Hairy cell leukemia is a rarely diagnosed form of leukemia. However, the vast majority of doctors consider it as independent disease, which has its own clinical picture, which does not coincide with other forms of blood cancer. The disease got its name because of the characteristic edges...

Leukemia is a malignant disease circulatory system. Its peculiarity is the uncontrolled division of leukocytes in the bone marrow and internal organs. With this disease in children, tumor tissue grows, which leads to the replacement of optimal circulatory processes. What's happened...

Chronic leukemia is, first of all, a complex pathological process during which the cells’ maturation algorithm is disrupted. Blood cancer develops slowly, on average 10-15 years. The onset of the disease itself may be imperceptible, but as it progresses it makes itself felt. Yes, and it happens in a very varied way. Delineation...

Leukemia is a group of malignant cancers that develop in the blood-forming organs (bone marrow) and cause large numbers of abnormal white blood cells (leukocytes) to be created and released into the blood. There are many types of this disease. Some of them are found mainly in...