What is uterine leukemia. Video: acute leukemia in the “Live Healthy!” program. Diagnosis of acute myeloid leukemia

Leukemia happens different types, depending on which blood cells have undergone mutation and the speed of development of the disease

Leukemia (blood cancer, leukemia, leukemia)- this group malignant diseases bone marrow, blood and lymphatic system.

Leukemia develops in the bone marrow - after all, it is in this organ that the formation of blood cells occurs: leukocytes (white blood cells), erythrocytes (red blood cells) and platelets (blood platelets).

Blood leukemia: what kind of disease is it?

Each type of cell performs its own functions. Red blood cells carry oxygen throughout our body and remove its byproduct, carbon dioxide. Platelets, by promoting blood clotting, prevent bleeding. Leukocytes protect our body from hostile microorganisms and prevent the development of infectious diseases. Therefore, it is leukocytes that are most often affected.

Causes of blood cancer (leukemia)

In a healthy body, cells first divide, develop, turn into mature cells, which regularly perform their assigned functions and after some time are destroyed, giving way to new young cells.

For unknown reasons, a mutation occurs in one of the bone marrow cells and, instead of becoming a mature leukocyte, the mutated cell becomes abnormal, cancerous. This cancer cell loses its protective function, but at the same time begins to divide uncontrollably, producing new abnormal cells.

Over time, cancer cells crowd out healthy cells from the blood. This is how leukemia develops. Penetrating into internal organs And The lymph nodes, leukemia cells become the cause of pathological changes occurring in them.

Why is this happening? Immature, young cells are most often affected by mutations. Various factors can contribute to this:

Increased radiation.
Work in hazardous industries and facilities with increased background radiation.
Hereditary predisposition.
Some congenital chromosomal diseases (for example, Down syndrome).
Long-term chemotherapy.
Smoking.
Chemical poisons contained in food or in the air.
Some viruses (for example, human immunodeficiency virus).

Under their influence, the abnormal cell begins the process of endless division, losing contact with the entire body and cloning itself. One such cell can create a population of hundreds of thousands of similar cells.

Abnormal cells, when multiplying, disrupt the process of normal division, development and functioning of healthy cells, since they deprive them of nutrition. Over time, they begin to take up too much space in the bone marrow.

When there are too many of them, cancer cells spread throughout the body through the bloodstream. They affect the heart, lymph nodes, liver, kidneys, lungs, skin, brain, forming peculiar “colonies” in them and disrupting the functioning of these organs.

To refer to this disease in medicine, the terms are used leukemia and leukemia. The name “blood cancer” is persistently used among patients, although this is an incorrect term that is not suitable for denoting diseases of the hematopoietic and circulatory system.

There are different types of leukemia, depending on which blood cells have undergone mutation and the speed of development of the disease. It can be acute or chronic.

If the disease progresses rapidly, it is acute leukemia. The tumor in this case develops from young, immature blood cells that cannot perform their assigned functions.

A chronic disease lasts a long time, since the mutated cells are still able to partially perform the functions of healthy cells and the symptoms of the disease do not appear immediately. For many years, the patient may not even realize that he has cancer.

There are often cases when chronic leukemia is discovered completely by accident, during a preventive examination, based on a blood test. Chronic leukemia develops from mature blood cells. Chronic leukemia does not occur as rapidly as acute leukemia, but over the years it inevitably progresses as it accumulates cancer cells in blood.

Depending on the type of cells damaged by the disease, different forms of leukemia are distinguished: myeloblastic, lymphoblastic and etc.

Leukemia symptoms

Very often, the first signs of the disease are no different from the symptoms of a common mild illness or cold. The patient may experience:

Increased weakness.
Fast fatiguability.
Irregular and unconditional rises in body temperature (to low values).
Increased sweating at night.
Frequent headaches.
Sudden weight loss.
Paleness of the skin.
Lack of appetite (up to the appearance of aversion to food and certain odors).
Frequent infectious diseases.

This is a group of nonspecific symptoms that do not alarm patients and do not give them a reason to see a doctor. But the next group of signs should already alert others, since they are impossible not to notice.

Frequent bruising.
Constant nosebleeds.
Pain in joints and bones.
Dry skin with icteric discoloration.
Increased sleepiness.
Excessive irritability.
Minor rash on the skin.
Increased bleeding of mucous membranes.
Problems with urination (difficult or reduced).
Deterioration of vision.
Poor healing of skin wounds.
The appearance of shortness of breath.
Enlarged lymph nodes. Often under the patient’s skin in the area of natural folds (in armpits ah and in the groin), dense, painless nodes may form on the neck, above the collarbones. If these formations are detected, an immediate visit to a doctor is required, who will give a referral for a blood test and ultrasound examination of the inflamed lymph nodes. Depending on the results obtained, the doctor will refer the patient to an oncologist, hematologist or surgeon.

The signs listed below indicate that the disease has already advanced.

Sharp enlargement of the spleen and liver.
Bloating (and increase in size), a feeling of heaviness in the hypochondrium.

How is leukemia determined?

To detect leukemia it is prescribed the following examinations and tests:

General blood analysis . Very often, leukemia is discovered accidentally, based on a test taken during preventive examination. Leukemia results in a very high white blood cell count, decreased hemoglobin and low platelet count in the blood.
Bone marrow aspiration – extraction of bone marrow cells for subsequent study under a microscope in the laboratory. Using a special needle, the doctor reaches the bone marrow by piercing the outer layer of the bone. In this case, it applies local anesthesia.
Bone marrow biopsy - another way to examine bone marrow cells. The essence of the procedure is to extract a small piece of bone along with bone marrow. The biopsy is performed under local anesthesia.

The resulting material is studied under a microscope. Biopsy and aspiration are not interchangeable procedures. Sometimes the patient is prescribed both. Aspiration and biopsy can not only confirm the diagnosis of leukemia, but also determine its type (since it is possible to accurately determine what type of cells are involved in the oncological process).

Genetic examination (cytogenetics) is the study of chromosomes in leukemic blood cells. This type of examination allows you to clarify the type of leukemia.
Cerebrospinal fluid puncture carried out to determine whether leukemia has spread to the central nervous system. The puncture is carried out with a long thin needle, which is inserted between the vertebrae ( lumbar region) spine. In this case, local anesthesia is used. The extracted cerebrospinal fluid is examined for the presence of cancerous blood cells.
X-ray chest, Ultrasound of organs abdominal cavity, biochemical analysis blood help determine the extent to which leukemia has spread to other organs.

How is leukemia treated?

Treatment for leukemia depends on what type it is. Some types are more successfully treated, others are almost impossible to treat, so treatment tactics vary in each specific case.

For the treatment of chronic leukemia, supportive tactics are usually chosen, with the goal of delaying or preventing the development of complications. Maintenance treatment for leukemia includes taking hormonal drugs, general strengthening agents, antibacterial and antiviral therapy to prevent infections.

Acute leukemia requires immediate medical intervention. Treatment consists of a large number of medications taken in large doses (called chemotherapy) and radiotherapy.

In some cases, immune suppression tactics are used, which allows the body to get rid of leukemia cells with further transplantation of healthy ones donor cells. Bone marrow transplantation can be performed either from a donor or from the patient himself. The patient's relatives can be recruited as donors. If incompatibility is detected, the search for a donor is carried out via the Internet.

Treatment is carried out in the hematology department. Patients are placed in separate boxes to prevent infection from outside.

How long do women, men, children with blood cancer (leukemia) live?

The incidence of leukemia ranges from 3-10 people per 100,000 population. Men get sick more often than women (1.5 times). Most often, chronic leukemia develops in patients aged 40-50 years, acute - in adolescents 10-18 years old.

Acute leukemia (without treatment) often ends in the death of patients, however, if treatment was started in a timely manner and carried out correctly, the prognosis is favorable (especially for children). Acute lymphoblastic leukemias are running out recovery of patients in 85-95% cases.

Acute myeloblastic leukemia is curable with a probability of being cured in 40-50% case. The use of stem cell transplantation increases this percentage to 55-60% .

Chronic leukemia progresses slowly. A patient (woman) may not suspect for years that she (he) has blood cancer. If chronic leukemia enters the blast crisis stage, it becomes acute. Life expectancy of patients in this case does not exceed 6-12 months . Death during blast crisis occurs from complications.

If the treatment chronic leukemia carried out correctly and started in a timely manner, it is possible to achieve stable remission for long years. When using chemotherapy average duration lives of men and women with blood cancer amounts to 5-7 years .

Leukemia (syn. leukemia, lymphosarcoma or blood cancer) is a group of tumor diseases with characteristic uncontrolled growth and various etiologies. Leukemia, the symptoms of which are determined based on its specific form, occurs with gradual replacement normal cells leukemic, against which they develop serious complications(bleeding, anemia, etc.).

general description

IN in good condition cells in the body are subject to division, maturation, performance of functions and death in accordance with the program that is embedded in them. After the death of cells, their destruction occurs, after which new, young cells appear in their place.

As for cancer, it implies a violation in the program of cells regarding their division, life and functions, as a result of which their growth and reproduction occur beyond any control. Leukemia is essentially a cancer that affects bone marrow cells—cells that healthy person are the beginning for blood cells (leukocytes and erythrocytes (white and red blood cells), platelets (blood platelets).

Leukocytes (aka white blood cells) blood cells, white blood cells). The main function is to provide protection for the body from the effects of foreign agents, as well as direct participation in the fight against processes associated with infectious diseases.
Red blood cells (aka red blood cells, red blood cells). IN in this case the main function is to ensure the transfer of oxygen and other types of substances to the tissues of the body.
Platelets (aka blood platelets). Their main function is to participate in the process that ensures blood clotting. It should be noted the importance of this function for the blood as it is considered in the form of a protective reaction necessary for the body in case of significant blood loss, accompanying defeat vessels.

People who have developed blood cancer are faced with disruptions in the processes occurring in the bone marrow, due to which the blood is saturated with a significant number of white blood cells, that is, leukocytes, deprived of the ability to perform their inherent functions. Cancer cells, unlike healthy cells, do not die in due time - their activity is focused on circulation through the blood, which makes them a serious obstacle to healthy cells, whose work, accordingly, becomes more complicated. This, as is already clear, leads to the spread of leukemia cells in the body, as well as to their entry into organs or lymph nodes. In the latter case, such an invasion provokes an enlargement of the organ or lymph node, and in some cases pain may appear.

Leukemia and leukemia are synonyms for each other, indicating, in fact, blood cancer. Both of these definitions act as the correct name for the disease relevant to their processes. As for blood cancer, this definition is not correct in terms of considering it from medical point vision, although it is this term that has become the most widespread in use. More correct name for blood cancer is hemoblastosis, which means a group of tumor formations formed on the basis of hematopoietic cells. A tumor formation (the tumor itself) is an actively growing tissue that is little subject to control by the body; in addition, this formation is not the result of the accumulation of unmetabolized cells in it or the result of inflammation.

Hemoblastoses, the tumor cells of which damage the bone marrow, are defined as leukemias or lymphomas. Leukemias differ from lymphomas in that, firstly, some of them have systemic damage (leukemia), while others do not have it (lymphomas). The terminal (final) stage of lymphoma is accompanied by metastasis (which also affects the bone marrow). Leukemia means primary lesion bone marrow, while lymphomas affect it secondarily, as a result of metastases. Considering the fact that leukemia is determined primarily by the presence of tumor cells in the blood, the term “leukemia” is used in the designation of leukemia.

To summarize the general description of the disease, let us highlight its features. Thus, blood cancer refers to a tumor that develops on the basis of a single cell directly related to the bone marrow. This implies an uncontrolled and constant division of it, occurring within a certain time interval, which can range from several weeks to several months.

In this case, as already noted, a concomitant process is the displacement and suppression of other blood cells, that is, normal cells (suppression determines the effect on their growth and development). Symptoms of blood cancer, taking into account these features of the impact, will be closely related to the lack of one or another type of normal and active cells. The tumor, as such, does not exist in the body with blood cancer, that is, it will not be possible to see it, which is explained by its certain “dispersion” throughout the body, this dispersion is ensured by the blood flow.

Classification

Based on the aggressiveness inherent in the course of the disease, acute forms of leukemia and chronic forms are distinguished.

Acute leukemia implies the detection of a significant number of immature cancer cells in the blood; these cells do not perform their functions. Symptoms of leukemia in this case appear quite early, and the disease is characterized by rapid progression.

Chronic leukemia determines the ability of cancer cells to perform the functions inherent in them, due to which for a long time symptoms of the disease do not appear. Detection chronic leukemia often occurs randomly, for example, as part of a preventive examination or when it is necessary to study the patient’s blood for one purpose or another. The course of the chronic form of the disease is characterized by less aggressiveness compared to its acute form, but this does not exclude its progression due to the constant increase in the number of cancer cells in the blood.

Both forms have important feature, it lies in the fact that contrary to the scenario of many diseases, the acute form never becomes chronic and the chronic form can never worsen. Accordingly, definitions such as “acute” or “chronic” form are used only for the convenience of attributing the disease to a specific scenario of its course.

Depending on the specific type of leukocytes involved in the pathological process, the following types of leukemia are distinguished:

Chronic lymphocytic leukemia (or chronic lymphocytic leukemia, lymphocytic chronic leukemia) – is a type of blood cancer that is accompanied by impaired division of lymphocytes in the bone marrow and impaired maturation.
Chronic myelocytic leukemia (or chronic myeloid leukemia, myelocytic chronic leukemia) – This type of blood cancer, the course of which leads to disruption of the division of bone marrow cells and disruption of their maturation, and these cells in this case act as younger forms of red blood cells, platelets and leukocytes.
Acute lymphoblastic leukemia (or acute lymphocytic leukemia, lymphoblastic acute leukemia) – The course of blood cancer in this case is characterized by a violation of the division of lymphocytes in the bone marrow, as well as a violation of their maturation.
Acute lymphoblastic leukemia (or acute myeloid leukemia, myeloblastic acute leukemia) – in this case, blood cancer is accompanied by a violation of the division of bone marrow cells and a violation of their maturation; these cells act as younger forms of red blood cells, platelets and leukocytes. Based on the type of cells involved in the pathological process, as well as the degree of disruption of their maturation, the following types of course of this form of cancer are distinguished:

leukemia without concomitant cell maturation;
leukemia, in which cell maturation does not occur fully;
promyeloblastic leukemia;
myelomonoblastic leukemia;
monoblastic leukemia;
erythroleukemia;
megakaryoblastic leukemia.

Causes of Leukemia

What actually causes leukemia is currently unknown. Meanwhile, there are certain ideas on this matter, which may well contribute to the development of this disease. In particular these are:

Radiation exposure: It is noted that those people who have been exposed to significant amounts of radiation are at greater risk of acquiring acute myeloid leukemia, acute lymphoblastic leukemia or chronic myelocytic leukemia.
Smoking.
Prolonged contact with benzenes, widely used in the chemical industry, as a result of exposure to which, the risk of developing certain types of leukemia increases. By the way, benzenes are also found in gasoline and cigarette smoke.
Down syndrome, as well as a number of other diseases with concomitant chromosomal abnormalities, all of this can also provoke acute leukemia.
Chemotherapy for certain types of cancer can also cause the development of leukemia in the future.
Heredity, this time, does not play a significant role in the predisposition to the development of leukemia. It is extremely rare in practice to encounter cases in which several family members develop cancer in a manner characteristic of identifying heredity as the factor that provoked it. And if it happens that such an option actually becomes possible, then it mainly implies chronic lymphocytic leukemia.

It is also important to note that if you have determined, based on the listed factors, your risk of developing leukemia, this is not at all a reliable fact for you to necessarily develop it. Many people, even if they simultaneously note several relevant factors listed above, do not encounter the disease.

Leukemia: symptoms

The manifestations of symptoms accompanying the disease we are considering, as we initially noted, are determined from the characteristics and extent of the spread of cancer cells, as well as from their total number. Chronic leukemia within early stage, for example, is characterized by a small number of cancer cells, which for this reason may long time be accompanied by an asymptomatic course of this disease. In the case of acute leukemia, which we also noted, the symptoms manifest themselves early.

Let us highlight the main symptoms that accompany the course of leukemia (in acute or chronic form):

enlarged lymph nodes (mainly those concentrated in the armpits or neck), pain in the lymph nodes with leukemia, as a rule, is absent;
increased fatigue, weakness;
susceptibility to the development of infectious diseases (herpes, bronchitis, pneumonia, etc.);
elevated temperature (without accompanying factors), increased sweating at night;
joint pain;
enlargement of the liver or spleen, against which, in turn, may develop expressed feeling heaviness in the area of the right or left hypochondrium;
disorders associated with blood clotting: bruising, nosebleeds, red dots appearing under the skin, bleeding gums.

Against the background of the accumulation of cancer cells in certain areas of the body, the following symptoms appear:

confusion;
dyspnea;
headache;
nausea, vomiting;
impaired coordination of movements;
blurred vision;
convulsions in certain areas;
the appearance of painful swelling in the groin area and upper extremities;
pain in the scrotum, swelling (in men).

Acute lymphoblastic leukemia: symptoms

Leukemia in children, the symptoms of which most often manifest themselves in this form of the disease, mainly develops between the ages of 3-7 years; moreover, it is among children that this disease, unfortunately, has become most widespread. Let us highlight the main symptoms relevant for ALL:

Intoxication. It manifests itself in malaise, weakness, fever, and weight loss is also noted. Fever can be triggered by an infection (viral, bacterial, fungal or protozoal (which is somewhat less common)).
Hyperplastic syndrome. Characterized by actual enlargement of peripheral lymph nodes of all groups. Due to infiltration of the spleen and liver, they increase in size, which may also be accompanied by abdominal pain. Leukemic infiltration of the periosteum in combination with tumor enlargement to which the bone marrow is exposed can cause aching sensations and joint pain.
Anemic syndrome. Manifests itself in the form of symptoms such as weakness, pallor, tachycardia. In addition, bleeding gums appear. Weakness is a consequence of intoxication and anemia itself.
Initial change in testicular size (enlargement). Occurs in about 30% of cases of primary form of ALL in boys. Infiltrates (areas of tissue within which cellular elements are formed that are not characteristic of them, with a characteristically increased volume and increased density) can be unilateral or bilateral.
Hemorrhages in retina, swelling of the optic nerve. In this case, ophthalmoscopy can often reveal the presence of leukemic plaques within the fundus.
Respiratory disorders. They are caused by enlargement of the lymph nodes within the mediastinum, which, in turn, can provoke respiratory failure.
In view of reduced immunity damage of any type, regardless of the intensity of exposure, area and nature of the lesion, forms a focus of infection on the skin.

As rather rare manifestations, but not excluded for this reason, complications such as kidney damage developing against the background of infiltration are distinguished, and clinical symptoms in this case it may be absent.

Acute myeloblastic leukemia: symptoms

This disease can manifest itself at any age, but most often it is diagnosed in patients over 55 years of age. Mostly, the symptoms characteristic of acute myeloid leukemia manifest themselves gradually. The earliest sign of the disease is malaise, and it can appear several months before the rest of the symptoms manifest themselves.

The symptoms of this disease are inherent in the previous form of leukemia and leukemia in general. So, here the anemic and toxic syndromes which manifests itself in dizziness, severe weakness, increased fatigue, poor appetite, as well as in fever without accompanying catarrhal symptoms (that is, without specific factors that provoke it: viruses, infections, etc.).

In most cases, the lymph nodes do not change particularly; they small sizes, painless. Their enlargement is rarely observed, which can determine their size within 2.5-5 cm, with the accompanying formation of conglomerates (that is, in this case, the lymph nodes are fused to each other in such a way that a characteristic “lump” appears), concentrated within the cervical region. supraclavicular area.

The osteoarticular system is also characterized by some changes. So, in some cases this means persistent pain that occurs in the joints lower limbs, as well as pain concentrated along spinal column, resulting in disturbances in gait and movement. Radiographs in this case determine the presence of destructive changes in various areas localization, the phenomenon of osteoporosis, etc. Many patients experience a certain degree of enlargement of the spleen and liver.

Again, general symptoms are relevant in the form of susceptibility to infectious diseases, the appearance of bruises with minor bruises or no impact at all, bleeding of various specifics (uterine, gum, nasal), weight loss and pain in the bones (joints).

Chronic myelocytic leukemia: symptoms

This disease is predominantly diagnosed in patients aged 30-50 years, and in men the disease occurs somewhat more often than in women, while in children it appears rarely.

Within early stages During the course of the disease, patients often complain of decreased performance and increased fatigue. In some cases, progression of the disease may occur only after about 2-10 years (or even more) from the moment the diagnosis was made.

In this case, the number of leukocytes in the blood increases significantly, which occurs mainly due to promyelocytes and myelocytes. At rest, as well as during exercise, patients experience shortness of breath.

There is also an enlargement of the spleen and liver, resulting in a feeling of heaviness and pain in the left hypochondrium. Severe blood thickening can provoke the development of splenic infarction, which is accompanied by increased pain in the left hypochondrium, nausea and vomiting, and increased temperature. Against the background of blood thickening, the development of disorders associated with blood supply cannot be ruled out; this, in turn, manifests itself in the form of dizziness and severe headaches, as well as in the form of impaired coordination of movements and orientation.

The progression of the disease is accompanied by typical symptoms: pain in the bones and joints, susceptibility to infectious diseases, weight loss.

Chronic lymphocytic leukemia: symptoms

The disease may not manifest itself for a long time, and its progression can last for years. In accordance with the progression, the following characteristic symptoms are noted:

Enlarged lymph nodes (for no reason or against the background of current infectious diseases such as bronchitis, tonsillitis, etc.).
Pain in the right hypochondrium resulting from an enlarged liver/spleen.
Exposure frequent appearance infectious diseases due to decreased immunity (cystitis, pyelonephritis, herpes, pneumonia, herpes zoster, bronchitis, etc.).
The development of autoimmune diseases against the background of disturbances in the functioning of the immune system, which consists in the fight immune cells an organism with cells belonging to the organism itself. Due to autoimmune processes, platelets and red blood cells are destroyed, nosebleeds, bleeding gums appear, jaundice develops, etc.

Lymph nodes in this form of the disease correspond to their normal parameters, but their enlargement occurs when the body is exposed to certain infections. After the source of infection is eliminated, they are reduced back to their normal state. The enlargement of the lymph nodes mainly begins gradually; changes are mainly observed primarily in the cervical lymph nodes and the lymph nodes of the armpits. Next, the process spreads to the mediastinum and abdominal cavity, as well as to the groin area. This is where symptoms common to leukemia begin to appear in the form of weakness, increased fatigue and sweating. There is no thrombocytopenia even during the early stages of the disease.

Diagnosis

The diagnosis of leukemia can be established solely on the basis of blood test results. In particular this general analysis, through which you can get a preliminary idea of the nature of the disease.

For the most reliable result The data obtained during the puncture are used to determine the relevance of leukemia. Bone marrow puncture involves making a puncture pelvic bone or area of the sternum using a thick needle, during which a certain amount of bone marrow is removed for subsequent examination using a microscope. A cytologist (a specialist who examines the results of this procedure under a microscope) will determine the specific type of tumor, the degree of its aggressiveness, as well as the volume covered by the tumor lesion.

In more complex cases, a biochemical diagnostic method is used, immunohistochemistry, with the help of which, based on the specific amount of a particular type of protein in a tumor, it is possible to almost 100% determine its inherent nature. Let us explain the importance of determining the nature of the tumor. Our body simultaneously has many cells that are constantly growing and developing, on the basis of which we can come to the conclusion that leukemia can be relevant in its most varied variations. Meanwhile, this is not entirely true: those that occur most often have already been sufficiently studied for a long time, however, the more advanced the methods for diagnosing, the more about possible options We recognize the varieties, and the same applies to their quantity. The difference between tumors determines the properties characteristic of each variant, which means that this difference also concerns the sensitivity to the therapy applied to them, including in combined types of its use. Actually, for this reason, it is important to determine the nature of the tumor, on the basis of which it will be possible to determine the optimal and most effective option treatment.

Treatment

Treatment of leukemia is determined based on a number of factors associated with it, its type, stage of development, the patient’s overall health and age. Acute leukemia requires immediate initiation of treatment, due to which it will be possible to stop the accelerated growth of leukemia cells. It is often possible to achieve remission (often the condition is defined this way, and not “recovery,” which is explained by the possible return of the disease).

As for chronic leukemia, it is extremely rarely cured to the stage of remission, although the use of certain therapy for it makes it possible to control the course of the disease. As a rule, treatment for chronic leukemia begins from the moment symptoms appear, while chronic myeloid leukemia in some cases begins to be treated immediately after diagnosis.

The main methods of treating leukemia are the following:

Chemotherapy. The appropriate type of medications are used, the action of which allows you to destroy cancer cells.
Radiotherapy or radiation therapy. The use of certain radiation (X-ray, etc.), which makes it possible to destroy cancer cells; in addition, the spleen/liver and lymph nodes that have become enlarged due to the processes of the disease in question are reduced. In some cases, this method is used as a preliminary procedure for stem cell transplantation, more about it below.
Stem cell transplantation. Through this procedure, it is possible to restore the production of healthy cells while improving the functioning of the immune system. The procedure preceding the transplantation may be chemotherapy or radiotherapy, the use of which allows you to destroy a certain number of bone marrow cells, as well as free up space for stem cells and weaken the effect of the immune system. It should be noted that achieving the latter effect is important for this procedure, otherwise the immune system may begin to reject the cells transplanted into the patient.

Forecast

Each type of cancer is effectively (or ineffectively) treatable in its own way; accordingly, the prognosis for each of these types is determined based on consideration of the complex picture of the disease, a specific course and associated factors.

Acute lymphoblastic leukemia and its prognosis in particular are determined based on the level of leukocytes in the blood when this disease is detected, as well as on the correctness and efficiency of therapy for it and the age of the patient. Children from 2 to 10 years old often achieve long-term remission, which, as we have already noted, if not full recovery, then, at a minimum, it defines a condition with no symptoms. It should be noted that the more leukocytes in the blood when diagnosing the disease, the less likely full recovery.

For acute myeloid leukemia, the prognosis is determined depending on the type of cells that are involved in the pathological course of the disease, the age of the patient and the correctness of the prescribed therapy. Standard modern treatment regimens determine about 35% of survival rates over the next five years (or more) for adult patients (up to 60 years). In this case, a trend is indicated in which the older the patient, the worse the prognosis for survival. Thus, patients over 60 years of age can only live five years from the moment their disease is diagnosed in only 10% of cases.

The prognosis for chronic myeloid leukemia is determined by the stage of its course; it progresses at a somewhat slower rate compared to acute leukemia. About 85% of patients with this form of the disease experience a significant deterioration in their condition 3-5 years after its discovery. In this case, it is defined as a blast crisis, that is, the last stage of the disease, accompanied by the appearance of a significant number of immature cells in the bone marrow and blood. The timeliness and correctness of the applied therapy measures determine the patient’s survival rate within 5-6 years from the moment this form of the disease is detected. The use of modern therapeutic measures determines a high chance of survival, reaching 10 years and sometimes more.

As for the prognosis for chronic lymphocytic leukemia, survival rates vary somewhat. Thus, some patients die within the next 2-3 years from the moment their disease is diagnosed (which occurs as a result of the development of complications in them). Meanwhile, in other cases, survival is determined to be at least 5-10 years from the moment the disease is detected; moreover, it is possible that these indicators may be exceeded until the disease enters the terminal (final) stage of development.

Joseph Addison

With the help of exercise and abstinence, most people can do without medicine.

Which doctor should I contact?

If you suspect a disease such as Leukemia, you should consult a doctor:

Every year, for every million inhabitants, there are 35 patients with leukemia, 5 of whom are children.

Leukemia (leukemia) is a cancer of blood-forming cells.

One immature cell, transformed into a pathological one, begins to multiply uncontrollably. This is how the disease begins to develop.

Leukemia is classified depending on how quickly the disease progresses and the type of cells affected.

The treatment process is difficult. Treatment methods are selected individually, depending on the type of leukemia.

Definition

Leukemia– oncological disease of hematopoietic cells. The beginning of this disease is laid by a single cell that has become leukemic as a result of abnormalities. Gradually, such a cell undergoes a number of changes and becomes malignant. It continuously produces malignant mature daughter cells and cells that remain immature.

In order to understand the essence of this disease, it will be useful to know how blood is formed, what types of blood cells exist, and what happens during leukemia.

Another factor underlying the classification of leukemia is the type of cells affected. If pathological changes affected lymphocytes, this is lymphoid (or lymphocytic) leukemia. In myeloid leukemia, myeloid cells are affected.

Thus, there are four types of leukemia:

Acute lymphocytic leukemia (ALL) most often occurs in children, but also affects adults.

Acute myeloid leukemia (AML) is common among children and adults. Sometimes this form of the disease is also called acute nonlymphocytic leukemia. AML is further divided into subgroups based on the type of myeloid cells and whether any chromosomal mutations are present. Treatment of acute promyelocytic leukemia differs significantly from treatment of other types of AML.

Chronic lymphocytic leukemia (CLL) occurs primarily in people over 55 years of age. In some cases, the patient's age may be younger. Children rarely get this type of leukemia.

Chronic myeloid leukemia (CML) primarily affects adults. It is observed only in a small number of children. CML was the first malignant blood disease to be identified. Due to the presence of leukocytes in the blood, this disease is called “leukemia” from the Greek. leuk – white and aemia – blood (literally “white blood”).

Other less common types of chronic leukemia (also called chronic lymphoproliferative conditions) include hairy cell leukemia, prolymphocytic leukemia, adult T-cell leukemia (lymphoma), Sezary reticulosis, chronic myelomonocytic leukemia, leukemia of large granular lymphocytes and leukemia mast cells. These varieties will not be described in this article. But many of the principles outlined here can be applied to them.

Causes

Unfortunately, it is impossible to determine the cause of this disease in most patients. But still, medicine knows some of the culprits of leukemia:

exposure to radiation (the tragedies of Chernobyl, Hiroshima and Nagasaki). People who have been exposed to large doses of radiation during other types of radiation therapy cancer, have a high chance of acquiring leukemia;

Taking certain medications used during chemotherapy may increase the risk of acute myeloid leukemia;

as a factor increased risk some viruses appear. Epstein-Bappa virus contributes to the development of lymphocytic leukemia. But only a small proportion of people infected with the virus get leukemia.
pre-existing blood disorders such as myelodysplasia (congenital spinal cord underdevelopment) and aplastic anemia;

heredity. Down syndrome often predicts the development of acute myeloid leukemia.

Symptoms

Thus, there is a failure in the creation of cell lines and disruption of their functions:

Leukemia cells are abnormal cells that cannot perform the functions of healthy cells. They do not fight infections. Therefore, people with leukemia often get infections and colds.

Such cells crowd out normal hematopoietic cells. The consequence of this is a decrease in red blood cells (erythrocytes) and platelets. As you know, red blood cells transport oxygen, and a lack of these important blood components leads to the development of anemia in patients characteristic features which are pallor and fatigue. A lack of platelets also has serious consequences: bleeding and random bruising.

Leukemia has the following symptoms:

Fever, chills, sore throat and other cold symptoms

Weakness and fatigue

Susceptibility to infections

Loss of appetite and/or weight

Painful, swollen lymph nodes, liver, or spleen

Bleeding and bruising from the slightest touch

Small red spots under the skin (called pinpoint hemorrhage or petechiae)

Swollen and bleeding gums

Sweating, especially at night

Joint or bone pain

different organs

If the number of white blood cells is extremely high, the blood becomes thick and has the consistency of syrup. Because of this acquired property of the blood, less oxygen is carried to organs, including the brain. Patients whose blood contains such a high level of leukocytes suffer from forgetfulness, clouding of consciousness, lethargy, drowsiness, and may even become a victim of a stroke. This condition requires immediate treatment.

When should you see a doctor?

Hard case

You should visit your doctor's office if:

sore throat lasts more than one or two weeks;

for some unknown reason, the gums, nose, eyes are bleeding, blood has appeared in the urine and feces, on the skin;

frequent infectious diseases, unexplained fever and sweating;

lymph nodes do not go away within two weeks;

feeling unusually tired or lacking energy;

you suddenly lost weight.

Most patients who experience these problems do not have leukemia. But, if this malignant blood disease is still present, and the person does not even suspect it, its insidious manner of manifestation can lead to an erroneous diagnosis.

Diagnostics

detailed history

Special attention

A blood test plays an important role in diagnosing leukemia. The blood sample is examined under a microscope to study what the cell looks like and to determine the number of mature cells and blasts. A blood test can detect leukemia in a patient, but it is impossible to accurately determine the type of this disease.

To further study the leukemia cells or determine the type of leukemia, a hematologist, oncologist, or pathologist performs a bone marrow biopsy. The doctor inserts a needle into a large bone (usually the pelvis) and removes a small amount of bone marrow, which is a liquid. This material is a sample. The medical term for the procedure is bone marrow aspiration. A biopsy is done with a larger needle, and a small part of the bone and bone marrow is removed. Sampling is usually carried out under local anesthesia, usually with a sedative (calming) effect.

The bone marrow is then examined under a microscope. If leukemia is detected in the bone marrow sample, further tests are performed to determine the type of leukemia. The patient's attending physician prescribes various tests that will show the extent of the disease. A lumbar puncture (known as a lumbar puncture) is done to look for leukemia cells in the cerebrospinal fluid (ie the fluid that fills the cavities of the brain and spinal cord). Fluorography can help detect signs of disease in the breast.

Treatment

Acute forms of this disease require immediate treatment. Its goal is to achieve remission. More needed intensive therapy which will prevent the disease from returning. Many people with acute leukemia can be cured. However, this radical treatment It’s quite difficult to bear physically and psychologically. Palliative treatment, which is aimed at alleviating the patient’s condition (this is also called supportive therapy), can provide good quality life for many months for some patients, particularly older patients whose chances of overcoming the disease are lower.

People with chronic types of leukemia may not need treatment emergency treatment. But it is necessary to be examined regularly in order to determine the moment when it is worth starting treatment. Therapy is usually carried out on an outpatient basis and may be limited to taking a few tablets per day. It should be noted that treatment in this case serves as disease control and is not intended to cure a person of leukemia. Defeat this insidious disease possible in most cases with the help of bone marrow transplantation. But for a number of reasons, only a few patients are suitable for such surgery.

The diagnosis of “leukemia” is perceived by a person as a bolt from the blue. Therefore, the support of family and friends is very important during this time. difficult period life. Doctors and nurses provide information and answer questions from people who are nearby at such a moment. It can be helpful to make a list of questions you want to ask your doctor. As often happens, people do not remember all the information the first time. Doctors understand this, so they repeat it if necessary. You can get additional information from booklets and the Internet.

Treatment methods

biological therapies

For patients who need repeated courses of intravenous chemotherapy, the doctor may suggest inserting a semi-permanent catheter (also known as a Hickman catheter) into a vein. This is a thin plastic tube that is inserted into a vein in the neck or chest. Painful sensations occur immediately after installation of the catheter, but quickly pass. The patient may receive injections, have blood tests taken, and receive blood transfusions through this flexible tube. It allows you to avoid marks from injections and IVs on your hands.

In treatment acute leukemia Chemotherapy of the cerebrospinal fluid (CSF) surrounding the brain and spinal cord plays an important role. Intravenous and oral drug therapy helpless because medications will not be able to reach this fluid due to the blood-brain barrier - the body's defense mechanism that protects the brain. Therefore, doctors administer medications intrathecally (which means directly into the cerebrospinal fluid) by lumbar punctures. Since all chemotherapy is accompanied by high toxicity, doctors break it into courses, after which the patient is given time to recover from side effects and his immune system to recover. In some cases, the patient is admitted to the hospital for treatment.

When carrying out radiotherapy, also called radiation therapy, high-energy rays are used (which, in particular, include X-rays), stopping the growth and reproduction of cancer cells. Radiation is given to an organ (such as the spleen) or the entire body, usually before a bone marrow transplant.

Biological therapy, or immunotherapy, involves the use of substances that affect the body's immune system's ability to destroy cancer cells. There are two types of this method of fighting leukemia: therapy using interferons, which stimulate the immune system to destroy cancer cells, and monoclonal antibodies, binding the cancer cell and helping the body’s defense mechanism to recognize it. The described method is usually used to treat chronic types leukemia.

In preparation for the transplant, the patient's bone marrow is subjected to powerful chemotherapy and radiation to kill leukemia cells. Currently, some medical centers prefer to transplant stem cells from a donor's peripheral blood. The donor's new bone marrow recognizes leukemia cells and kills them. This mechanism is called the graft-versus-leukemia effect. A few days before the transplant, the patient's bone marrow is destroyed and then replaced with new marrow. Healthy bone marrow is introduced into the blood through special bag, as with a blood transfusion through an IV. New bone marrow cells travel through the blood into the bones and begin to grow. It may take several weeks before the transplanted brain can produce enough cells to fight infection and stop bleeding. During this time, the patient should remain in the hospital to avoid infection. various infections and be under the constant supervision of specialists who will ensure that he does not bleed.

Healthy bone marrow cells are taken from a donor or the patient before treatment with high doses of radiation. Donors are most often a sibling or a volunteer from the bone marrow donor registry.

Bone marrow donation

general anesthesia

A needle is inserted into a vein in the arm, some blood is pumped out, and it is placed in a machine that separates the resulting blood into plasma and other types of blood cells. Young cells are kept separately, and all other components (plasma and the main part of the cells) are returned to the donor in the same way, i.e. insert a syringe with the same or a new needle into a vein of the other arm. This procedure is done many times and lasts several hours. After its successful completion, the donor can go home and not worry about his well-being.

The donor's bone marrow contains reserve potential and functions normally after blood donation. Not everyone can fulfill this noble mission, since a necessary condition is the compatibility of the bone marrow of the donor and the patient. There is a 25 percent chance that a sibling's cells will be suitable for transplantation. If the patient does not have relatives whose bone marrow is suitable for transplantation, it is possible to find the right person from the bone marrow donor registry. The registry is a list of residents of the country who have expressed their desire to become donors of their bone marrow if it turns out to be compatible.

Maintenance treatment

infectious diseases

serious consequences

Anemia and bleeding are nothing new for people diagnosed with leukemia. To treat them, transfusions of platelets and red blood cells are given.

Side effects of treatment

normal tissues

side effects

As a rule, chemotherapy is aimed at destroying rapidly multiplying cells. Because cancer cells tend to divide very actively. Unfortunately, the body also contains healthy cells that divide rapidly: these are cells in the mucous membrane of the mouth and pharynx, sperm-producing cells in the testicles, cells in the hair roots and healthy bone marrow cells.

The medications and dosage determine which normal cells are affected. A side effects, which then appear, in turn, are determined by the degree of damage to healthy cells. For example, if chemotherapy affects the hair root cells, they may fall out. But hair loss is not always expected as a result of chemotherapy. In many cases, the drugs attack the stomach lining and cause nausea, loss of appetite, and even vomiting.

Most side effects go away during rehabilitation. Sometimes, as a result of the use of drugs, the skin becomes particularly sensitive to sunlight and does not lose it after the recovery period. Therefore, it is necessary to consult a doctor before going out in the sun.

If chemotherapy has an adverse effect on the testicles, men may stop producing sperm. However, to their delightful surprise, expectant fathers discovered that the testicles could regain their function. Because you can't predict what the side effect will be, many men choose to donate their semen to a sperm bank if they want to have children in the future.

Women's ovaries may also be affected. Menopause-like changes occur, with characteristic hot flashes and irregular menstrual cycles. In such cases, hormone replacement therapy (HRT) is prescribed as a temporary or permanent measure if the ovaries do not recover. Most children treated for leukemia have no problems conceiving when they grow up. But again, it all depends on the medication, dosage and whether radiotherapy was used.

Patients exposed to radiation often experience hair loss. The scalp or area of skin exposed to radiation may become red, sore, and itchy. Applying lotions and creams can only make the situation worse. Therefore, it is necessary to talk to your doctor before applying any products to the area.

Other side effects of radiotherapy may include nausea and loss of appetite. Modern powerful anti-nausea medications will come to the rescue. After radiation therapy, patients feel very tired. They need more rest than before. Don't forget about physical exercise. They will help maintain muscle tone and the body as a whole. good condition. Some side effects either do not go away or go away after a long period of treatment.

Children (especially young children) who have undergone radiation treatment to the brain may have difficulty learning and coordinating. Taking this into account, doctors use the lowest possible doses of radiation and only when chemotherapy does not produce positive results. Moreover, there is a possibility that radiotherapy to the testicles may affect reproductive function and the process of hormone release. Many boys treated in this way will subsequently be unable to have children. Some may need to take hormones that help normal growth and development.

Patients who have a bone marrow transplant usually experience more side effects than they might have had before the surgery. This is explained by the fact that preoperative treatment is more intense. In addition, there is the possibility of developing secondary disease or graft-versus-host disease (GVHD), especially if the bone marrow was donated. This condition occurs because immunocompetent cells the transplant reacts against the patient's tissues (often the liver, skin and digestive tract are affected).

GVHD can occur in mild to very severe forms at any time after transplant surgery (even years later). New drugs reduce the risk of developing this condition and are used to treat the consequences if they occur.

Nutrition

bad feeling

Eating well means getting enough calories to maintain weight and regain strength. Patients who eat well during cancer treatment tend to feel better and more energetic. They can cope with the side effects of therapy (which is important). Doctors, nurses, and dietitians can teach you about healthy eating during cancer treatment.

Follow-up of patients with leukemia

As a result of cancer treatment, side effects may occur many years later. For this reason, patients should have regular checkups and report any changes or problems in their health status to their doctor without delay.

Psychological support

Parents of children with leukemia worry about whether their children will be able to be full participants in school and social life. Children themselves may be frustrated by not being able to spend as much time with friends as before.

People who learn about their terrible diagnosis are often overwhelmed by worries about tests, treatment methods, hospital stays and payment for medical care. Doctors, nurses and other staff can respond to exciting questions and recommend specialists who can help solve specific problems.

Leukemia (leukemia, blood cancer, leukemia) is a group of malignant diseases of blood cells. Leukemia primarily occurs in the bone marrow, the organ that produces blood cells - leukocytes (white blood cells), erythrocytes (red blood cells) and platelets. Leukemia is caused by a mutation in one of the bone marrow cells. Instead of developing into a normal mature white blood cell, it becomes a cancer cell.

Abnormal white blood cell loses the ability to perform its functions and at the same time divides uncontrollably. This explains what leukemia is. As a result, the number of cancer cells increases and they begin to crowd out healthy blood cells. This leads to anemia, bleeding, and infections. Penetrating into the lymph nodes and other organs, leukemic cells cause pathological changes in them.

The success of treating the disease depends on the type of cancer and the age of the patient. In 2012, 352 thousand people worldwide suffered from blood cancer. Men are 30% more likely than women to suffer from this cancer. Blood cancer is often mentioned in various literary works and films. Many people learned about leukemia from the movie “Love Story” and other romantic works of art.

There are several types of leukemia. According to the nature of the course, the disease is divided into acute and chronic form. Leukemia symptoms acute form develop rapidly, while chronic leukemia develops gradually over several years. Depending on what type of cells is damaged by the disease, lymphoblastic, myeloblastic and other forms of leukemia are distinguished. Signs of leukemia include extreme fatigue, bleeding and bruising, and an increased risk of infection. They are caused by a lack of normal blood cells.

Leukemia is the most common type of cancer in children. Blood cancer is also common in older people. Scientists do not know why leukemia develops. But risk factors contributing to the onset of the disease have been identified. These are radiation exposure, carcinogenic chemicals, smoking, heredity. However, most leukemia patients have not encountered these risk factors in their lives.

The symptoms of leukemia are very different and depend on the form of the disease. Signs of leukemia include headache, fever, tendency to bruise and bleed, bone and joint pain, enlarged spleen, swollen lymph nodes, weakness, frequent infections, lack of appetite and weight loss.

Leukemia (bleeding) is a malignant lesion of the circulatory system. The disease originates in the organ that produces blood cells (red - erythrocytes, white - leukocytes) - the bone marrow, where the process of mutation of just one bone marrow cell begins. It turns into cancerous, and does not become a normally functioning leukocyte, as it should be. This cell (blast) begins an uncontrolled act of division, which is why the number of cells that pose an open threat to the body inexorably increases. As a result, healthy cells are forced out, which gives their competitors in this fight for life access to the organ system and lymph nodes.

Unfortunately, at the moment, the source of the disease leukemia remains a frightening gap in the world of medicine. However, there are some facts that can serve as a means of predicting the occurrence of blood cancer. For example, the likelihood of developing leukemia increases significantly if a person has undergone radiation therapy, or therapy using chemicals, as well as after consuming certain substances (benzene, formaldehyde). Often leukemia, photos of which can be found in encyclopedias, affects people with genetic disorders (Down syndrome, Charcot-Marie disease, Engelman syndrome and others). In addition, heavy smokers also run the risk of becoming a victim of leukemia.

Blood leukemia is of two types - acute and chronic. Although these two concepts are parts of the same disease, the symptoms of chronic leukemia are quite different from the signs of acute leukemia.

Weight loss, permanent or frequent nausea, bone pain not previously observed, fever, sore throat, stomatitis, severe weakness And fast fatiguability, excessive sweating at night, migraines - all these are signs by which blood cancer can be identified.

The list doesn't end there. Leukemia is accompanied by enlargement of the liver and/or spleen, the appearance of a rash and bruises on the body.

So, what are the features acute leukemia from chronic? Incubation period Chronic leukemia takes much longer. We are not even talking about months, but years. Symptoms do not appear as severely as with acute version diseases. Typically, chronic blood cancer is diagnosed completely by accident, when medical examination, including blood tests.

Two or three decades ago, the recovery rate for patients with blood cancer was equal to zero. However, medicine is progressing, and scientists are creating effective medications that can help not only avoid death, but also return to a normal, familiar life.

Chronic leukemia

In chronic leukemia, therapeutic intervention, although necessary, does not need to be rushed. During a certain period of time, the patient simply needs to be under the watchful supervision of doctors.

The method of combating chronic leukemia is as follows:

Use of biological therapeutic agents.
Radiation therapy, which will help rid the body of blasts.
Treatment using chemicals.
Stem cell transplant.

It is worth mentioning that there are some preventive actions which can prevent the development of blood cancer. Here are a number of reasons influencing the appearance of leukemia: effect on the body chemical substances, ionizing radiation. You can try to protect yourself from excessive contact with these disease-causing factors. We also advise those who have hereditary chromosome defects not to forget about the danger and regularly undergo a full medical examination.

Forecast

With the disease leukemia, the patient's immunity becomes much weaker, therefore, the risk of penetration into the body infectious lesions very large. Therefore, the doctor is obliged to constantly monitor the patient’s condition in order to notice the manifestation of symptoms of pneumonia and fungus, thanks to which it is possible to get rid of the virus at the very beginning of the development of the disease.

Death with leukemia can occur due to the patient having such factors as:

renal failure;
heart failure;
hemorrhagic syndrome;
acute adrenal insufficiency.

The prognosis for leukemia is not as good as we would like to see, however, it could be worse. Remission occurs in 95% of children. In 70-80% of those defeated by the disease, its manifestation is not observed at all for 5 years. In this case, they are included in the list of those who have recovered. In case of relapse, achieving a second remission is not impossible. But after remission, the patient will most likely need a bone marrow transplant. Long-term survival in this situation is 35-65%. In general, the prognosis for those suffering from chronic leukemia is quite encouraging. Life expectancy in some cases (not so rare) is as much as 20 years.