Leukemia is a malignant clonal disease of the hematopoietic system. It is also known as blood cancer. It should be noted that leukemia includes a whole group of diseases that differ in the causes and conditions of occurrence. It is difficult to consider this topic completely, since it is specific and multifaceted, but its main aspects should be studied. So now we will focus on the classification of the disease, symptoms and treatment.
Acute Leukemia: Causes and Symptoms
This is a form of the disease characterized by rapid development and active accumulation of altered white blood cells in the brain and blood.
Before proceeding to the consideration of the symptoms of acute leukemia, it should be noted that it is of two types - granulocytic (myeloid) and lymphoblastic. Each of them will be discussed separately.
The reasons why this disease occurs are still not fully understood. According to one version, its formation is provoked by genetic disorders, radiation effects, problems with the immune system and the use of chemicals that suppress blood formation.
Whatever the reason, a hematopoietic cell mutation occurs. This gives rise to the development of a tumor clone.
Common symptoms of acute leukemia include:
- Dramatic weight loss, not associated with physical activity or diets.
- General deterioration of health. The man seems to be weakening every day. Extreme fatigue is also felt, even if he did not strain.
- Drowsiness and unwillingness to do anything.
- Heaviness in the abdomen, especially in the left part under the ribs, arising after a meal of any calorie content.
- Propensity to infectious diseases.
- Increased sweating.
- A sharp loss of appetite.
- Elevated body temperature.
In rare cases, at an early stage of leukemia, symptoms can occur in shortness of breath, blanching of the skin, as well as bruising, seizures, and bone pain.
Lymphoblastic leukemia
In simple terms, a person suffering from these diseases has a tumor in the bone marrow. Due to the fact that he is affected, lymphocytes do not have time to develop enough to begin to fully perform their protective functions.
In this disease, in 85% of cases, it is precisely B-lymphocytes that provide humoral human immunity.
The clinical symptoms of lymphoblastic type leukemia include:
- Intoxication syndrome. It manifests itself in a sharp weight loss, fever, malaise and weakness. May be accompanied by a protozoal, fungal, viral or bacterial infection.
- Hyperplastic syndrome. An increase in all peripheral lymph nodes indicates its presence. The sizes of the spleen and liver also change. As a result, a person often has a stomach ache.
- Bone aches and pain. It occurs due to leukemic infiltration and an increase in bone marrow occurring under the influence of a tumor.
- Anemic syndrome. You can find out about its presence by pallor, bleeding of the mucous membranes and oral cavity, tachycardia and weakness arising from intoxication and anemia.
- Hemorrhagic syndrome. It manifests itself in petechiae (minor hemorrhages in the skin) and ecchymosis (dark blue bruise). Possible vomiting with blood and black, semi-fluid stools (melena).
- Respiratory disorders
- Edema of the optic nerve and retinal hemorrhage.
In boys, the presence of this disease is also often indicated by an initial enlargement of the testicles.
This is an extremely dangerous disease. Immunity is greatly reduced, and because of this, any damage to the skin becomes the focus of infection. Often there are panaritium and paronychia (purulent inflammation).
Diagnosis and prognosis of lymphoblastic leukemia
In addition to interviewing and examining the patient, the diagnosis involves the delivery of peripheral blood for analysis and a smear of bone marrow puncture for myelogram.
These procedures are required. By the composition of the blood, thrombocytopenia (a decrease in platelets), anemia (a decrease in hemoglobin), an increase in the erythrocyte sedimentation rate and a change in the number of leukocytes can be detected.
A myelogram allows you to determine the inhibition of platelet, neutrophilic, as well as erythroid germ.
The examination program also includes the following procedures:
- Lumbar puncture. The patient is injected with a needle at the lumbar level into the subarachnoid space of the spinal cord. This is necessary to exclude the presence of neuroleukemia.
- Chest x-ray. Helps determine if the mediastinal lymph nodes are enlarged.
- Ultrasound of the abdominal cavity. With its help, it is possible to assess the condition of the lymph nodes and parenchymal organs.
- Blood chemistry. Helps to identify if there are abnormalities in the functioning of the kidneys and liver.
If the symptoms of leukemia tests are confirmed, then the doctor prescribes treatment. The basis of therapy is chemotherapy.
First, a person undergoes intensive treatment. The duration is usually about six months. The goal is to achieve remission, which is manifested in the normalization of blood formation and elimination of blasts. Then prescribe maintenance therapy, which helps slow down or completely stop the further development of the disease. This stage lasts about two years.
All forecasts, as well as treatment, are individual. The patient's condition and risk level are taken into account. If treatment fails, bone marrow transplantation may be suggested.
On average, five-year adult survival is 35–40%. In the nursery - 80-85%.
Myeloid leukemia
This disease is also known as acute granulocytic leukemia. It manifests itself in the uncontrolled growth of immature blood cells. They accumulate in the bone marrow, internal organs and in the peripheral blood, as a result of which the functioning of all body systems is disrupted.
What are the symptoms observed in this type of acute leukemia in adults:
- Temperature from 38 ° to 40 °.
- Strong headache.
- Subcutaneous hemorrhage and bruises as if from nowhere.
- Bleeding and soreness of the gums.
- Uterine, gastrointestinal and nosebleeds.
- A feeling of lack of air even with low physical exertion.
- Cardiopalmus.
- Rapid depletion of the lungs, kidneys, and heart.
- The appearance of bronchitis, tonsillitis, necrotic stomatitis, paraproctitis, pneumonia.
Less often there are blue-red spots on the skin, joint pain and swollen lymph nodes.
Diagnosis and prognosis of myeloid leukemia
As in the case of the previous disease (and any other disease too), a person must pass blood for analysis. Symptoms of leukemia in adults can only be confirmed by her laboratory research by specialists.
With this disease, there is a decrease in the level of reticulocytes and red blood cells. White blood cell counts fluctuate, and significantly - from 0.1 * 10 9 / l to 100.0 * 10 9 / l. Platelets are reduced, their level is less than 130.0 * 10 9 / L.
Also, the absence of basophils (leukocytes that destroy foreign agents in the body) and eosinophils (sources of destructive enzymes) in the blood is recorded. Even with this disease, the erythrocyte sedimentation rate is increased (more than 15 mm / hour).
Therapy prescribed by a doctor is aimed at destroying the leukemic clone. The patient is placed in special conditions, characterized by increased sterility. A high protein diet is also prescribed. Every human product is heat treated.
This is about treatment and symptoms of acute leukemia. Forecasts in adults are mixed. This disease, like therapy, is a huge burden on the body. And the older the person, the sadder the prognosis.
Unfortunately, in 60% of older patients, a relapse occurs within three years after the end of therapy, which lasts an average of 2-3 years. Five-year survival varies from 4 to 46%.
Chronic lymphocytic leukemia
This disease is considered one of the most common among those that affect the hematopoietic system. In 30-35% of people who noticed symptoms of leukemia, they were diagnosed with a chronic form. Every year, out of 100,000 people, 3-4 get sick with it.
Chronic leukemia is very slow. Atypical cells that appear among lymphocytes do not immediately manifest themselves. Most often, the disease is detected in the later stages, when they become more than normal. At an early stage, there are practically no symptoms of blood leukemia. In adults, it can be detected in the first stage only if a general routine blood test is performed. Because an increased number of white blood cells cannot go unnoticed.
It should be noted that there is a predisposition to this disease. Scientists still cannot determine the exact set of genes that turn out to be damaged with it. But, according to statistics, in those families where at least one person suffered from chronic leukemia, the risk of illness in his relatives increases by 7 times.
As mentioned earlier, development is asymptomatic. In the later stages, all of the above manifestations begin to become noticeable. One of the most serious consequences is manifested in autoimmune complications. They can lead to hemolytic crisis and life-threatening bleeding.
Diagnosis of chronic leukemia
As a rule, the process of detecting a disease is not difficult. Difficulties arise only in the differential diagnosis of leukemia along with other tumors of a lymphoproliferative nature.
A blood test helps to identify the presence of prolymphocytes and lymphoblasts. If you do it systematically, then you can fix the growing lymphocytosis.
Biochemical analysis allows you to determine the presence of deviations. In the early stages, they are not, but then hypogammaglobulinemia (low level of immunoglobulins in the blood) and hypoproteinemia (abnormally low level of protein in the plasma) appear. If the patient has liver infiltration, then deviations in liver tests are also possible.
By means of a myelogram, the number of lymphocytes in the bone marrow punctate is revealed. In the early stages, it is relatively low (approximately 50%). But with the development of the disease, the indicator can reach 98%.
In addition to the above, the diagnosis performed after the detection of symptoms of blood leukemia includes immunophenotyping. This procedure involves the characterization of cells using probes or monoclonal antibodies. This allows you to determine their functional status and type. During the procedure, CD23, CD19 and CD5 antigens are often detected. Sometimes it is possible to detect b-cell markers CD79b and CD20.
Is it possible to treat a chronic disease?
Unfortunately not. Even if symptoms were detected early on. In adults, the prognosis of chronic leukemia cannot be called positive - it is an incurable disease. However, if the diagnosis is established in a timely manner, and the doctor selects the right therapy, then the quality of life of the patient will be able to improve.
At the initial stages, the patient is not prescribed any medication, he is simply under the supervision of a hematologist. Taking medications can be prescribed only with significant progression of the disease, the appearance of complications and a deterioration in the well-being of a person.
Life expectancy with acute leukemia, the symptoms and diagnosis of which was mentioned above, depends on a mass of factors. These include the age and gender of the patient, the timeliness of initiation of therapy and its effectiveness. Duration can vary from several months to tens of years.
So far, no cases of complete, permanent remission have been identified. But many patients manage to partially recover. At the same time, it turns out to reduce the number of lymphocytes by 50%, reduce the size of the lymph nodes and spleen, and increase the neutrophil, hemoglobin and platelet counts by 50%.
Acute Promyelocytic Leukemia
Another type of disease that cannot be told about. A specific symptom of leukemia in adults in this case is an abnormal accumulation of promyelocytes - cells that are larger than the notorious myeloblasts. In most cases, this disease occurs in young people - not older than 40 years.
The disease is fast. The main symptom of leukemia in adults is bleeding that occurs even with minor skin lesions, followed by bruising.
In principle, this disease is characterized by all the previously mentioned manifestations. Of the specific symptoms, it is possible to note the DIC syndrome, which manifests itself in a blood clotting disorder that occurs due to the massive release of thromboplastic substances from the tissues.
After confirming the symptoms of leukemia, treatment begins. It is carried out with the participation of doctors of various profiles, as well as with the help of transfusiological and laboratory services. First, as a rule, freshly frozen cryoprecipitate plasma and platelet concentrate are administered. Prior to confirming the diagnosis, ATRA therapy may be given. This is a combination treatment aimed at rearranging the gene. Then chemotherapy is prescribed.
Usually the course lasts 2 years. If there is no result, arsenic trioxide may be prescribed.
On average, life expectancy in 70% of cases reaches 12 years without exacerbations. To date, promyelocytic leukemia is one of the most treatable malignant pathologies.
Acute megakaryoblastic leukemia
Much has been said above about various types of disease. Finally, it is worth noting the symptoms and prognoses of acute megakaryoblastic type leukemia.
The presence of this disease is indicated by the presence in the blood and bone marrow of cells with a strongly colored nucleus, which also have filiform outgrowths and a narrow cytoplasm. Also, analysis often reveals fragments of nuclei of ugly megakaryocytes.
Most often, this type of leukemia occurs in children with Down syndrome.
Diagnosis of this disease presents a certain difficulty, since the clinical picture does not have any specific features. It is also difficult to carry out treatment, especially cytostatic therapy, which is necessary in this case. Therefore, the most effective way is to transplant a bone marrow.
Complete remission and an increase in life expectancy are most often observed in children. For adults, forecasts are less positive.
Therapy
Treatment of leukemia of any kind includes the following procedures:
- Radiation therapy. Affects malignant tumors. Helps to remove the cells of which they are composed.
- Chemical therapy. A catheter is inserted into the area of the spinal canal through which powerful drugs acting on the tumor are introduced into the body.
- Bone marrow transplantation. It is offered to the patient only if a relapse occurs. But first, the surgeon removes the cancer cells. And only then is their replacement with new ones.
- Taking antibiotics to consolidate the result.
In addition to the above, it is important to maintain a balanced diet enriched with vitamins, minerals and useful macro- and microelements. A strict bed rest is also necessary, since a healthy sleep is a loyal assistant in the normalization of body functions.
The most important thing is not to delay the trip to the oncologist when detecting alarming symptoms. The sooner a diagnosis is established and treatment is prescribed, the more positive the prognosis will be.