Leukemia (leukemia, blood cancer)

leukosis (Blood cancer, leukemia, leukemia) - is a group of malignant diseases of the hematopoietic system, which flow with the exclusion of full bone marrow pathological germs blood elements. We should understand that the leukemia blood - these are processes that cause the development of cytopenia, flowing with a deficit of various blood cells. Such a state leads to immunosuppression, bleeding and tendency to infectious diseases.

GENERAL

Human blood - is a liquid medium consisting of plasma and cells suspended therein: leukocytes, erythrocytes and platelets. Each type of form elements has a specific function: the white blood cells responsible for combating various infectious agents RBCs transport oxygen from the lungs to all organs and tissues of the body and promote clotting platelets blood.

Most of these cells formed in bone marrow tissue, which is centered within the pelvic bones and ribs, in a much lesser extent - in the long bones of the limbs and in the vertebrae. Bone marrow - the only human tissue containing a cluster of immature stem cells without given specialization. This is where the blood forming organs, or the gradual formation of new cells to replace the spent its life cycle.

In normal formation violation cells into the bloodstream ejected huge number of abnormal or immature leukocytes. They can not fulfill their protective function. In addition, in contrast to normal cells, modified, not eliminated at the right time, and continue to circulate in the organs and tissues, gradually replacing healthy. Visible or palpable tumor in leukemia asked, oncological structures scattered throughout the body by blood flow.

The exact causes of leukemia are unknown, but it is expected a negative impact on the process of environmental pollution, the accelerated pace of life and constant stress.

leukemia exposed to people of any ageAmong childhood cancer leukemia occurs in 30% of cases. The largest number of episodes of illness detected in children in the fourth year of life.

CAUSES

Despite the comprehensive study of the pathological process, we could not reliably determine the cause of leukemia. Identified predisposing factors, the impact of which can provoke the development of disease.

The causes of leukemia:

• radiation exposure. The probability of acute and chronic blood cancer increases significantly when exposed to high doses of ionizing radiation. The reason for this phenomenon is not only the effect of radiation after a nuclear explosion or man-made disaster, negative effects also have radiotherapy and part of the diagnostic X-ray irradiation rays.
• Influence of chemicals. Benzyl widely used on an industrial scale, they are not only in the fuel composition, and they are found in tobacco smoke. Health hazards are some of the components of varnishes and paints, and pesticides used in agriculture and in the home.
• Medication. Among medicaments have carcinogenic cytostatics, high doses of antibiotics penicillin, levomitsetinovogo series and drugs that are widely used in chemotherapy.
• viral infections followed by the invasion of the pathogen into the body's healthy cells. However, they often provoke mutations. The modified cells are transformed into malignant tumors, triggering the development of blood cancer. Often this phenomenon has been observed in HIV-infected people.
• Heredity It does not appear significantly to the development of leukemia. Extremely rare cases of leukemia observed among blood relatives. Considering these phenomena, often it is about identifying the chronic form of lymphocytic leukemia.
• genetic abnormalities. People with Klinefelter's syndrome and Down, Fanconi disease and Turner have a predisposition to the development of leukemia. For example, trisomy 21-th pairs of chromosomes in Down syndrome increases the risk of leukemia by 20 times. The cause of the disease can be congenital immunodeficiency.

As a rule, the development of hematological malignancies is not provoked by just one factor. The pathological process plays the role of a chain of events that activates an oncogene or affects the formation of mutated cells.

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

CLASSIFICATION

Classification by type of blood cancer the disease:

• Acute leukemia - blood cancer detected many immature blasts that do not fulfill the protective functions, the symptoms develop rapidly, the disease is prone to rapid progression.
• Chronic - it is a long time in a latent state, but cancer cells are found to cope with the task of maintaining life. This phenomenon is due to the fact that the process involved in blood cells, which is already fully formed or located at the last stage of development. Such conditions are usually detected during a random blood test during routine inspections.

Acute leukemia can not move in chronic and conversely, chronic has no tendency to move in an acute shape. For chronic leukemias characterized by periods of relapse, when this blood test pattern resembles acute form of the disease.

Classification of the degree of differentiation of transformed cells:

• lymphoblastic - detect when a mutation in lymphoid cells, characteristic of childhood;
• granulocyte (myelogenous) - changes affect the granulocytic white blood cells, is more common in adults.

Depending on the type of cell affected by a pathology:

• Chronic lymphocytic leukemia - in violation maturation and dividing leukocytes.
• Chronic myelocytic leukemia indicates a violation of maturation and dividing leukocytes, erythrocytes and platelets.
• Acute lymphoblastic leukemia - severe impairment maturation and dividing leukocytes.
• Acute myelogenous leukemia - violation maturation and dividing leukocytes, erythrocytes and platelets. The disease occurs rapidly and with a severe clinical picture.

SYMPTOMS

The initial stage of leukemia may resemble a common cold, but later her symptoms become distinctive features.

Common symptoms of an early stage of leukemia:

• causeless fever;
• profuse sweating at night;
• tachycardia;
• joint pain;
• fainting and dizziness;
• fatigue, drowsiness;
• loss of appetite, weight loss;
• pale skin, dark circles under his eyes;
• headache.
• enlargement of the spleen and liver;
• increase of some groups of lymph nodes;
• bleeding from the nose and gums, bruising;
• regular colds and exacerbation of chronic diseases.

Symptoms of various types of leukemia:

• Chronic lymphocytic leukemia. The disease is characterized by slow flow, progressing long-term - for a few months or years. Often diagnosed in older people, and the children occasionally. After the accumulation of cancer cells there is an increase of lymph nodes, pain under the right rib, bleeding from the nose, jaundice of the sclera and bleeding gums.
• Chronic myelocytic leukemia typical for people from 30 to 50 years, more frequently in males. Patients with rapidly growing feeling of fatigue and reduced efficiency. Before the appearance of pronounced signs of leukemia can go from 2-3 to 10 years. These symptoms include: shortness of breath at rest and at low loads, nausea, vomiting, fever, enlargement of the spleen and liver, migraine, dizziness, and sometimes the loss of orientation in the space.
• Acute lymphoblastic leukemia often diagnosed in children aged 1 to 6 years. Intoxication occurs on the basis of an infectious viral disease, there is an increase lymph nodes, shortness of breath, bleeding in the retina of the eye, low levels of hemoglobin, and an increase in liver spleen. One-third of the boys reveal accumulation of fluid in the testicles.
• Acute myeloid leukemia It appears at different ages, but is more common in older people after 60 years. Patients complain of dizziness, weakness, severe fatigue, recurrent headaches and sweating at night. In the bone joints of the feet appears stable soreness. In addition, there is pain along the spine line and osteoporosis. These symptoms provoke change human gait. Sometimes reveal an enlarged spleen and liver. Lymph nodes may reach 5 cm in diameter and form conglomerates after adhesion tissues. All of these symptoms develop on the background of the common symptoms of leukemia.

DIAGNOSTICS

Leukemia can be suspected by the symptoms, but to identify leukemia and accurate diagnosis is necessary, based on the parameters of blood analysis. To clarify various additional methods are used.

Diagnostic Methods

• Clinical blood test. Typically, in this pathology observed an extremely high number of white blood cells, hemoglobin decreased performance, there is thrombocytopenia.
• Aspiration bone marrow tissue with local anesthesia from the pelvic bone or breast bone. To this end, through a puncture needle is made of thick fence of a small amount of the sample and sent for cytology.
• BiopsyAt which the addition of bone marrow tissue taken bone portion. A study of tumor tissue determine the type, severity and extent of the lesion. Aspiration and biopsy are not mutually exclusive but are complementary examination methods.
• Puncture cerebrospinal fluid It allows you to detect the spread of cancer cells in the central nervous system organs. To this is introduced between the lumbar vertebrae needle for sampling CSF.
• cytogenetics (Genetic analysis of blood cells) for the presence of chromosomal abnormalities to clarify the type of leukemia.

TREATMENT

leukemia the foundation of treatment is chemotherapy. Furthermore, use of bone marrow transplantation.

Haematologist based on regulated regimen of certain forms of the disease, which is constantly being improved. But individual approach as the treatment of other diseases, leukemia do not practice - all doctors appointment followed a well-established program. Correction therapy may be associated with the overall condition of the patient and concomitant pathologies.

What you need to know about chemotherapy:

• chemotherapy involves the use of drugsCapable of destroying cancer cells or inhibit their reproduction. Assign one or multiple medication.
• The treatment may be conducted in an outpatient clinic or conditions in specialized hospitals. It depends on the complexity of the diagnosis, drug side effects and the patient's condition. Therapy includes several successive courses potent receiving means intermittently for 2-4 weeks.
• High doses of chemotherapy in acute forms of leukemia helps the body to quickly get rid of the leukemic cells. Treatment should begin immediately after the confirmation of the diagnosis. On this will depend directly on the outcome of the disease.

The goal of therapy is followed by maintenance therapy with the appointment of the same doses of cytostatics. The last stage is regarded as a prevention to maintain the achieved results and to prolong remission.

The rules of treatment of some cancers is used irradiation with radioactive isotopes for the prevention, treatment and in preparation for bone marrow transplantation.

Transplant donor, or autograft own bone marrow is performed in cases when after a course of chemotherapy symptoms of leukemia survived. This operation helps to restore hematopoiesis, which positively affects the immune system.

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

COMPLICATIONS

The most common complication of leukemia are infectious lesions of various origin that are attacking the weakened body of the patient with leukemia.

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

Possible effects of chemotherapy:

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

PREVENTION

primary prevention measures:

• healthy lifestyle;
• preventive laboratory blood tests;
• Warning influence of risk factors;
• watching the children with family history;
• sanitation of foci of infection;
• strengthening the immune system.

Secondary prevention measures:

• carrying out effective preventive treatment;
• regular visits to the Oncology and Hematology;
• monitoring of blood parameters;
• ban on changing climatic conditions after a course of treatment;
• restriction of physical therapy;
• Preventive vaccination according to the vaccination schedule.

FORECAST FOR RECOVERY

Prognosis in leukemia depends on the time of diagnosis, the patient's age, type of damaged cells, the prevalence of pathological processes and response to therapy.

Often in leukemia poor prognosis in men, children older than ten years and the elderly. Late detection of blood cancer with a significant increase in the number of white blood cells reduces the chances of prolonged remission. Children from 2 to 10 years can be achieved long-term remission with proper treatment.

Acute leukemias are characterized by rapid development and in the absence of proper treatment are fatal. With adequate treatment of leukemia survives about 50% of patients, but there are forms of the disease with recovery rates at 90-95% and 3-5%. In the latter case, doctors are making every effort, but an effective means of saving these patients is only a bone marrow transplant.

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