Leukemia in children, the symptoms of which are most often manifested precisely in this form of the disease, mainly develops within the age of 3-7 years, moreover, it is among children that this disease, unfortunately, has received its greatest prevalence. We highlight the main symptoms relevant to ALL:
- Intoxication. It manifests itself in malaise, weakness, fever, weight loss is also noted. An infection (viral, bacterial, fungal or protozoal (which is noted less frequently)) can provoke a fever.
- Hyperplastic syndrome. It is characterized by an actual increase in 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 periosteum infiltration in combination with the tumor growth that the bone marrow undergoes can cause aches and pains in the joints.
- Anemic syndrome. It manifests itself in the form of symptoms such as weakness, pallor, tachycardia. In addition, bleeding gums appears. Weakness is the result of intoxication and anemia itself.
- Initial change in testicular size (increase). About 30% of primary forms of ALL occur in boys. Infiltrates (tissue sites within which cellular elements are formed that are not characteristic of them, with a characteristic increased volume and increased density) can be unilateral or bilateral.
- Hemorrhages in the optic retina, swelling of the optic nerve. Ophthalmoscopy in this case often reveals the presence of leukemic plaques within the fundus.
- Respiratory disorders They are caused by an increase in lymph nodes within the mediastinum, which, in turn, can provoke respiratory failure.
- Due to reduced immunity, damage of any type, regardless of the intensity of exposure, the area and nature of the lesion, forms an infection focus on the skin.
As quite rare, but not excluded for this reason, manifestations, such complications as kidney damage developing on the background of infiltration are distinguished, and clinical symptoms in this case may be absent.
This disease can manifest itself at any age, but most often it is diagnosed in patients after 55 years. Mostly the symptoms characteristic of acute myelogenous leukemia manifest themselves in a gradual manner. As the earliest sign of the disease, malaise is distinguished, and it may appear several months before the rest of the symptoms manifest themselves.
Symptoms of this disease are inherent in the previous form of leukemia and leukemia in general. So, the anemic and toxic syndromes that we have already examined manifest themselves here, which manifests itself in dizziness, severe weakness, increased fatigue, poor appetite, and also in fever without accompanying catarrhal phenomena (that is, without specific factors provoking it: viruses, infections, etc. .).
In most cases, the lymph nodes are not particularly affected, they are small, painless. Their increase is rarely noted, which can determine sizes for them within 2,5-5 cm, with concomitant formation of conglomerates (that is, the lymph nodes are soldered together in such a way that a characteristic “lump” appears), which are concentrated within the neck supraclavicular site.
The osteoarticular system is also characterized by some changes. So, in some cases, this means persistent pains that occur in the joints of the lower extremities, as well as pains that are concentrated along the spinal column, as a result of which gait and movement are affected. Radiographs in this case determine the presence of destructive changes in various areas of localization, the phenomenon of osteoporosis, etc. Many patients experience a certain degree of enlargement of the spleen and liver.
Again, common symptoms are relevant in the form of susceptibility to infectious diseases, the appearance of bruises with minor bruises or no effect at all, bleeding of various specifics (uterine, gingival, nasal), weight loss and pain in bones (joints).
Symptoms of leukemia in the acute stage will be due to:
- hyperplasia of tumor tissues (blast degeneration of KM, an increase in LN (lymph nodes) and the appearance of tumor-like infiltrates in organs);
- inhibition of normal hematopoiesis (anemia, hemorrhagic disorders and bleeding, frequent infections due to leukopenia);
- progressive intoxication.
Acute lymphoblastic leukemia is more common in children, myeloblastic leukemia is more common in adult patients. Myeloblastic leukemia is much worse than lymphoblastic leukemia chemotherapy, but rarely complicated by damage to the central nervous system.
Attention. The clinical picture in acute lymphoblastic and acute myelocytic leukemia is practically the same.
Symptoms of leukemia in adults and children associated with hyperplastic syndrome (tumor tissue hyperplasia) are manifested by a moderate and painless increase in LU, liver and spleen. A quarter of patients have an increase in tonsils and LN of the mediastinum. With a significant increase in the mediastinum LN, shortness of breath and an obsessive cough may appear.
Skin tumor infiltrates are formed due to the accumulation of tumor cells in the skin. Leukemids have the appearance of plaques and differ in a specific bluish-red tint.
Attention! For myeloid leukemia, proliferation of gingival tissue is specific. Gingival hyperplasia in some patients may be the first manifestation of the disease.
Anemic syndrome in patients with acute leukemia is manifested by a decrease in hemoglobin and red blood cells. The degree of anemia depends on the severity of leukemic hyperplasia and CM infiltration. Severe inhibition of hematopoiesis with a decrease in Hb (hemoglobin) below 60 g/l and erythrocytes less than 1.3 * 1012 is observed in a third of patients.
Hemorrhagic disorders are characteristic manifestations of inhibition of bone marrow hematopoiesis.
Acute leukemia – hemorrhagic symptoms:
- the presence of small-spotted and small-spotted rashes (the first rashes most often appear on the legs);
- frequent nosebleeds;
- the appearance of heavy or profuse bleeding;
- the development of neurological symptoms associated with NMC (cerebrovascular accident).
Due to inhibition of hematopoiesis and severe leukopenia, frequent infectious diseases are observed in patients with leukemia. In 80% of patients, often recurring pneumonia, purulent skin infections, herpetic infections are noted. In severe cases, sepsis may develop.
Attention. The development of neuroleukemia is more characteristic of lymphoblastic leukemia. The clinical picture will develop gradually, the rate of progression of symptoms will depend on the severity of bone marrow damage.
The main manifestations will be:
- development of meningoencephalic syndrome;
- pseudotumor syndrome (increased intracranial pressure, stunning, vomiting, headaches, etc.);
- damage to the cranial nerves (the symptoms will depend on which pair is affected) and peripheral nerves.
Acute leukemia can be manifested by bone pain (ossalgia), severe sweating, unexplained weight loss, fatigue, constant drowsiness, low-grade fever (for no apparent reason), periodic chills and fever, constant muscle weakness, decreased immunity.
Externally, there is a strong pallor (yellow or an unhealthy gray color is possible) of the skin, dark circles under the eyes, hemorrhagic rash on the skin and mucous membranes, an increase in LU, liver and spleen.
The severity of the clinical picture and the rate of attachment of specific symptoms of leukemia will depend on the severity of inhibition of bone marrow hematopoiesis.
In the KLA in acute leukemia revealed:
- the presence of anemia;
- fluctuation in the number of white blood cells (can vary significantly from 0.1 to 200 * 109);
- is there a so-called leukemic failure (lack of intermediate forms between mature cells and blasts).
Non-lymphoblastic acute leukemia can be accompanied by the presence of immature granulocyte cells (myelocytes, promyelocytes, etc.) in the blood. The number of immature cells, as a rule, does not exceed 10%.
Acute leukemia can also be classified by the level of leukocyte changes.
With leukemic leukemia, an increase in leukocyte cells from 80 * 109 (up to 500 * 1012) is noted. Subleukemic leukemia is accompanied by a white blood cell count of 25 to 80. Aleukemic – from the age norm to 25. Leukopenic forms of acute leukemia are characterized by a decrease in the level of leukocytes below the age norm.
In childhood and adolescence, acute leukemia is more often observed. What is it and why is it dangerous? This type of disease is caused by mutations in blood cells in an immature, primary (blast) state. Depending on which forms of the primary cells have mutated, the following types of acute leukemia are distinguished:
- acute lymphoblastic leukemia;
Since during acute leukemia in the blood, useful working particles are replaced by immature ones, the blood gradually loses its functions, namely supplying organs with oxygen and nutrients. Also, the work of white blood cells to protect the body from foreign microorganisms is significantly reduced or completely lost.
All types of this disease have a first stage (attack), remission, relapses. It should be noted that both primary and repeated relapse of acute leukemia are possible. The general symptomatology of the disease is as follows:
- tumor growths in the bone marrow;
- severe forms of anemia;
- general weakness with shortness of breath and dizziness;
- bleeding and ulceration of the mucous membranes (stomatitis, tonsillitis, ulcers in the esophagus and intestines are common);
- skin rash;
- enlargement of the liver, spleen, lymph nodes;
- pain in the bones when they are beaten (cause the growth of mutant cells in them);
- sepsis and other infectious complications.
The stage of remission occurs when immature cells are no longer detected in the blood, no more than 5% in the bone marrow, and there are no leukemic growths outside the bone marrow.
Reasons and diagnosis
Leukemia in adults and children causes abnormalities in the structure of chromosomes, which may be due to hereditary defects or external influences. These include:
- radiation (radiation);
- carcinogens (drugs, food, chemicals);
- chemotherapy for tumors.
The theory of the viral etiology of leukemia has not yet been proven.
Among hereditary factors, there is a significant increase in leukemia diseases among those suffering from Down, Bloom, and Turner syndromes.
Diagnosis of leukemia includes:
- external examination (palpation of the lymph nodes, detection of changes in the mucous membranes);
- laboratory blood tests for the quantitative composition of red blood cells, lymphocytes, red blood cells, platelets;
- bone marrow biopsy;
- PCR (allows you to detect the Philadelphia chromosome, if any);
- FISH analysis (shows changes in chromosomes);
- IFT (identifies cells using markers and antigens).
To identify acute leukemia, use:
- Peripheral blood test. Anemia is detected, accompanied by a decrease in the number of red blood cells and the level of hemoglobin. Platelet count changes. In the period of exacerbation, it decreases, when entering into remission, the indicator normalizes. The level of leukocytes can both decrease and increase. Blast cells appear in the blood. In some forms of leukemia, they may be absent.
- Bone marrow puncture. Inhibition of red blood cell production and an increase in the number of blast cells are noted.
- Trepanobiopsy bone. Samples are sent for histological examination, which helps to detect blast bone marrow infiltration and confirm the diagnosis.
Important. The basis for the diagnosis of acute leukemia is the detection of more than 20% blasts in a smear of punctate CM.
The establishment of morphological types of leukemia is carried out using:
- smears of KM and peripheral blood;
- histological examination of biopsy of LU;
- results of cytochemical diagnostics (myeloid leukemia is characterized by a positive reaction with black Sudan B, myeloperoxidase, weakly positive with non-specific esterase and negative with alkaline phosphatase);
- CM cell immunofunctioning method (antigens specific for each leukemia are investigated. This method is also used to clarify the type of lymphoblastic leukemia (T-cell or B-cell));
- molecular genetic analysis of blasts.
Important: To make a diagnosis of neuroleukemia, more than 5% of blasts should be detected in a smear of cerebrospinal fluid.
What actually causes leukemia is currently not known for certain. Meanwhile, there are certain ideas on this subject, which may well contribute to the development of this disease. In particular, these are:
- Radioactive exposure: it is noted that those people who have been exposed to such exposure in significant amounts of radiation are at a greater risk of acquiring acute myeloid leukemia, acute lymphoblastic leukemia or chronic myelocytic leukemia.
- Prolonged contact with benzenes widely used in the chemical industry, as a result of which, accordingly, the risk of developing leukemia of certain types increases. By the way, benzene is also found in gasoline and cigarette smoke.
- Down syndrome, as well as a number of other diseases with concomitant chromosomal abnormalities – all this can also provoke acute leukemia.
- Chemotherapy for certain types of cancer can also cause future leukemia.
- Heredity, this time, does not play a significant role in predisposition to the development of leukemia. It is extremely rare in practice that there are cases in which several family members develop cancer in the manner characteristic of identifying heredity as the factor that provoked it. And if it happens that such an option really becomes possible, then mainly it implies chronic lymphocytic leukemia.
It is also important to note that if you have identified the risk factors for developing leukemia by these factors, this is not at all a reliable fact for your mandatory development. Many people, noting for themselves even several of the relevant factors listed above, do not encounter a disease, meanwhile.
The manifestations of symptoms associated with 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 in the early stages, for example, is characterized by a small number of cancer cells, which for this reason may be accompanied by an asymptomatic course of the disease for a long time. In the case of acute leukemia, which we also noted, the symptoms manifest themselves early.
We highlight the main symptoms that accompany the course of leukemia (in acute or chronic form):
- an increase in lymph nodes (mainly those that are concentrated in the armpits or in the neck), soreness of lymph nodes with leukemia, as a rule, is absent;
- increased fatigue, weakness;
- susceptibility to the development of infectious diseases (herpes, bronchitis, pneumonia, etc.);
- increased temperature (without concomitant changes to its factors), increased sweating at night;
- joint pain;
- an increase in the liver or spleen, on the background of which, in turn, a pronounced feeling of heaviness in the region of the right or left hypochondrium may develop;
- bleeding disorders: the appearance of bruises, nosebleeds, the appearance of red dots under the skin, bleeding gums.
Against the background of accumulation of cancer cells in certain areas of the body, the following symptoms appear:
- nausea, vomiting;
- violation of coordination of movements;
- blurred vision;
- convulsions in certain areas;
- the appearance of painful edema in the groin, upper limbs;
- scrotum pain, swelling (in men).
The main symptoms of leukemia
The main cause of acute leukemia is a violation of the hematopoietic cell maturation processes, giving rise to a malignant process. Emerging cancer cells replace normal; getting into the circulatory system, they penetrate into organs and tissues, causing leukemic infiltration. The provoking factors that trigger the mutation include:
- genetic predisposition (the risk of leukemia increases in the presence of Down syndrome, Klinefelter’s disease, Fanconi anemia);
- poisoning of the body with chemical carcinogens (organic solvents, arsenic, benzene, asbestos);
- the effect of ionizing radiation;
- side effects of chemotherapy (leukemia often develops with the use of cytostatics for myeloma, lymphoma, lymphogranulomatosis);
- acute viral infections that suppress the immune system;
- hematological diseases (sickle cell anemia, myelodysplasia, paroxysmal hemoglobinuria).
Chronic myelocytic leukemia: symptoms
This disease is mainly diagnosed in patients aged 30-50 years, and in men the disease is more common than in women, while in children it rarely appears at all.
In the early stages of the course of the disease, patients often complain of decreased performance and increased fatigue. In some cases, the progression of the disease can occur only after about 2-10 years (and 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 with exercise, shortness of breath appears in patients.
An increase in the spleen and liver is also noted, resulting in a feeling of heaviness and pain in the left hypochondrium. Marked thickening of the blood can trigger the development of spleen infarction, which is accompanied by increased pain in the left hypochondrium, nausea and vomiting, and fever. Against the background of blood thickening, the development of disorders related to blood supply is not 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 manifestations: pain in the bones and joints, susceptibility to infectious diseases, weight loss.
For a long time, the disease may not manifest itself in any way, and its progression can last for years. In accordance with progression, the following symptomatology characteristic of it is noted:
- Enlarged lymph nodes (causeless or against the background of relevant infectious diseases such as bronchitis, tonsillitis, etc.).
- Pain in the right hypochondrium resulting from an enlarged liver/spleen.
- Exposure to the frequent occurrence of 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 struggle of the body’s immune cells with cells belonging to the body 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 increase occurs when certain infections affect the body. After the source of infection is eliminated, they are reduced back to normal. The increase in lymph nodes mainly begins gradually, mainly changes are noted, primarily in the framework of the cervical lymph nodes and axillary lymph nodes.
Leukemia is classified according to various characteristics. By the nature of the course of tumor processes, their acute and chronic forms are distinguished. In this case, these definitions are conditional and do not correspond to generally accepted ones. So, the forms of leukemia do not depend on the duration of the disease and never turn into one another, but each has a stage of remission and relapse. A dangerous feature of leukemia is the rapid transport of mutant cells by blood to any organs, which causes the onset of the tumor process in them.
Consider chronic leukemia in more detail. What is it and why is it called that? This type of disease is caused by mutations of already formed, ready-to-work blood cells (red blood cells, white blood cells and platelets). More often it manifests itself at the age of 50 years and older. Forms of chronic leukemia:
- lymphocytic leukemia;
- hairy cell leukemia;
Each of them has its own characteristic symptoms. For example, with myelocytic leukemia, the only signs of the onset of the disease are weakness, sweating, fatigue. The spleen is not enlarged, the blood composition is normal. The only thing that may alert is an increased number of neutrophils in the blood, although this is observed in any infectious processes.
Common features of progressive chronic leukemia are:
- increased sweating;
- enlarged spleen;
- swollen lymph nodes;
This disease causes mutations in mature lymphocytes, with 90-98% of them in group “B”. Here, benign and malignant stages are distinguished. The latter very quickly passes into lymphosarcoma. The onset of the disease is almost indefinable, since the patient does not feel any suspicious symptoms at all, and all blood tests show the norm, including the number of leukocytes.
Over time, a sick person begins to tire more quickly, sweating appears, and the lymph nodes and spleen increase slightly. Chronic lymphocytic leukemia has an independent form called hairy cell leukemia, characterized by villous outgrowths of the cytoplasm, moreover, it contains a lot of phosphatase and is resistant to tartaric acids.
At the initial stages, the diagnosis of all forms of lymphocytic leukemia is difficult even when performing blood tests, since their results are similar for any infectious ailments. Also, inflammatory processes in the lymph nodes, which may not be associated with leukemia, are prevented from correctly diagnosing. Patients are first treated with antibiotics, and then the diagnosis is clarified by histological and
perform an x-ray (with leukemia in the lungs, lymphocyte infiltrates are formed, chest lymph nodes are enlarged).
In chronic leukemia, the main symptoms will also be anemia of varying severity, bone pain, general intoxication symptoms, weight loss, sweating, bleeding, increased LU, etc.
The main difference between chronic and acute leukemia is the lack of leukemic failure in the analyzes and a small number of blast cells.
Caution: If more than 30% of blasts are detected, a diagnosis of myeloid or lymphoblastic crisis is made.
The treatment regimen for acute leukemia is selected depending on the age of the patient, the type of disease and the general condition of the body. There are 2 main methods of therapy: the use of cytostatics and bone marrow transplantation.
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Acute leukemia is treated with standard polychemotherapy. Types and doses of drugs are selected by the oncologist. Treatment includes the following steps:
- Induction of remission. With the help of drugs, a decrease in the number of blast cells in the blood is achieved.
- Consolidation. This stage of chemotherapy helps destroy the remaining malignant cells.
- Reinduction. It is used to consolidate the result. Drugs are administered in the same doses as in the first stage.
Chemotherapy causes many side effects (exacerbation of infectious diseases, signs of intoxication of the body, indigestion, anemia, thrombocytopenia). To eliminate these symptoms, use:
- antibacterial agents (Ceftriaxone, Levofloxacin);
- antifungal drugs (fluconazole);
- detoxification solutions (Hemodez).
With a pronounced change in the composition of the blood, the plasma components, platelet and erythrocyte mass are transfused.
A transplantation of donor bone marrow contributes to the appearance of healthy stem cells, from which normal blood components are subsequently formed. Transplantation is performed only during the period of complete remission of leukemia. Bone marrow freed from blast cells is filled with healthy elements. In preparation for the operation, immunosuppressant treatment is performed. This suppresses the immune system and prevents the reappearance of cancer cells. Surgical intervention is contraindicated in:
- violation of the functions of internal organs;
- acute viral and bacterial infections;
- recurrence of cancer, not translating into remission;
- elderly patient.
For the treatment of acute leukemia, the following folk remedies are used:
- Propolis. 3-5 g of this product is chewed before each meal. The product saturates the body with vitamins and reduces the intensity of side effects of chemotherapy.
- Lungwort. The leaves of the plant are harvested in spring. They make salads seasoned with vegetable oil. The plant contains substances that normalize the hematopoietic system.
- Buckwheat tincture. 1 tbsp. l chopped tops of a flowering plant pour 400 ml of boiling water, leave for half an hour. Filter the infusion and take 100 ml 3-4 times a day.
- A decoction of birch buds. 1 tbsp. l raw materials are mixed with 3 cups of birch leaves, boiled in 1,5 liters of water. The resulting tea is taken 100 ml 3 times a day.
Treatment with folk remedies does not imply the abandonment of traditional therapeutic methods. Before applying this or that method, you need to consult an oncologist.
- super early (survival rate of only 10%);
- late (success is achieved in 38% of cases).
2. By localization
- outside the bone marrow;
- bone marrow (the most dangerous);
A very serious and, in most cases, unpredictable disease is leukemia. What is it dangerous in addition to impaired blood function? Firstly, the fact that cancer cells spread easily and quickly throughout the body. Secondly, the most serious complications of the course of the disease, in which mutant cells can penetrate the lining of the brain. Thirdly, the side effects caused by all types of treatment for leukemia.
The main focus of treatment for leukemia will be the use of cytostatic therapy aimed at killing tumor cells.
Leukemia treatment is divided into certain stages. Among them are:
- creating remission (remission induction);
- maintaining achieved remission;
- prevention of central nervous system damage (neuroleukemia);
- therapy in remission;
- post-induction treatment.
The main antitumor drugs are:
- Mercaptopurine, etc.
For reference. Treatment is carried out according to special schemes. Drugs alternate depending on the phase and day of treatment. All therapy is carried out under the control of tests (including regular bone marrow puncture).
Cytostatic agents are combined with glucocorticosteroid therapy (dexamethasone, prednisone).
Very important! An absolute contraindication to the use of glucocorticosteroids is an invasive form of aspergillosis (fungal infection).
In order to prevent neuroleukemia, the head is irradiated and methotrexate is administered by the endolumbar method (inside the spinal canal) or intrathecal (under the meninges).
Additionally, according to indications, symptomatic therapy (antibacterial, antifungal, detoxification), blood transfusion, etc.
Bone marrow transplantation is highly effective. After its implementation, there is practically no relapse of leukemia. However, there is a risk of death of the patient as a result of transplant rejection and the development of immunodeficiency.
The treatment of leukemia is determined on the basis of a number of factors accompanying it, its type, stage of development, the state of health of the patient as a whole and his age. Acute leukemia requires immediate treatment, due to which it will be possible to stop the accelerated growth of leukemia cells. Often it turns out to achieve remission (often the condition is determined that way, and not “recovery”, which is explained by the possible return of the disease).
As for chronic leukemia, it is extremely rarely cured before the stage of remission, although the use of a certain therapy in it allows monitoring the course of the disease. As a rule, treatment of chronic leukemia begins with the onset of symptoms, while chronic myeloid leukemia in some cases begins to be treated immediately after a diagnosis is made.
The following are identified as the main methods for treating leukemia:
- Chemotherapy. Appropriate type of medication is used, the action of which allows to destroy cancer cells.
- Radiotherapy or radiation therapy. The use of a certain radiation (X-ray, etc.), due to which it is possible to destroy cancer cells, in addition, the spleen/liver and lymph nodes, which underwent an increase against the background of the processes of the disease in question, are reduced. In some cases, this method is used as a previous procedure for stem cell transplantation, about it below.
- Stem cell transplantation. Due to this procedure, it is possible to restore the production of healthy cells while improving the immune system. The preceding transplantation procedure may be chemo- or radiotherapy, the use of which can destroy a certain number of bone marrow cells, as well as free up space under the stem cells and weaken the effect of the immune system. It should be noted that the achievement of the latter effect plays an important role for this procedure, otherwise the immune system may begin to reject cells transplanted to the patient.
Each of the types of cancer in its own way is effective (or ineffective) treatable; accordingly, the prognosis for each of these types is determined on the basis of a comprehensive picture of the disease, a specific course and related factors.
Acute lymphoblastic leukemia and the prognosis for it is in particular determined on the basis of the level of leukocytes in the blood when this disease is detected, as well as on the basis of the correctness and efficiency of therapy in his address and on the age of the patient. Children from 2 to 10 years often achieve prolonged remission, which, as we have already noted, if it is not a complete recovery, then at least determines the condition with absent symptoms. It should be noted that the more white blood cells there are in diagnosing a disease, the less likely it is to recover completely.
For acute myeloid leukemia, the prognosis is determined depending on the type of those cells that are involved in the pathological course of the disease, on the age of the patient and on the correctness of the prescribed therapy. Standard modern treatment regimens determine about 35% of cases of survival over the next five years (or more) for adult patients (up to 60 years).
The prognosis for chronic myeloid leukemia is determined by the stage of its course, it progresses in a somewhat slower manner compared to acute leukemia. About 85% of patients with this form of the disease come to a pronounced worsening of the condition 3-5 years after its discovery. It is defined in this case as a blast crisis, that is, the last stage of the course of the disease, accompanied by the appearance of a significant number of immature cells in the bone marrow and blood.
As for the prognosis for chronic lymphocytic leukemia, survival here varies somewhat in terms. So, some patients die in the next 2-3 years from the moment they detect a disease (which occurs as a result of the development of complications in them). Meanwhile, in other cases, the survival rate has been determined for at least 5–10 years from the moment of detection of the disease; moreover, these indicators may be exceeded until the disease passes to the terminal (final) stage of development.
If symptoms appear that may indicate the possible relevance of leukemia, you should consult a hematologist.
The prognosis for leukemia largely depends on the age of the patient. Favorable is the age of thirty years. In this category of patients, stable remission often occurs. It is also faster and more often able to induce remission in women.
Extremely unfavorable for the prognosis is the age of 30 to 60 years.
Bad prognostic signs are: the presence of M3, M4, L3 morphological type of leukemia, massive bleeding, a decrease in platelet count below 30 * 1012, an increase in white blood cell count of more than 20 * 1012, the development of neuroleukemia, the addition of fungal and bacterial infections.
Very important! With the timely detection of the disease and the conduct of adequate therapy, as well as in the absence of aggravating prognostic signs, the five-year survival rate of patients with leukemia reaches 80%. If untreated, mortality is 100%.
When conducting maintenance therapy, the patient should be constantly monitored by a hematologist. A complete blood count is given once a week until the end of maintenance treatment (hereinafter – once a month). Biochemical analysis is carried out every three months.
KM puncture is performed if a relapse is suspected.
Upon achieving stable remission, the complete absence of relapse and concomitant diseases five years after the end of maintenance treatment, the patient can be deregistered.
For reference. Due to the fact that the exact cause of the development of leukemia is still unknown, there is no specific prevention of leukemia.
Symptoms of various types of disease
Symptoms of acute myeloid leukemia are as follows:
- a slight increase in the spleen, the development of febrile syndrome;
- leukemic pneumonitis (lesions are located in the lungs, which contributes to the appearance of cough);
- leukemia inflammation of the cerebral cortex (accompanied by severe headaches, febrile syndrome, neurological disorders);
- leukemic damage to the kidneys (severe renal failure develops, the amount of urine excreted decreases);
- specific skin rashes (look like spots of pink or brown);
- enlargement and compaction of the liver;
- signs of intestinal damage (loose stools, severe abdominal pain, flatulence, less commonly ulcerative defects form on the intestinal mucous membranes).
Symptoms in acute lymphoblastic leukemia are as follows:
- Enlarged spleen and lymph nodes. In the early stages of the disease, pathological changes in the supraclavicular lymph nodes are recorded. They acquire large dimensions and dense texture. Pain syndrome occurs when squeezing the surrounding nerve endings.
- Manifestations of pulmonary infiltration. The patient complains of coughing and shortness of breath, which occurs even at rest.
- Stomach ache. They occur with damage to lymph nodes located in the abdominal cavity. In men, there may be signs of testicular damage (a feeling of fullness and pain in the scrotum).
For erythroblastic acute leukemia in adults, anemia is characteristic. The number of red blood cells and the concentration of hemoglobin in the blood are reduced. The skin turns pale, weakness and dizziness appear.
The diagnosis of leukemia can be established solely on the basis of blood tests. In particular, this is a general analysis, due to which you can get a preliminary idea of the nature of the disease.
For the most reliable result on the relevance of leukemia, data obtained during puncture are used. Bone marrow puncture consists in performing a puncture of the pelvic bone or sternum using a thick needle, during which a certain amount of bone marrow is removed for subsequent examination using a microscope.
In more complex cases, the method of biochemical diagnostics, immunohistochemistry, is used, with which, on the basis of a specific amount of a particular type of protein in the tumor, it is possible to almost 100% determine its nature. Let us explain the importance of determining the nature of the tumor. Our body at the same time has a lot of cells, constantly growing and developing, on the basis of which we can conclude that leukemia can be relevant in their most diverse variations.
Meanwhile, this is not entirely true: those that are found most often have already been sufficiently studied for a long time, however, the more perfect the methods for diagnosis, the more we learn about possible varieties, the same applies to their number. The difference between the tumors determines the properties characteristic for each variant, and this means that this difference also applies to sensitivity to the therapy applied to them, including the combined types of its use.