Mar 05, 2018
Leukemia is a malignant disease of the blood system, characterized by a predominance of bone marrow cell reproduction processes, and sometimes the appearance of pathological hematopoiesis in other organs. leukemias are close in origin to tumors. It is a disease of structures that create blood( bone marrow and lymphatic system-spleen, liver and lymph nodes), in which a large number of abnormal white blood cells are produced. These malignant cells are thrown into the blood, where they circulate throughout the body and can penetrate into other body tissues, including the liver, skin and central nervous system. How to use folk remedies for this disease look here.
The blood contains three basic types of cells. Red blood cells carry oxygen;platelets are important for blood clotting;white blood cells fight infectious diseases and form part of the body's immune system. White cells, in turn, are divided into two types. Cells produced by the bone marrow destroy bacteria and other foreign organisms, surrounding them;cells produced by the lymphatic system produce antibodies that destroy carriers of infections. Immature white blood cells, which are called blast cells, are produced by the bone marrow and lymphatic system, but are not released into the blood stream until they ripen. Usually the body produces only as many white blood cells as necessary to replace dead cells. With leukemia, too many blast cells and mature white cells are produced. The excessive amount of white blood cells in the bone marrow interferes with the production of other types of blood cells. As a result of a lack of red blood cells, body tissues experience oxygen starvation, platelet deficiency greatly increases the risk of bleeding, and the lack of mature white blood cells can weaken the immune system.
Different types of leukemia are divided into acute and chronic depending on how fast the disease progresses, and what white blood cells are exposed.
Acute leukemia is a rapidly progressive disease characterized by the growth of the youngest, undifferentiated cells that have lost their ability to ripen, usually requiring immediate treatment.
Symptoms. The disease occurs with high fever, weakness, development of severe manifestations of hemorrhagic diathesis. Infectious complications, necrotic tonsillitis join. The patient notes pain in the limbs;painfully tapping on the sternum. The number of leukocytes in the blood increases, especially the number of pathological young forms, the so-called blast cells. There is also a small number of mature forms in the blood smear, and intermediate forms are usually absent. In case of doubtful results of peripheral blood tests, a bone marrow puncture is performed, in which proliferation of blast cells is detected.
Treatment of acute leukemia is carried out by the appointment of a combination of several cytostatics: vincristine, 6-mercaptopurine, methotrexate and large doses of prednisolone( 60-100 mg).According to the appropriate indications, symptomatic agents are prescribed( antibiotics, hemostatic drugs, vitamins).If necessary, blood is poured. After achieving clinico-hematologic remission, sustained chemotherapy is continued for a long time.
Chronic leukemia has two stages of development: gradual and acute. During the stage of gradual development that can last for many years, symptoms are often absent, and treatment may not be required;However, the symptoms and rapid development of the disease in the second stage, the acute development of chronic leukemia, resemble the symptoms of acute leukemia.
Leukemia is also classified as white blood cells that have been exposed to acute myeloblastic leukemia, chronic myelogenous leukemia and monocytic leukemia, which seize myeloid cells;as well as acute and chronic lymphatic leukemia, when the cells of the lymphatic system are affected.
Chronic myeloleukemia is accompanied by a violation of maturation of granulocytes, increased their multiplication, the appearance of foci of extra-bone marrow hematopoiesis.
Symptoms of .The disease can develop gradually with the appearance of complaints of increased fatigue, poor appetite, weight loss. When the examination reveals an increase in the size of the liver, spleen, lymph nodes. Possible increased bleeding. The diagnosis is made in a blood test, in which a significant increase in the number of white blood cells is found to be 500,000 or more. When studying a blood smear, a large number of young forms of neutrophils are detected: myeloblasts, myelocytes. There may be a small anemia and a change in the number of platelets. Often increases the content of uric acid in the blood, which can lead to even a secondary gout. In the late stages of the disease there are infectious complications, there is a tendency to thrombosis.
Treatment. In the expanded stage of the disease, the main treatment is myelosan, which is used at a dose of 4-6 mg / day. When the level of leukocytes is reduced by half from the initial value, the dose is reduced by half. When the level of leukocytes becomes close to normal, go to a maintenance dose, for example 2 mg 1-3 times a week. With the low effectiveness of such therapy and the progression of the disease, treatment is carried out according to principles analogous to the treatment of acute leukemia, i.e.use a combination of cytotoxic agents. Extra-cerebral leukemia infiltrates, often in the terminal stage, are treated more often by irradiation. Simultaneously, symptomatic therapy is used.
Chronic lymphatic leukemia is a benign tumor of lymphatic tissue. Characterized by lymphatic leukocytosis, increased reproduction of lymphocytes in the bone marrow, increased lymph nodes, spleen, liver. The disease usually occurs in old age. In the study of blood often for a number of years only lymphocytosis( 40-60%) is noted, although the total number of leukocytes fluctuates near the upper limit of the norm. Gradually, the lymph nodes begin to increase, primarily in the neck, in the armpits, then the process spreads to other areas. There are increased fatigue, sweating, weakness, sometimes an increase in temperature. At research the lymph nodes are dense, mobile, painless. X-ray reveals an increase in the lymph nodes of the mediastinum with the displacement of its organs. Spleen and liver, as a rule, are often increased. In peripheral blood the number of leukocytes is increased mainly due to small lymphocytes. A characteristic sign of chronic lymphocytic leukemia is the dilapidated nucleus of lymphocytes( the shadows of Humprecht).Chronic lymphocytic leukemia can be complicated by bacterial infections, autoimmune hemolytic anemia and thrombocytopenia, shingles, exudative pleurisy, and damage to the nervous system.
Treatment. In more mild cases, with only mild blood changes, active treatment may not be performed. Indications for the beginning of therapy are: worsening of the general condition, rapid increase in lymph nodes, spleen and liver, the appearance of leukemic infiltration of organs. Assign chlorbutin( leukeran) in a dose of 2 mg 2-6 times a day( depending on the number of leukocytes in the blood) for 4-8 weeks. For maintenance therapy, chlorbutin is used in a dose of 10-15 mg 1-2 times a week. With resistance to this drug, it is not used again, but cyclophosphamide is administered intermittently in large doses 600-800 mg once a week. This therapy, especially in the presence of cytopenia, is combined with prednisolone in a dose of 15-20 mg daily. In the treatment of cytostatics, especially chlorobutin, it is often necessary to monitor peripheral blood due to the possibility of developing cytopenia. Effective for chronic lymphatic leukemia can also be local radiation therapy.
Half the cases of leukemia are acute leukemia. Acute lymphocytic leukemia is most common in children, while more than 80 percent of cases of acute myeloblastic leukemia occur in adults. From the types of chronic leukemia as a whole, the most common is chronic lymphocytic leukemia and myeloid leukemia.
Although leukemia is considered a childhood disease, it mainly affects people over the age of 60, especially men. Treatment can lead to recovery, although the recurrence of the disease is frequent. Currently, treatment of acute lymphocytic leukemia in children is successful: 50-70 percent of children permanently get rid of the symptoms of the disease.
• Chemotherapy is used to treat acute leukemia and chronic leukemia at the acute development stage. First, large doses are used to stimulate recovery, and in the case of acute lymphocytic leukemia, lower doses of drugs can be used for months or years to prevent the recurrence of the disease. The patient can be removed from the bone marrow for storage in a frozen state. Removal of bone marrow can protect it from damage when treated with high doses of chemotherapeutic drugs;then the stored bone marrow cells are put back in place.
• Radiation therapy can be used to destroy leukemic cells in the cerebrospinal fluid, central nervous system, spleen and lymph nodes( with acute lymphocytic leukemia, as well as in chronic myelogenous leukemia and lymphocytic leukemia).
• Corticosteroids( usually prednisone) can be prescribed prior to chemotherapy or in addition to it( for acute lymphocytic leukemia and chronic lymphocytic leukemia and at the stage of acute development of chronic myelogenous leukemia).
• Bone marrow transplantation can be used to treat( and possibly cure) acute lymphoid and myeloblastic leukemia and chronic myelogenous leukemia( if it is possible to find a compatible donor).The best results are achieved when the donor is a close relative. Prior to the transplant, the patient undergoes intensive chemotherapy, sometimes together with complete body irradiation, to destroy leukemic cells. The patient can also extract the bone marrow to treat it to kill leukemia cells, and then, after chemotherapy or a combination of chemotherapy and irradiation, bring it back into place.
• An operation to remove an enlarged spleen, one of the organs where white cells are produced, may be necessary for chronic lymphocytic leukemia.
• For all forms of leukemia during treatment, red blood cell or platelet transfusion can be used to maintain adequate levels of blood components. Analgesics can be prescribed for all forms of leukemia.
• Antibiotics or antifungal agents may be needed to treat infectious diseases in all forms of leukemia. Conventional infectious diseases are dangerous for the patient with leukemia, because both cancer and its treatment suppress the body's immune system.