Stages of acute leukemia
To determine the tactics of treatment and prognosis, it is important to identify the stages of acute leukemia. In the course of acute leukemia, the following clinical stages can be distinguished( Table).
Table Criteria for evaluating the efficacy of acute leukemia therapy
No effect of
Progression of the process or worse results than with clinical and hematologic improvement
Initial stage of acute leukemia: it is often diagnosed retrospectively;more often the clinician faces the first acute period of the disease( the first attack of the disease), which is characterized by severe suppression of normal hematopoiesis, high blastocyst of red bone marrow, marked clinical manifestations.
Complete remission: conditions in which the number of blast cells in bone marrow points does not exceed 5%, or the total number of lymphoid cells is less than 30%, of which blast cells less than 5%.The parameters of peripheral blood are close to normal. Possible leukopenia is not less than 1.5х109 / l and thrombocytopenia is not lower than 100х109 / l with a tendency to increase the content of granulocytes and platelets. There are no clinical signs of leukemia infiltration of the liver, spleen and other organs.
Incomplete remission is characterized by a positive dynamics of the disease on the background of the treatment: the number of blast cells in the bone marrow is not more than 20%, the disappearance of blasts from peripheral blood, the elimination of clinical manifestations of neuroleukemia, incomplete suppression of extraostembral foci of leukemia infiltration.
Recovery: complete remission for 5 years or more.
Relapse: conditions in which there is an increase in the number of blast cells in the punctate of the red bone marrow( more than 5%) and / or the appearance of extraostembral foci of hematopoiesis. If the patient has a number of blast cells in the red bone marrow more than 5%, but less than 10%, a completely normal blood test and a normal ratio of sprouts in the punctate of the bone marrow, relapse does not ascertain. In such cases, repeated puncture is performed 1-2 weeks later;If the blastocyst in the red bone marrow persists and exceeds 5%, a relapse is diagnosed.
The terminal stage of acute leukemia is characterized by ineffectiveness of cytostatic therapy, and against this background anemia, granulocytopenia, thrombocytopenia increase, and tumor proliferation increases.