Blood cancer - Causes, symptoms and treatment. MF.

What is blood cancer? In order to answer this question, we will first understand what is cancer in general.

So, cancer is a malignant tumor of epithelial tissue, that is, from cells covering our organs: the mucous membrane of the stomach, the intestines, the mouth cavity, the bronchi and so on, as well as the skin. That is, cancer is only a narrow concept of a certain type of malignant tumors. In addition to cancer, there are other forms, such as sarcomas, which develop extremely malignant and more aggressive than cancer, including blood sarcomas.

Blood cancer is a tumor that develops from one( !) Bone marrow cell by constantly uncontrolled division of it within a certain period of time( from several weeks to several months), displacing and suppressing the growth and development of other, normal blood cells. Accordingly, the symptoms of the disease will be associated with a deficiency in the body of certain normal working cells.

In the photo, a cancer cell of blood under the

microscope. Of course, there is no specific tumor that can be seen or touched in the body, it is "scattered" throughout the body - in the bone marrow( more often in the inner part of the sternum, pelvic bones), and sothe tumor cells circulate with the blood flow.

Causes of blood cancer

Why does the cell begin to divide endlessly? Our body functions as a single whole, a closely related team in which each player engages in his business, communicating with others and helping them fulfill their function. Universal cells - assistants are the blood cells, being born in the bone marrow, after maturation they go on a journey through the body: red blood cells-feeding other cells with oxygen, leukocytes - protecting them from the invasion of viruses and microbes, platelets- retaining the integrity of the tissue, forming blood clots and stopping bleedingif necessary. But at some point, any of the blood cells can turn into cancerous( more vulnerable young, immature cells) under the influence of various factors: radiation, chemical poisons that we consume with food or breathe in with air, genetic predisposition, as well as previous treatment with chemotherapy drugsabout another malignant disease. Sometimes the cause or trigger factor may be viruses, for example - human immunodeficiency virus( HIV).For example: among children who were in the zone of the Chernobyl disaster, a large number of cancerous blood diseases were noted. In this case, the cell loses its connection with the body, and begins to work for itself: endlessly to share, again and again, giving birth to a population of thousands and hundreds of thousands of similar ones.

Why do they bring so many troubles? Cancer cells multiplying, take food from normal cells, prevent them from growing and divide, perform their functions, take up more and more space in the bone marrow, when the places there become too small, the cells leave it, and exit into the bloodstream, filling other tissues and organs, forming in them the similarity of colonies and breaking their function, they can be: liver, heart, lymph nodes, kidneys, skin, lungs and even the brain.

"Blood cancer" is the wrong term for oncological diseases of the blood supply and hematopoiesis system, but it is firmly established among patients.

There are several types of blood tumors:

- leukemia( leukemia, from the Latin "leukos" - white): tumors from bone marrow cells:
• Acute - from young, immature blood cells, flow extremely aggressively;
• Chronic - from mature cells, flow easier.
- hematosarcoma( from the Latin "hemos" - blood) - extremely malignant, from lymphatic tissue( lymph nodes) - lymphosarcoma, for example, B-cell and others.

Most often, when they say "blood cancer", they mean some form of leukemia or lymphosarcoma, as these diseases are most often found in hematological practice. The clinically more correct name for "blood cancer" is hemoblastosis, i.e.group of tumors originating from the hematopoietic cells. Tumor - poorly controlled by the body actively expanding tissue that originated from a single mutated cell;it is not a consequence of inflammation or accumulation of nonmetabolized cells. Hemoblastosis, in which tumor cells predominantly affect the bone marrow, are called leukemias. In the past, leukemia was often called leukemia or a proteinosis because of the appearance of a large number of immature leukocytes in the blood. But, since this sign is not characteristic of all types of leukemia without exception, the term leukemia was abandoned.

In addition to leukemia, hemoblastosis also includes hematosarcomas - formations that originated from the hematopoietic cells, but which are extramodern sprouting tumors. Significantly less common is a type of hemoblastosis, such as a lymphocytoma - a tumor consisting of mature lymphocytes, or a growth that resembles a lymph node, with little or no damage to the bone marrow.

Both in hematosarcomas and in lymphocytomas, tumor cells can eventually spread throughout the body and affect the bone marrow. At this stage it is usually impossible to distinguish hematosarcoma from acute leukemia, and lymphocyte from chronic lymphocytic leukemia.

All hemablastoses are characterized by the systemic nature of the lesion, which makes possible the defeat of other organs and tissues. Another characteristic feature of the course of these diseases is that all extra-extramural( nonleukemic) hemoblastoses are able to be leukemized, i.e.metastasize to the bone marrow.

Metastases of hemoblastoses in organs and tissues that are not related to hematopoies reflect a new stage of the disease: the appearance of a subclone( the next generation of tumor cells) adapted to this tissue. Often, metastases in different organs behave independently, often have different sensitivity to chemotherapy regimens.

For the separation of hemoblastoses into evil and benign as criteria, the presence or absence of a tumor progression is usually accepted. Those.benign tumors are characterized by a monotonous course without the appearance of qualitative changes, in fact they do not spread throughout the body. Malignant neoplasms, on the other hand, progress quite quickly and differ in clinical dynamism - a rapid increase in symptoms that are already visible to the naked eye.

Symptoms of blood cancer

The first alarming bells may be: weakness, dizziness, unstable temperature rises to low figures, not associated with any colds, bone pain, aversion to smells or food, headaches. These symptoms are nonspecific and, more often than not, do not force patients to consult a doctor. Changes in the state are often noticed by relatives: excessive pallor, weight loss, dry and icteric skin color, drowsiness or, on the contrary, unusual irritability of patients. With some types of disease sharply increases the spleen and liver, patients complain of an increase in the abdomen in size, swelling, heaviness in the hypochondrium, usually it is a harbinger of a far-reaching stage. In addition, there may be increased bleeding of mucous membranes, small rashes on the skin.

In the case of tumors of lymphatic tissue, the first symptom is the appearance of a dense, painless node under the skin in places of natural folds( in the groin, in the axillary hollows, above the clavicles, on the neck) - these are the lymph nodes. When finding such tumors, you should immediately( !) Go to the doctor and take blood tests, as well as perform ultrasound examination of enlarged lymph nodes, after which the therapist will refer to the appropriate specialist( surgeon, oncologist or hematologist).
Hematologist is a doctor engaged in the treatment of diseases of the hematopoietic system.

Photo of patients with blood cancer( right) Korobchenko Victor 27.10.1992-03.10.2007 Diagnosis Acute lymphoblastic leukemia hybrid( T-cell and myeloid) early relapse)

examination The diagnosis of leukemia is based only on blood tests: first of all a general analysis, which gives a preliminary idea of ​​the nature of the disease. The most reliable variant of leukemia is based on bone marrow puncture data: a thick needle pierces the sternum or hip bone, a small amount of bone marrow is injected into the syringe and examined under a microscope.

An experienced cytologist( a doctor working with a microscope) will necessarily tell the type of tumor, how aggressive it is, the amount of damage it has to the bone marrow. In addition, in complex cases, diagnostics is increasingly used at the biochemical level: immunohistochemistry, by the number of these or those proteins in tumor cells, it is possible to determine its nature with an accuracy of 100%.

Why do I need to know the nature of the tumor? In our body, a huge number of cells grow and develop at the same time, on the basis of this, it can be assumed that there can be a huge variety of leukemia variants. This is not quite true: the most frequently encountered of them have long been studied, but the more sophisticated the methods of diagnosis, the more varieties of tumors we learn. Different tumors - are differently sensitive to treatment, different drugs or their combinations are used. In order to choose the appropriate drug for treatment and it is necessary, necessarily, to know the nature of the tumor.

Treatment of blood cancer

As a treatment, chemotherapy is used: it is an intravenous( dropper) injection of highly toxic strong drugs, in large doses, designed to destroy all foreign aggressive cancer cells, while, of course, it is impossible not to damage your own, good and necessary. In view of this, especially rapidly developing cells from the normal tissues are affected: hair follicle cells( hence the hair loss), cells of the gastrointestinal tract( nausea and vomiting, stool disorders), cells of the reproductive system, as well as bone marrow( anemia-decrease in the number of erythrocytes and leukopenia - decrease in leukocytes - immunity).Scientists from all over the world are constantly working on the development of drugs that can not affect normal cells, but unfortunately, such a tool can not yet be found, since cancer cells are too similar to our native cells. In addition, the situation is complicated by the ability of some tumor cells to change their structure and at the same time become insensitive to medications, to escape their effects, in this case, to choose stronger and toxic drugs, but even in these cases, the effect may not occur.

Without the use of chemotherapy, the chances of survival in patients are minimal. Usually, the time from detection of the disease to the death of patients without treatment is 1-5 months.

It is worth mentioning one more method of treatment: the so-called "bone marrow transplantation".Of course, no one transplants, meaning a parenteral( dropper) introduction of a bone marrow cell concentrate of a healthy donor, which is taken by puncture. Preliminary high dose of chemotherapy drug destroys all cells of the patient's bone marrow( in order to destroy the population of cancer cells to the last), after which an intravenous infusion is made. The procedure is very dangerous and is performed according to strict indications, usually with high-grade tumors and in young patients. At this time, patients are extremely vulnerable to infection and are in intensive care units.

Unfortunately, until now no other methods of treatment of leukemia have been developed.

Do not trust different healers and homeopaths, who in large numbers offer their services, this is a loss of precious time for the patient, you need to begin treatment as soon as possible with a qualified specialist. As an auxiliary treatment, if desired, you can use various vitamins( vitrum, multitabs and others), to prevent complications from the digestive tract, decoctions of herbs( chamomile, yarrow, sea buckthorn oil) are recommended that have local anti-inflammatory, hemostatic and wound-healing effects. It is strictly forbidden to use such "folk remedies" as tinctures of mushroom, hemlock, celandine and other poisonous substances during chemotherapy treatment! All of them have a pronounced toxic effect and poison the body, the protective forces of which are undermined by an oncological disease, further exacerbating the patient's condition.

Prophylaxis of blood cancer does not exist.

Prognosis of the disease

The prognosis and outcomes of the disease depend primarily on the shape of the tumor: for acute leukemia, the forecast is worse, they flow rapidly and rapidly lead to the death of patients. Chronic leukemias flow more benignly, remission of the disease( clinical recovery) is achieved more quickly and require fewer courses of severe chemotherapeutic treatment.

Blood cancer in children

Malignant blood diseases are quite common in children. In this case, most often sick children aged 2 to 5 years. Boys are more often ill. The appearance of the disease in childhood is probably associated with the effect of radiation: exposure to the mother during pregnancy, as well as with violation of the cells of sick children in the genetic apparatus( hereditary causes).Blood tumors in children clinically manifest themselves, as in adults, with a variety of symptoms: pain in the bones, joints, weakness, dizziness, drowsiness and rapid fatigue of the child, skin pallor, enlargement of the liver, spleen and lymph nodes. In children, this form of the disease is often diagnosed as "neuroleukemia": headaches, dizziness, neurological symptoms( meningeal, brain damage, encephalic brain tissue damage), and others, this form develops in case of relapsea period of time after the completion of treatment), treatment is rather difficult, new combinations of chemotherapy drugs are used.

To treat leukemia in children, as in adults, chemotherapy is used, the effect of which in children is often better than in adults, this is due to the ability of the child's body to recover more quickly after treatment. In addition, in childhood, bone marrow transplantation is used from donors, which can become immediate relatives( brothers and sisters, compatible in a number of indices).Recovery in children is usually observed in 70% of cases with acute lymphoblastic leukemia, in contrast to adults, and in 40% in acute myeloblastic leukemia.

Prognosis and survival rate for leukemia.

The level of incidence of blood tumors in different countries varies in a wide range: from 3 to 10 people per 100 thousand population. In this case, men are 1.5 times more likely than women. The maximum incidence of chronic leukemia is observed in people aged 40 to 50 years, acute - 10-18 years. The peak of the disease is observed at the age of 2 to 5 years with a gradual decrease in the number of people aged 7 years and older. A less significant increase in the number of cases falls at the age of 10-13 years. Boys suffer from acute leukemia more often than girls. The frequency of leukemia in children is 3.2-4.4 cases per 100 thousand of the population.

The prognosis for acute leukemia is much worse than for chronic leukemia. Acute leukemias flow rapidly, aggressively, react poorly to treatment.
Among acute leukemias, there is a predominance of cases of acute lymphoblastic leukemia, whose frequency is 75-85%.

Acute leukemias without treatment very quickly lead to the death of patients, but with proper treatment the prognosis, especially for children, is favorable.
The probability of curing patients with acute lymphoblastic leukemia ranges from 60-65% to 85-95%.

The recovery of patients with acute myeloblastic leukemia during adequate treatment is 40-50%.In the case of stem cell transplantation, 55-60%.

Chronic leukemias develop slowly, gradually, for 1 year or more, but until a certain point, called a blast cry, when chronic leukemia actually turns into acute, and behaves extremely aggressively, the life span of such patients is no more than 6-12 months.

Death from chronic leukemia occurs during blast crisis from complications. With the timely treatment of chronic leukemia, you can achieve remission for many years. On the background of chemotherapy, the average life expectancy is 5-7 years.

Hematosarcomas are extrarenal tumors from the hematopoietic tissue?very similar to leukemia, and with time passing into them. But remission is usually two times longer than with chronic leukemia. The forecast for hematosarcomas is influenced by the presence of symptoms of tumor intoxication: general weakness, body temperature rises, changes in biochemical blood tests( increased lactate dehydrogenase).The more severity of symptoms, the worse the response to treatment and the correspondingly worse prognosis.

Consultation of a doctor - oncologist on the topic of blood cancer

1. Which of the blood tumor is the most dangerous? Of course, these are acute leukemias. They develop from young, immature cells of the bone marrow( blasts) and come in several forms depending on the nature of the hematopoietic growth:
lymphoblast - from the cells of the lymphoid germ( the final stage is lymphocytes);
myeloblastnye-from the cells of the myeloid germ( erythrocytes, platelets).
The prognosis for these tumors is usually poor, they are poorly sensitive to chemotherapy, quickly lead to the death of patients. An exception is acute childhood leukemia.

2. What complications can occur as a result of chemotherapy?
Since drugs affect almost all cells of the body, side effects can be the most diverse, most frequent: stomatitis - inflammation of the oral mucosa, associated with direct toxic effects of drugs on sensitive cells of the mucosa and their death, with the infection that can join thateven more exacerbate the condition, it should be noted that not only the mouth mucous but also all internal organs of digestion "dies"( there may be diarrhea, abdominal pain);nausea, is associated with the irritant effect of drugs on the emetic center of the brain, for its suppression drugs that reduce the sensitivity of the vomiting center to chemotherapy drugs( for example, an emet, ondansetron) are used;the most formidable and dangerous complication is agranulocytosis - complete disappearance of all groups of cellular elements in the blood( leukocytes - threat of infection, platelets-threat of bleeding, less erythrocyte-their life span is higher), this complication is life threatening for the patient and requires treatment inconditions of resuscitation.

3. Can we cure cancer of the blood?
It is not always possible to talk about cure, only when it is possible to detect a tumor at an early stage, when there is no lesion of internal organs and the protective forces of the organism are not undermined. Most often, it is possible to achieve a long-term remission of the tumor, when blood tests and the bone marrow picture are normalized, the patient feels well, there are no signs of illness, that is, to prolong the life of patients, but in this case the disease can return. It is believed that if there are no signs of illness for more than 5 years, the patient is considered to be recovered.

4. Does the cancer transmit with blood transfusions and from mother to child?
No, with blood transfusion the cancer is not transmitted, this is due to the fact that some of the tumor cells die right away when blood is collected, the remaining ones are destroyed by the patient's healthy immune system.

Cancer is also not transmitted from mother to child, it is related to the functioning of the hematoplacental barrier, where the blood cells of the mother and fetus contact but do not mix, do not reach the child through the barrier. Other malfunctions of the fetus can be observed in sick mothers: slow development, lack of oxygen due to deterioration of nutrition due to a lack of normal blood cells of the mother.