Acute lymphoblastic leukemia is one of the malignant diseases that can be cured by contacting a doctor. To do this on time, you need to know about the disease all the smallest details.
What is acute lymphoblastic leukemia?
Acute lymphoblastic form is considered the most common among leukemia( approximately 80%).
Most often it affects boys under the age of 6 and boys, girls suffer several times less.
When lymphoblastic leukemia is affected lymph nodes, bone marrow, thymus gland and internal organs, for example, the spleen.
If the disease recurs after chemical therapy, the central nervous system is involved in its process.
Causes of
The exact causes of the disease are not established. Currently, scientists can identify only triggering acute lymphoblastic leukemia factors , which include:
- Infectious diseases transferred to infancy.
- Postponed chemotherapy, radiation therapy and ionizing radiation.
- Stillbirth, which my mother used to have.
- Biological mutagens and their negative effect on a pregnant woman.
- The child's weight at birth is more than 4 kg. Genetic pathology of the child, for example, Down's syndrome, immunodeficiency and the like.
- The presence of malignant neoplasms in a family history.
Scientists believe that the disease develops because of a combination of several factors listed, as well as a predisposition to it.
Symptoms and signs
Lymphoblastic leukemia is characterized by the presence of certain syndromes:
- Intoxication. Characterized by the usual signs of intoxication, that is weakness, fever and rapid weight loss.
- Hyperplastic. Peripheral lymph nodes are enlarged, painful conglomerates of dense texture are revealed when feeling. Joints ache and swell, there is pain in the bones and fractures of the latter. If the infiltrate has penetrated the liver and spleen, severe pain in the abdominal region appears.
- Anemic. The skin acquires a painful paleness, the mucous mouth bleeds, tachycardia and hemorrhagic syndrome( bloody vomiting, hemorrhages, ecchymoses) appear.
Diagnosis
Diagnosis begins with the collection of anamnesis, including family history, and analysis of symptoms. After appointing tests and examinations:
- General and biochemical blood tests. They show the level of hemoglobin, leukocytes and erythrocytes, the presence of thrombocytopenia, kidney and liver damage. Also in the blood are detected myelocytes and metamyelocytes, if there is no intermediate form of maturation.
The picture shows a picture of blood in acute lymphoblastic leukemia
- Myelogram. It is carried out in 3 stages. First, an analysis is made of the morphology of cytology, showing the hypercellularity of the bone marrow and infiltration by blast cells. Then a cytochemical analysis is carried out, and after it - immunophenotyping to determine the type of cells.
- A spinal puncture showing the presence of CNS damage by leukemia cells.
- ultrasound. It determines the degree of lymph node enlargement and the size of the affected organs.
- Chest X-ray to see if the mediastinum is enlarged.
If a patient is prescribed chemotherapy, additional tests are performed, for example, urinalysis, ECG and echocardiography.
Treatment of
The main treatment for lymphoblastic leukemia is chemotherapy, which is divided into three stages:
- Induction. The duration takes about several weeks, until a stable remission is achieved. It is a chemotherapy with the use of cytostatics. Medications destroy leukemic cells, restore blood formation. As drugs can be used vincristine, glucocorticosteroids, asparaginase, anthracycline and others. Statistics show that in more than 85% of cases it is possible to achieve a stable remission.
- Consolidation. Lasts up to several months. It is directed to the destruction of the remaining pathogenic cells. Most commonly prescribed are methotrexate, 6-mercaptopurine, vincristine, prednisolone, cytarabine, asparaginase and other drugs. To increase the effect, it is advised to inject drugs intravenously.
- Supportive therapy .The duration is several years. Therapy is aimed at maintaining remission, eliminating the risk of relapse. The patient is prescribed 6-mercaptopurine and methotrexate.
Depending on the response to treatment, the age of the patient and the concomitant diseases, other drugs may be prescribed. For example, taking multivitamins or antibiotics. In rare cases, bone marrow transplantation is required.
Prognosis of survival in adults and children
The prognosis for cure in childhood is more favorable than in the adult. So, statistics show that
- survives for 5 years: up to 84% of children;
- up to 40% of adults;
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