Chronic lymphocytic leukemia is a malignant tumor consisting of lymphocytes. The disease can occur asymptomatically in the first stages, but it threatens with serious complications if the time does not begin to treat it.
Epidemiology
The disease is widespread among the general population, however, it most often affects Europeans.
Statistics show that every year it registers 3 cases per 100,000 people, and that:
- disease affects mostly elderly people;
- the female sex is ill with them 2 times less often;
- disease can be inherited;
Classification of
In modern medical practice, nine forms of chronic lymphocytic leukemia are distinguished:
- Benign. The disease is extremely slow, complications, if they develop, then to old age. With a benign form the patient can live up to 50 years.
- Progressive. The number of white blood cells in the blood and the size of the lymph nodes and spleen grows rapidly. This causes early development of complications and a short life span( up to 10 years).
- Tumor. Characterized by the growth of the size of the lymph nodes.
- Bone marrow. It is characterized by extensive lesions of the bone marrow.
- Splenomegalytic. Characterized by a rapid increase in the size of the spleen.
- Complicated with cytolytic syn-mom. With this form, tumor cells die under the influence of the immune system, which causes an intoxication of the body.
- Prolymphocytic. The special feature of this form is its rapid development, enlarged spleen and peripheral lymph nodes. Immunological analysis shows that B-cell chronic lymphocytic leukemia, the T-cell nature of lymphocytic leukemia, most often the first.
- Complicated with paraproteinemia. In this case, tumor cells release a protein that is not present in the body.
- Hair-cell. It is named so because the tumor cells have processes that look similar to villi.
- T-shape. The disease develops rapidly, causing more damage to the skin.
From the form depends not only the forecast, but also the risk groups. Thus, the T-form, more often than not, affects young Japanese.
Causes of
It is not known for certain why chronic lymphocytic leukemia occurs. There are several theories, the most popular of which is the virus-genetic.
To the factors causing the destructive effect of the virus it is possible to attribute:
- the effect of ionizing radiation;
- exposure to strong X-rays;
- exposure to vapors of varnishes and other chemicals;
- long-term intake of gold salts and strong antibiotics;
- associated viral diseases;
- presence of intestinal infections;
- constant exposure to stress;
- transferred operations;
The genetic predisposition to the disease has a decisive role. In the vast majority of patients in a family history, cases of chronic lymphocytic leukemia were detected.
Clinical Symptoms
Symptoms of chronic lymphocytic leukemia can be combined under several syndromes, which are characterized by a certain set of symptoms:
- Hyperplastic. The basis is the growth of tumor cells, expressed by an increase in lymph nodes, edema of the neck and face. Because of the increase in the spleen, the patient may feel a sharp pain localized at the top of the abdomen.
- Intoxicating. When tumor cells are destroyed, the decay products accumulate in the body, causing it to be poisoned. This generates a general state of weakness, increased fatigue and sweating, a stably elevated temperature, weight loss.
- Anemic. Associated with a deficiency in the body of certain metals and trace elements. Expressed by weakness, dizziness, noise in the ears, shortness of breath, pain in the thoracic region.
- Hemorrhagic. If it does, it's weak. Expressed by subcutaneous and submucosal hemorrhages, as well as bleeding from the nose, gums, uterus and other organs.
The disease can also be accompanied by immunodeficiency syndrome, expressed by weakened immunity. The fact is that with chronic lymphocytic leukocytes, leukocytes are formed in a small amount, because the body can not resist infections.
Stages of the disease
Chronic leukemia is distributed in 3 stages:
- Initial. The only stage that does not require treatment. During this stage, the number of leukocytes in the blood increases slightly, and the spleen slightly increases in size.
- Expanded. During this stage, the syndromes described above begin to appear. It is necessary to see a doctor so that the disease does not flow into the next stage.
- Terminal. Accompanied by complications, the emergence of secondary tumors.
With early diagnosis, the disease can be stopped, so if you have any doubts, it's worth visiting a doctor.
Complications of
Most often, patients die not from lymphocytic leukemia directly, but from its complications. The most common are infectious viruses and bacteria. Also the disease can be complicated:
- by an allergic reaction to insect bites;
- anemia;
- increased bleeding;
- by the appearance of a secondary tumor;
- by neuraleukemia;
- with renal insufficiency;
The occurrence of complications depends on the form and stage of the tumor. Sometimes the disease can occur even without them.
Diagnostic methods
Diagnosis of chronic lymphocytic leukemia begins with the collection of anamnesis and analysis of symptoms. After this, the patient is prescribed:
- Clinical and biochemical blood tests.
- Urinalysis.
- Puncture of bone marrow. During the procedure, puncture the bone and extract its contents. The study reveals the nature of tumor cells.
- Trepanobiopsia. An accurate study to assess the condition of the bone marrow.
- Puncture or removal of lymph nodes for the purpose of their study.
- Cytochemical tests that determine the type of tumor.
- Cytogenetic studies of the bone marrow. Identify hereditary mutations.
- Lumbar puncture, determining the lesions of the nervous system.
- ultrasound and X-ray to assess the condition of organs.
- MRI to detect the prevalence of the process.
- ECG for the detection of cardiac arrhythmias.
During the diagnosis, you may also need additional advice from doctors, for example, therapist, cardiologist and others.
Blood picture
In chronic lymphatic leukemia , an increased amount of white blood cells is found in the blood test.
The value is greatly enhanced due to mature cells. Among them, there may be young forms called pro-lymphocytes and lymphoblasts. The number of the latter can grow up to 70% during the exacerbation of the disease.
Treatment of chronic lymphocytic leukemia in children and the elderly
It should be noted that chronic lymphocytic leukemia does not always require treatment. So, at an early stage, a doctor's observation is shown.
A bone marrow transplant is considered to be a radical and effective method of treatment. However, it is rarely resorted to because of the complexity of the procedure and the high probability of rejection of the material.
The main method of treatment of chronic lymphocytic leukemia is chemotherapy, which can be performed according to such scenarios:
- Monotherapy with glucocorticosteroids. It is used in the presence of autoimmune complications. The main drug is Prednisolone in a dosage of 60-90 mg / day.
- Therapy with alkylating agents , for example, Chlorambucil or Cyclophosphamide. Sometimes it can be combined with prednisolone.
- Cladribine + Prednisolone. Often this therapy allows you to achieve complete remissions.
Along with this, haemostatic and detoxification preparations can be used.
Nutrition
When a chronic leukemia is detected, compliance with proper nutrition is indicated. It is necessary to limit the intake of fats to 40 grams, replacing it with protein.
It's important to focus on fresh plant foods that contain a lot of vitamins. Also shown is herbal medicine with a high content of iron and ascorbic acid.
Prognosis and life expectancy of
It is possible to predict the course of the disease only on the basis of its activity indices.
- As the statistics show, the chronic lymphocytic leukemia has a slow course in only 30% .In this case, the lethal outcome is not due to illness, but for other reasons.
- On the other hand, abrupt development is observed in 15% of cases of , which terminate in death 2-3 years after the diagnosis was made.
- In other respects, the disease is observed in two stages: in slowly progressing and terminal, which lasts up to 10 years, until the patient's death.
Prevention of
There is no specific prophylaxis against chronic leukemia. The main preventive tool is the timely treatment of leukemia with the use of antibiotics. Lowering the risk of overflow to a chronic form can also be a healthy lifestyle, the basic rules of which are:
- observance of the daily routine;
- moderate physical activity;
- rejection of bad habits;
What is chronic lymphatic leukemia, its symptoms and treatment methods in this video: