Leukemia is a group of diseases with malignant damage to the hematopoietic cells. As a result of this pathological disturbance, not only the function of hemopoiesis changes, but the work of the whole organism also changes for the worse. Patients with leukemia belong to different age categories, this disease is also affected by very young children.
What is leukemia in humans?
Leukemia is a condition in which the bone marrow is affected, more precisely its cells. These cells by nature perform the function of the "progenitor" of the main hematopoietic cells - erythrocytes, leukocytes, platelets.
In leukemia, the circulatory system is gradually saturated with altered leukocytes( white blood cells), which do not perish in the normal period of hematopoiesis.
Pathological leukocytes( leukemia cells) interfere with the normal operation of normal white blood cells, displace them and accumulate in the stagnant brain, internal organs and lymph nodes, which accordingly changes the functioning of these systems.
Leukemia cells not only reduce the number of normal leukocytes and those cells that precede their development, but also cause cytopenia, that is, deficiency of elements such as red blood cells and platelets. What happens to the body with such atypical processes can be understood if one knows the function of blood cells.
- Leukocytes are the main protectors of our body from the influence of various alien organisms - viruses, bacteria, fungi. Also, suppression and rapid elimination of any developing infectious process depend on leukocytes.
- Erythrocytes, that is, red blood cells, provide transport throughout the body and an uninterrupted supply to tissues and organs of oxygen and nutrients.
- Platelets are responsible for the normal process of blood coagulation.
The picture clearly shows the blood picture for leukemia
In the circulatory system of all the major hematopoietic cells there should be a certain amount, their deviation in one direction or another leads to various health problems. With leukemia, the deficit of the main blood cells negatively affects the general process of hematopoiesis, leads to significant changes in the immunity, affects the occurrence of a number of pathological conditions.
Many people are wondering what is the difference between concepts such as leukemia and leukemia. These two terms denote one disease, also malignant blood damage can occur under the names of the anemia, blood cancer.
Tumor formation, inherent in malignant tumors, with leukemia is absent - cancer cells are carried by the blood current throughout the body. Leukemia is divided into several species, depending on which cells have undergone atypical rebirth.
Classification of
In medicine, several classifications of leukemias are used. Basically, this disease is divided by the nature of its course, by the types of mutated cells.
Classification of gastrointestinal tract helps to determine more accurately the choice of treatment methods and determines the prognosis of the course of malignant pathology.
Types of
The type of leukemia is acute and chronic.
- Acute leukocytosis is characterized by the appearance of immature cells, which completely lose their functional significance. This form of the disease develops rapidly, all the symptoms grow rapidly and the person's condition is severe.
- Chronic leukocytosis is exhibited when atypical blood cells are detected during diagnosis, but they still partially fulfill their functions. In this regard, the disease is not manifested with pronounced symptomatology and is often accidentally detected during examination for other reasons. Chronic course also implies the progression of the disease, although this is much slower compared to an acute leukemia.
Degrees of differentiation
- Undifferentiated. This type of leukemia is exposed when immature cells that do not have a clearly traced structure of the structure are revealed in the blood.
- Cytaric.
- Bled leukemia.
According to the cytogenesis of
, cytogenesis is the development and division of cells. According to this parameter, acute leukemia is divided into:
- Lymphoblastic.
- Monoblastic.
- Myeloblast( myeloid).
- Myelomonoblastny.
- Erythromyeloblast.
- Megacaryoblast.
- Undifferentiated.
The group of chronic leukocytosis in cytogenesis is divided into myelocytic and lymphocytic species, which also have their classification.
Chronic leukopenia of the myelocytic species is divided into:
- Myelocytic leukemia.
- Eosinophilic leukemia.
- Neutrophilous leukemia.
- Basophilic leukemia.
- Erythremia.
- Myelosclerosis.
- Essential thrombocythemia.
Chronic leukopenia of lymphocytic origin are divided into chronic lymphocytic leukemia and paraproteinemic leukemia. The latter group also has its classification:
- Primary macroglobulinemia of Waldenstrom.
- Myeloma disease.
- Illness of heavy chains of Franklin.
- Lymphoma of the skin.
Chronic leukemia of monocytic origin is divided into three subspecies:
- Myelomonocytic.
- Monocyte.
- Histiocytosis X.
Based on the immune phenotype
Modern diagnostic methods allow more accurate determination of the type of altered cells in leukemia depending on their immune phenotype and antigenic markers.
The total number of leukocytes and the presence of blast cells in the peripheral blood
- Leukemia leukemia. In blood tests more than 50-80 × 109 / L of white blood cells, blasts are among them.
- Subleukemic of leukemia. In the blood 50-80 × 109 / L of leukocytes, blasts are also found.
- Leukopenic leukemias are exposed when the white blood cells are significantly below normal, but blasts are still preserved
- Aleyukemichesky leukemia - leukocytes are small, blasts are not found.
Causes of
What exactly is developing leukemia medics has not been established to date. But, nevertheless, there are a number of provocative causes in adults and children, whose influence was revealed in patients with blood cancer. To their group are:
- Radiation radiation. It can single exposure to large doses of radiation, examples of such impact can be tragedies in Nagasaki, Chernobyl. An excessive dose of radiation can be obtained by humans even with radiation therapy.
- Prolonged exposure to chemicals such as benzenes. Similar occurs when working at some chemical industry enterprises, when smoking, with constant exposure to gasoline.
- Some medicines related to chemotherapy.
- A number of pathologies with chromosomal abnormalities - Klinefelter's syndrome, Down's disease.
- Long-term immunodeficiency states.
- Diseases of the blood in an anamnesis - congenital maldevelopment of the bone marrow, aplastic type of anemia.
Heredity does not play a leading role in the onset of leukemia. Very rarely, family cases of patients with this malignant disease are established.
Manifestations of the disease in adults and children
It is practically impossible to determine leukemia at the initial stages of its development by symptoms. In chronic course, the symptomatology grows slowly, with acute development of the disease, the manifestations of the disease will be brighter, and the deterioration of the general well-being of the patient comes faster.
The photo shows the infiltration of soft tissues in leukemia
The course of the disease depends on the number of modified cells and their location in the body.
The first signs of the pathology of
The first signs of acute and chronic leukemia include:
- An increase in the size of the lymph nodes. In most patients, these changes are seen on the neck and in the armpits. At palpation of pain, these enlarged lymph nodes are absent.
- Appearance of strong, unreasonable fatigue and weakness.
- Frequent infectious diseases. Normal leukocytes become smaller and therefore they do not perform their protective function. A person develops frequent bronchitis, relapsing pneumonia, herpes becomes aggravated.
- Appearance of almost constant sweating during sleep.
- Temperature rise without the influence of various colds or infectious diseases.
- Discomfort and heaviness left and right under the ribs. In palpation, the liver and spleen are enlarged in size.
- Changes in the body that result from a disorder in the blood coagulation function. These include the appearance of bruises on the body, various reddish spots under the skin( pinpoint hemorrhages), bleeding from the nose, increasing bleeding gums.
Other symptoms of anemia
The accumulation of cancer cells in various systems and organs leads to the appearance of other signs of the disease, it is:
- Consciousness disorder, its periodic confusion, inhibition.
- Shortness of breath.
- Pains and a feeling of heaviness in the head.
- Nausea, the urge to vomit.
- Pathological change in coordination of movements.
- Periodically occurring seizures, they can affect both individual parts of the body, and be generalized.
- Ophthalmic problems - shroud before the eyes, blurred vision and falling vision.
- Puffiness affecting the groin, hip, shin area. In men, swelling can spread to the scrotum, which leads to painful sensations.
Signs of acute lymphoblastic leukemia
Acute lymphoblastic leukemia is most often detected in children, the peak incidence falls on the age from one to six years.
The pathological process involves the bone marrow, thymus gland, lymph nodes, spleen and then other internal organs. CNS lesion mainly occurs after relapse of the disease and the course of chemotherapy.
The most obvious and often detectable symptoms of lymphoblastic leukemia are:
- Intoxication syndrome. In children it manifests itself as the beginning of a cold. There is weakness, fever, appetite decreases, there is an ache in the joints, you can notice weight loss.
- Enlargement of peripheral lymph nodes.
- Increased spleen and liver may occur against a background of abdominal pain.
- Anemic syndrome. In acute lymphoblastic leukemia, symptoms such as weakness, pallor or icterus of the skin, palpitations increase, bleeding gums are possible.
- Hemorrhages in the retina of the eye , with ophthalmological examination revealed puffiness of the optic nerve, leukemia plaques.
- Shortness of breath. Development of respiratory disorders occurs due to an increase in the internal lymph nodes in the chest, which cause changes in the work of the respiratory system.
- In boys, in almost 30% of cases, infiltrates in the testicles appear, leading to their increase.
With lymphoblastic leukemia, immunity is significantly reduced, this leads to frequent colds and the occurrence of long-term non-healing wounds on the skin when it is injured. Also, this disease can be accompanied by kidney damage, but in the first stages of the symptoms of this pathology there.
Acute myeloblastic
In acute myelogenous leukemia( AML), a reduced number of all major blood cells - platelets, erythrocytes, leukocytes.
The disease for a long time does not show itself a certain symptomatology, you can pay attention only to the periodically appearing malaise. AML is detected at any age, but more fall in this type of blood cancer should people over 55 years.
The main symptoms of acute myeloid leukemia include:
- Toxic and anemic syndrome. The sick person periodically has attacks of dizziness, increased weakness and fatigue. Long there is a bad appetite and the body temperature rises periodically, there is a strong night sweats.
- Changes in the osteoarticular system. This is manifested by the appearance of persistent tenderness, embracing all or part of the joints of the lower limb. Strong pains along the spine are fixed, they lead to restriction of movements and to a pathological change in gait. On the roentgenogram of the bone system, destructive disorders and foci of osteoporosis are noted.
- Enlarged liver and spleen. This symptom does not appear in all patients.
AML rarely leads to an increase in lymph nodes. If this happens, the dimensions increase to about 5 cm, and when palpation is felt in the lymph nodes conglomerate, formed due to the soldering of tissues. This type of blood cancer is characterized by common signs of leukemia, bruises and subcutaneous hemorrhage on the body, increased bleeding, joint pain, weight loss.
Chronic myelocytic
Among patients with chronic myelocytic leukemia, most people are between 30 and about 50 years old.
This type of leukemia is more susceptible to men, pathology is very rarely diagnosed in childhood. The analysis reveals a significant increase in leukocytes due to the growth of myelocytes and promyelocytes.
At the early stages of the development of the chronic form of the disease, the patient complains only of a decrease in working capacity and fast-onset fatigue.
The growth of the rest of the symptoms is very slow, often from two to three and up to 10 years from the time of detection of the disease to the development of its pronounced stages.
The following symptoms are noted:
- The appearance of dyspnea , this occurs both in physical activity and at rest.
- Pain and heaviness under the ribs to the left. Diagnosis of enlarged liver and spleen.
- Blood thickening leads to the development of necrosis sites in the spleen , which can be suspected of intensifying pain, the appearance of nausea, vomiting, febrile syndrome.
- Vertigo, migraine, disorientation in the orientation in space and in the coordination of basic movements.
Patients with chronic myelocytic leukemia exhibit susceptibility to infectious diseases, weight loss, periodic bone pain.
Symptomatic of chronic lymphocytic
This type of disease progresses slowly, for several years. After many cancer cells are formed, the following symptoms may appear:
- Enlarged lymph nodes. Usually, the increase occurs against the background of the most common infectious diseases, after recovery, the size of the nodes becomes normal. Initially, the cervical lymph nodes are affected, then the axillary lymph nodes, lymph nodes of the mediastinum, the abdominal and inguinal regions are involved in the pathological process.
- Pain in the right upper quadrant of , caused by liver growth.
- Platelet and erythrocyte destruction leads to frequent bleeding from the nose of , increased bleeding of gingival tissue, jaundice of the skin and sclera.
Chronic lymphocytic leukemia with its progression is manifested and general cancer symptoms.
Stages of
Acute leukemia is divided into several stages. But first a hidden period is identified, this time is from the effect of the disease-provoking factor and before the appearance of the first clinical signs of hemopoiesis.
- The initial leukemia stage is often diagnosed accidentally by blood tests. The doctor can pay attention to leukopenia, leukocytosis, signs of anemia, a decrease in the number of platelets. At the initial stage, all clinical signs are most pronounced.
- The unfolded stage is characterized by a clinical picture and the main inherent changes in blood in leukemia.
- Remission. The attenuation of the process can be complete and incomplete.
- Relapse of leukemia. Exacerbation can lead to both the appearance of new bone marrow lesions, and to the localization of cancer cells in other organs. Each subsequent relapse is more difficult for the patient.
- The terminal stage is exposed when an ineffectiveness of cytostatics is detected. In blood tests anemia, thrombocytopenia, granulocytopenia.
How to detect the oncology of the hematopoietic system?
Leukemia is detected exclusively by blood tests. In addition, the sternum or pelvic bone is punctured for bone marrow sampling.
Cytological examination of the bone marrow allows you to determine the type of altered cells, the aggressiveness of the tumor. Also, patients can be assigned such studies as ultrasound, radiography, computer diagnostics, lymph node biopsy.
Blood test
When leukemia is detected in blood tests:
- Severe anemia( decreased hemoglobin).
- Deviation from the norm of the number of leukocytes, can be both their reduction, and a multiple increase.
- Thrombocytopenia.
- Disturbance in the leukocyte formula.
- Identify atypical cells.
- In acute leukemia, blasts and a number of mature cells without transitional elements are found in the blood.
- In chronic leukemia, bone marrow cells are identified.
Is it possible to cure the disease?
Currently, leukemia, detected at an early stage of development, is well treatable. With timely and complete therapy, it is possible to achieve a stable remission, which often lasts for decades , especially for children.
How to treat leukemia?
The main types of treatment for all types of leukemia are:
- Chemotherapy.
- Radiation therapy.
- Stem cell transplantation. Irradiation or chemotherapy is often used before transplantation.
How many live: forecast
The prognosis for patients with leukemia is set according to their age, the form of blood cancer, the prevalence of cancer, the body's response to treatment.
Most often, a bad prognosis is expected in men, children, adolescents with an age of more than 10 years, in adults over sixty years old.
Chances for long-term remission are reduced with late diagnosis, the initial many times overestimated level of leukocytes. Acutely developing leukemia is characterized by a rapid course, and if there is no course of treatment, then the patient's death occurs quickly.
A video about the symptoms and treatment of leukemia: