Tumor pathologies often affect the circulatory system. One of the most dangerous pathological conditions is chronic myelogenous leukemia - a cancerous blood disease characterized by indiscriminate reproduction and growth of blood cells. This pathology is also called myeloid leukemia of a chronic form.
The disease rarely affects children and adolescents, more often found in 30-70-year-olds more often than males.
What is chronic myelogenous leukemia?
In fact, myeloid leukemia is a tumor formed from early myeloid cells. Pathology is cloned and among all hemoblastoses is about 8.9% of cases.
For chronic myelogenous leukemia, a typical increase in the blood composition of a specific type of leukocytes, called granulocytes, is typical. They are formed in a red bone marrow substance and in large quantities penetrate into the blood in an immature form. At the same time, the number of normal leukocyte cells decreases.
Causes of
The etiological factors of myeloid leukemia of a chronic nature are still the subject of study and cause scientists a lot of questions.
It has been reliably revealed that the development of chronic myeloid leukemia is affected by the following factors:
- Radioactive irradiation. One of the proofs of this theory is the fact that among the Japanese, who are in the zone of the atomic bomb attack( the case with Nagasaki and Hiroshima), the cases of development of chronic myeloid leukemia have become more frequent;
- Influence of viruses, electromagnetic beams and substances of chemical origin. This theory is controversial and has not yet received a definitive confession;
- Hereditary factor. Studies have shown that in people with chromosomal disorders, the likelihood of myeloid leukemia increases. Usually these are patients with Down syndrome or Klinefelter, etc.;
- Some medications, such as cytostatics, are used to treat tumors in conjunction with irradiation. In addition, alkenes, alcohols and aldehydes can be dangerous for health. Very negative on the health of patients with myeloid leukemia is reflected in nicotine addiction, aggravating the condition of patients.
Structural disorders in red bone marrow cellular chromosomes lead to the birth of new DNA with an abnormal structure. As a result, clone cells of abnormal cells begin to be produced, which gradually displace normal to such an extent that their percentage in the red bone marrow becomes prevalent.
As a result, abnormal cells multiply uncontrollably, by analogy with cancer. And their natural death by conventional conventional mechanisms does not happen.
The concept of chronic myelogenous leukemia and its causes of appearance, will tell the following video:
When entering the general bloodstream, these cells do not cope with their main task, which leads to a lack of immune defense and resistance to inflammation, allergic agents with all the ensuingconsequences.Phases
The development of myeloid leukemia of chronic form occurs in three consecutive phases.
- The phase is chronic. This stage lasts about 3.5-4 years. Usually it is with her that most patients get to a specialist. The chronic phase is characterized by constancy, because patients have the minimum possible set of symptom-complex manifestations. They are so insignificant that patients sometimes do not attach any importance to them. A similar stage can be detected with an accidental blood test.
- Accelerated phase. is characterized by the activation of pathological processes and the rapid increase of immature leukocytes in the blood. The duration of the acceleration period is a year and a half. If the treatment process is adequately selected and started on time, then the probability of the pathological process returning to the chronic phase increases.
- A blistering crisis or terminal phase. This is a stage of exacerbation, it lasts no more than six months and ends lethal. It is characterized by an almost absolute replacement of red bone marrow cells by abnormal malignant clones.
In general, pathology is inherent in the leukemia development scenario.
Symptoms
The clinical picture of myeloid leukemia varies according to the phase of the pathology. But it is possible to distinguish the general or common symptomatology.
Chronic stage
For this stage of chronic myelogenous leukemia typical manifestations are:
- Weak symptomatology typical of chronic fatigue. General health worsens, worries about impotence, weight loss;
- Due to the increase in spleen volumes, the patient notes a rapid saturation with food intake, in the left abdomen often there is soreness;
- In exceptional cases, there is a rare symptomatology associated with blood clots or blood thinning, headaches, memory and attention disorders, visual disturbances, dyspnea, myocardial infarction.
- Men in this phase may develop too long, causing a painful manifestation of an erection or priapic syndrome.
Accelerated
The accelerating stage is characterized by a sharp increase in the severity of pathological symptoms. Anemia is rapidly progressing, and the therapeutic effect of cytotoxic drug preparations is significantly reduced.
Laboratory diagnosis of blood shows a rapid increase in leukocyte cells.
Terminal
The phase of the blast crisis of chronic myelogenous leukemia is characterized by a general deterioration in the clinical picture:
- The patient has a pronounced febrile symptomatology, but without infectious etiology. The temperature can rise to 39 ° C, causing a feeling of tremendous tremor;
- Hemorrhagic symptoms caused by bleeding through the skin, intestinal membranes, mucous tissues, etc.;
- Severe weakness bordering on exhaustion;
- The spleen reaches an incredible size and is easily palpated, which is accompanied by heaviness and pain in the abdomen to the left.
The terminal stage usually ends lethal.
Diagnostic methods
Diagnosis of this form of leukemia is administered by a hematologist. It is he who conducts an examination and appoints a laboratory blood test, ultrasound diagnosis of the abdominal region. In addition, bone marrow puncture or biopsy, biochemistry and cytochemical studies, cytogenetic analysis are performed.
Blood picture
For chronic myeloid leukemia, the following blood pattern is typical:
- In the chronic stage, the proportion of myeloblasts in bone marrow fluid or blood accounts for about 10-19%, and of basophils - more than 20%;
- At the terminal stage, lymphoblasts and myeloblasts exceed the 20% threshold. When conducting a biopsy study of the medullary fluid, large clusters of blasts are found.
Treatment
The therapeutic process for the treatment of chronic myelogenous leukemia consists of such directions:
- Chemotherapy;
- Bone transplant;
- Irradiation;
- Leukopheresis;
- Ectomy of the spleen
Chemotherapy treatment involves the use of traditional drugs such as Myelosan, Cytosar, Hydroxyurea, etc. The latest drugs of the latest generation are also used - Spriceil or Glivec. Also shown is the use of medications based on hydroxyurea, Interferon-α, etc.
After the transplant, the patient does not have immune protection, so he is in the hospital until the moment of survival of the donor cells. Gradually, bone marrow activity returns to normal and the patient recovers.
If chemotherapy does not provide the necessary efficacy, irradiation is used. This procedure is based on the use of gamma rays, which affect the zone of the spleen. The task of such treatment is to stop growth or destroy abnormal cells.
In exceptional situations, removal of the spleen is indicated. Such intervention is carried out mainly at the phase of the blast crisis. As a result, the overall course of the pathology significantly improves, and the effectiveness of treatment with medicines increases.
When the leukocyte level reaches excessively high values, leukopheresis is performed. This procedure is almost identical to plasmapheresis. Often, leukopheresis is included in complex therapy with medication.
Life expectancy forecast
The majority of patients die in the accelerative and terminal stages of the pathological process. About 7-10% die after diagnosing myeloid leukemia within the first 24 months. And after a blast crisis, survival can last about 4-6 months.
If it is possible to achieve remission, then the patient can live after the terminal stage for about a year.
Detailed video about the diagnosis and therapy of chronic myelogenous leukemia: