January 3, 2012
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Acute lymphocytic leukemia (another name - acute lymphoblastic leukemia ) - A disease of malignant nature, which is most often seen in children, whose age - from 2 to 4 years.
Symptoms of acute lymphocytic leukemia
When the manifestation of lymphocytic leukemia patients primarily complain of a feeling of weakness, malaise. They have greatly reduced appetite, unreasonably increases the body temperature, skin pale due anemia and overall intoxication . Pain is most often manifested in the spine and limbs. In the process of developing the disease increases peripheral And in some cases mediastinal lymph nodes . For about half of the cases, characterized by the development hemorrhagic syndrome , Which is characterized by petechiae and hemorrhage .
Due to the occurrence of extramedullary lesions may develop CNS neuroleukemia . To correctly establish the diagnosis in this case is carried out CT scans of the brain, EEG, MRI and CSF study. More rarely observed leukemic infiltration of the testicles . In this case, the diagnosis is based on the research result obtained in the biopsy samples
Diagnosis of acute lymphocytic leukemia
As a rule, examination of patients begin with the analysis of peripheral blood. It results in almost every case (98%) will be exceptional blasts and mature cells, without intermediate stages. In the case of acute lymphocytic leukemia be found normochromic anemia and thrombocytopenia . A number of other features typical to have a smaller number of cases: about 20% of cases develop leukopenia, half the time - leukocytosis . To suspect the disease may already be an expert on the basis of complaints of the patient, as well as the overall picture of the blood. However, accurate diagnosis is impossible without a detailed study of the bone marrow. In the first such study, when attention is drawn to the histological . Cytochemical and cytogenetic characterization Bone marrow blasts . Enough informative identification Philadelphia chromosome (Ph-chromosome). To deliver the most accurate diagnosis and the right treatment plan, should be carried out a series of additional tests to determine whether there are lesions of other organs. For further examines this patient otolaryngologist . urologist . neurologist , Conducted studies of the abdomen.
When the diagnosis as factors of poor prognosis patient's age is considered to be older than 10 years, the presence of high leukocytosis, the morphology of B-ALL, male gender, leukemic CNS.
Treatment of acute lymphocytic leukemia
Basically, with proper treatment, the disease can be cured completely.
In most cases it is possible to achieve a complete cure. In the treatment of acute lymphocytic leukemia apply certain principles that are important for successful treatment.
What is important is the principle of a wide range of effects, the essence of which consists in the application of chemotherapeutic agents with different mechanisms of action. Using the principle of adequate dosing is equally important, because when a sharp decrease in doses of medication possible recurrence of the disease, and if too high doses increase the risk of complications manifestations lymphocytic leukemia. In the appointment of chemotherapy patient doctor adheres to the principle of phasing and continuity.
However, the main principle in the process of therapy is the continuity of care from start to finish. Recurrence of disease greatly reduces the chance of a complete recovery of the patient. In the event of recurrence is used for the treatment of a few short blocks Chemotherapy at high doses.
The symptoms of chronic lymphocytic leukemia
This oncological disease of the lymphatic tissue, which is characterized by the accumulation of tumor lymphocytes at Peripheral Blood . lymph nodes and bone marrow . If we compare this shape with acute lymphocytic leukemia state, in this case, tumor overgrowth occurs more slowly and disorders of hematopoiesis taking place only at a late stage disease.
Symptoms chronic lymphocytic leukemia a weakness, a feeling of heaviness in the abdomen, especially in the left hypochondrium, increased sweating. The patient is sharply reduced body weight greatly increases the lymph nodes. It lymphadenopathy usually observed as the first symptoms of chronic lymphocytic leukemia forms. Due to the fact that in the process of developing the disease increases spleen, expressed a feeling of heaviness in the stomach. Often patients become more susceptible to various kinds of infections. However, the development of symptoms is fairly slow and gradual.
Diagnosis of chronic lymphocytic leukemia
According to available data, about a quarter of cases, the disease is found by chance during a blood test, a person who is appointed for a particular occasion. For the diagnosis of "chronic lymphocytic leukemia" patient is prescribed a number of studies. First, however, the physician inspects the patient. It is mandatory to conduct clinical blood test, during which counting of leukocyte. The picture of defeat, which is typical for this disease is detected during the study of the bone marrow. Also, during a full examination of the patient with suspected chronic lymphocytic leukemia performed immunophenotyping bone marrow and peripheral blood, biopsy Enlarged lymph nodes.
To study the tumor cells allows Cytogenetic analysis . And to predict the level of risk of infection of the disease is possible by determining the level immunoglobulins .
In the process of diagnosis and determine the stage of chronic lymphocytic leukemia. Guided by this information, the doctor decides on tactics, and especially its treatment.
Stages of chronic lymphocytic leukemia
Today, there is a specially designed system of staging of chronic lymphocytic leukemia, which is usually determined by the three stages of the disease.
To step A characteristic lesions no more than two groups of lymph nodes or lymph node involvement at all. Also at this stage, the patient is offline anemia and thrombocytopenia .
On stage in chronic lymphocytic leukemia occurs defeat three or more groups of lymph nodes. The patient has no anemia and thrombocytopenia.
For step C is characterized by thrombocytopenia or anemia. The data display is not dependent on the number of affected groups of lymph nodes.
Also in the diagnosis of lymphocytic leukemia stage to the designation letters add Roman numerals denoting a specific symptom:
I - presence lymphadenopathy
II - enlarged spleen (splenomegaly)
III - the presence of anemia
IV - the presence of thrombocytopenia
Treatment of chronic lymphocytic leukemia
A feature of the treatment of this disease is considered to be what experts define inappropriate therapy in the early stages zvbolevaniya. The treatment is not carried out due to the fact that the majority of patients in the early stages of the chronic form of the disease there is a so-called "smoldering" for the disease. Accordingly, a sufficiently long period, people can live without drugs, lead a normal life and feel relatively well. Therapy of chronic lymphocytic leukemia begin only in cases of a number of symptoms.
Thus, treatment is appropriate if the patient's blood rapidly growing number of lymphocytes, lymph node enlargement progresses, spleen, increased very strongly, growing anemia and thrombocytopenia. Also, treatment is required if the patient has signs of tumor intoxication: night sweating, rapid loss of body weight, fever Constant severe weakness.
To date, identifies a number of approaches to the treatment of the disease.
For the treatment of actively used chemotherapy . However, if, until relatively recently to conduct the procedure used drug hlorbutin , At the moment is considered to be more effective group of drugs - purine analogues. For the treatment of chronic lymphocytic leukemia is also used method bioimmunoterapii using monoclonal antibodies. After introduction of these drugs selectively destroy tumor cells and healthy tissue in the patient's body is not damaged.
If applied treatments do not produce the desired effect, the intended doctor method is used high-dose chemotherapy followed by transplantation of blood stem cells. If the patient has a large tumor mass is present, the method is used radiation therapy as an auxiliary treatment.
If a strong increase in the spleen to the patient can be shown the complete removal of the body.
When choosing tactics of treatment of chronic lymphocytic leukemia patient physician necessarily guided by extensive data of all studies and takes into account the individual characteristics of the individual patient and the disease.
Prevention lymphocytic leukemia
The reasons that can trigger a manifestation of lymphatic leukemia, determine the impact of a number of chemicals. It should therefore be very cautious about contact with such substances.
Patients who have a history immunodeficiency Hereditary chromosomal defects, people with relatives diagnosed with chronic lymphocytic leukemia should have regular checkups and attending professionals. Patients who have undergone chemotherapy, should be very serious about infection prevention. In view of this patient after chemotherapy is necessary to remain in a certain period of isolation, to observe sanitary and hygienic conditions, avoid contact with sick people contagious diseases. Also, in order to prevent in some cases, patients are assigned to receive Antiviral means antibiotics .
Individuals diagnosed with lymphatic leukemia in the chronic form, should have protein-rich meals, constant blood tests, mandatory time to use all the means that are prescribed by a doctor. You can not eat aspirin And aspirinosoderzhaschie drugs that can provoke bleeding .
When the manifestation of lymph node tumors, discomfort in the abdomen the patient should immediately consult your doctor.
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