How long do they live with leukemia, prognosis of life with acute leukemia? How long do they live with leukemia, prognosis of life with acute leukemia. Treatment and prognosis for chronic lymphocytic leukemia Juvenile myelomonocytic leukemia

The ability of abnormal cells to quickly spread throughout the body makes blood cancer one of the most dangerous diagnoses. In acute leukemia, the patient's life prognosis directly depends on the type of disease, the correct selection of the treatment regimen and the presence of complications of the disease.

What determines patient survival?

Until recently, the prognosis for blood cancer in the vast majority of cases was disappointing. This is not surprising: suppression of hematopoiesis provokes a decrease in immunity, anemia, bleeding and disruption of the internal organs and central nervous system, which significantly weaken the patient’s body.

Today, the question of how long patients with leukemia live cannot be answered even approximately: prognoses depend on the thoroughness of care, the possibility of using intensive chemotherapy regimens and many other factors. The main conditions for long-term survival of a patient with acute leukemia include:

absence of disturbances in the functioning of internal organs before the start of therapy;
minimum duration of the diagnostic period (the period of time between the initial stage of the disease and the administration of the first dose of chemotherapy);
absence of other oncological diseases;
achieving complete remission after 1-2 courses of chemotherapy;
age and gender of the patient (prognosis is least favorable for male patients under 2 and over 60 years of age);
careful care (compliance with the prescribed diet and sterility in the room where the patient is);
timely administration of antimicrobial and antifungal therapy, blood transfusions (transfusions of blood components) to exclude complications of leukemia;
the possibility of transplanting bone marrow tissue from a related or suitable unrelated donor and successful engraftment of the graft.

Also, patient survival depends on the type of blast cells and the degree of their differentiation, which determines the aggressiveness of the disease. For example, in acute lymphoblastic leukemia, the most favorable prognosis is for patients with a B-lymphocyte tumor clone.

The presence of chromosomal pathologies (for example, translocation on chromosomes 9 and 22, which creates a mutant gene producing oncogenic tyrosine kinase) is necessarily clarified at the diagnostic stage.

Characteristic disorders at the gene level allow not only to predict the prognosis, but also to improve it through the use of compensating drugs. In the case of translocation (9;22), the so-called. "Philadelphia chromosome", the effect of the oncogenic substance is stopped by Imatinib, Nilotinib and other tyrosine kinase inhibitors.

Can acute leukemia be cured?

The use of intensive therapy helps to achieve a state of remission (no clinical signs of the disease in the patient). Depending on the results of tests of bone marrow tissue and blood, complete and incomplete remission are distinguished.

Complete remission occurs in the absence of immature (blast) cells and their concentration in the hematopoietic tissue decreases to 5% or less. In case of incomplete remission, the proportion of blasts in the bone marrow tissue is up to 20%. In fact, this condition characterizes the positive dynamics during the treatment, and not the final result of therapy.

The initial goal of treatment (polychemotherapy) is to achieve complete remission and maintain this condition for 2-5 years after the end of the first stage of therapy.

However, even in the case of complete remission, doctors cannot diagnose complete recovery, because There is a possibility that signs of leukemia will reappear. Only patients who have not had a relapse within five years after the end of the main stage of chemotherapy are considered recovered. To prolong remission and destroy possible abnormal blasts, a second stage of therapy is prescribed - maintenance treatment.

Maintenance treatment includes taking cytostatic tablets, following a diet, daily routine and hygiene. The absence of this stage of treatment greatly increases the risk of relapse of the disease. With each subsequent manifestation of leukemia, the period of remission is shortened, and the chances of five-year survival drop sharply.

How long do patients with different types of leukemia live?

With acute leukemia, the symptoms in adults, the prognosis and course of the disease may differ slightly from the manifestations of the disease in children. This is due, first of all, to the fact that most children suffer from the lymphoblastic form of leukemia, as well as the age-related peak in the incidence of leukemia.

At the age of over 60 years, which accounts for the highest incidence of myeloid leukemia, internal organs are more difficult to tolerate chemotherapy, and in most cases it is impossible to reduce the likelihood of cancer recurrence by transplantation of hematopoietic tissue.

In acute lymphoblastic leukemia, the prognosis is highly dependent on the cell type. For example, with a mutation of B lymphocytes, the 5-year survival rate of sick children after treatment will reach 88-90%, and for adults and elderly patients - 40%. Remission occurs in 4 out of 5 patients, but many types of lymphoblastic leukemia have a high risk of relapse.

The prognosis for patients with T-leukemia is least favorable. This type of disease is typical mainly for teenagers.

With myeloid leukemia, the 5-year survival rate for patients under 15 years of age reaches 70%. In patients 45-60 years old, this figure decreases to 25-50%, depending on the type of tumor clone. Patients over 65 years of age live longer than 5 years after completion of treatment in 12% of cases.

The worst prognosis is observed with megakaryoblastic blood leukemia, in which platelet precursor cells undergo mutations. This diagnosis is recorded quite rarely, mainly in children.

The frequency of remission during treatment reaches 60-80% of cases, and its average duration after the first course of therapy is 1-2 years. The use of maintenance cytostatics can increase the duration of the asymptomatic period. Full recovery, according to statistics, occurs in approximately 10% of all clinical cases of myeloid leukemia. The use of TCM can increase the chances of long-term (more than 10 years) survival to 80%.
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The influence of complications of leukemia and cytostatic therapy on patient survival

Any oncological process can negatively affect not only the organ in which the tumor develops directly, but also the patient’s entire body. This is especially true for neoplasias in the endocrine, lymphatic and hematopoietic systems. How long the patient will live after the end of treatment is determined not only by the anticancer effectiveness of the drugs, but also by the presence of complications of the tumor process itself and chemotherapy.

Enlargement of the lymph nodes, spleen, liver and kidneys due to leukemic infiltration can provoke disruption of the internal organs. This reduces the patient’s quality of life, and in some cases makes it impossible to use high-dose chemotherapy.

An excessive amount of blasts in the blood increases its viscosity, which contributes to the deterioration of the organs. Due to the formation of leukemic and myeloid blood clots in small arteries in the body, hemorrhages and heart attacks can occur.

All these factors significantly increase the risk of death for the patient, although they can only indirectly affect the likelihood of relapse.

The myelotoxicity of many groups of cytostatic drugs, as well as nausea and vomiting that accompany chemotherapy, may force the patient to abandon potentially curative courses in favor of less effective ones. The use of setrons and corticosteroids makes it possible to stop the negative effects on the gastrointestinal tract.

Despite the danger of the disease, with timely diagnosis and early initiation of treatment, the probability of achieving complete remission and 5-year survival of the patient is quite high. The prognosis for the effectiveness of treatment directly depends on the type of leukemia, the tolerability of the prescribed chemotherapy regimen and maintenance therapy, as well as the exact compliance with the instructions of the attending physician by the patient and his relatives.

In our article we will try to figure out what kind of disease this is and how to treat it.

What is acute leukemia

Leukemia (another name is leukemia) is a malignant disease of the human bone marrow, popularly also called “blood cancer.” The root cause of the disease is a disruption of the hematopoietic process in the body: immature blood cells called blast cells are produced in the bone marrow. As a rule, these are the precursors of white blood cells. Blast cells, due to uncontrolled reproduction, as they accumulate, prevent the bone marrow from producing normal blood cells. These malignant cells accumulate in the kidneys, liver, spleen and other organs and cause disruption of the blood supply to the organs.

Due to the fact that there are 2 different lines of hematopoiesis in the human body, there are two main types of leukemia:

Lymphoblastic, because formed by blast cells, precursors of lymphocytes;
Myeloblastic, because based on leukocyte precursors.

The term acute leukemia means an aggressive form of the disease, when the disease develops at a rapid pace.

The most common disease is acute lymphoblastic leukemia, which accounts for about three-quarters of all malignant diseases of the hematopoietic system. Acute and chronic leukemia occurs on average in four cases per 100 thousand people. Children make up about a quarter of the total number of cases. The overwhelming majority of children suffer from this disease before the age of 14; boys are more susceptible to it.

Stages of leukemia

There are three stages of acute leukemia:

Initial - symptoms are not expressed or are “masked” as other diseases, for example, ARVI.
Expanded - all the typical signs of the disease “Acute leukemia” are present, the symptoms are clearly expressed. At this stage, basically, remission or complete cure of the disease occurs.
Terminal - stage of deep inhibition of hematopoietic functions.

Disease factors

In general, the causes of this disease, unfortunately, have not been found. There are a number of dependencies on factors that cause the disease in some cases:

Chemotherapy used to treat another type of cancer increases the risk of the disease.
Heredity - the likelihood of the disease increases due to the presence of genetic disorders and the presence of the disease in relatives.
Smoking.
Radiation exposure, etc.

However, there are many patients with leukemia who did not have established risk factors for the disease; the causes of the disease remain unidentified. Science does not stand still and perhaps in the near future scientists will find the answer to the question of the causes of the disease.

Acute leukemia. Symptoms

Symptoms in adults and children are practically the same. The only difference is that in adults, acute leukemia most often takes on a chronic form, which means that the onset of the disease is often camouflaged and is expressed only in increased fatigue and frequent infectious diseases.

General symptoms

Common symptoms characteristic of any stage are:

Losing weight for no reason.
Complaints about deterioration of health, the patient is often tired.
Attacks of weakness, apathy, the patient may suddenly want to sleep.
Feeling of heaviness in the abdomen, mainly in the left hypochondrium.
More frequent infectious diseases.
Increased sweating.
Unreasonable increase in body temperature.

Associated symptoms

Such symptoms do not directly indicate that a person has leukemia, since they are also characteristic of other ailments, but they are included in the clinical picture of the disease:

Pale skin (due to anemia).
Dyspnea.
The gums may bleed, there may be bruises all over the body, and the nose may suddenly bleed.
Headache.
Deterioration of vision.
Nausea and convulsions.
Poor coordination when walking.
Painful sensations in bones and joints.

Diagnostics

When diagnosed with acute leukemia, the diagnosis is carried out in several stages.

The first and most obvious step in diagnosing leukemia is a clinical blood test. Decoding the hemogram shows how far the disease has progressed. The blood picture shows the presence of pathological changes in the composition of the blood: low levels of red blood cells and platelets, the presence of blast cells.

At the second stage, the patient is hospitalized in a hospital and the attending physician prescribes a puncture of the bone marrow and cerebrospinal fluid for laboratory tests of their composition.

The third stage is to identify the effect of the disease on other human organs through ultrasound, computed tomography, etc.

Treatment

Treatment of acute leukemia usually consists of three stages:

Achieving a reduction in the number of blast cells to a level that is safe for health and the onset of remission. Chemotherapy is carried out with special drugs (cytostatics) for several weeks, which destroy malignant blood cells.
Destroying residual abnormal blast cells to prevent relapse of the disease.
Carrying out maintenance therapy.

Unfortunately, acute leukemia, despite treatment, has an unpleasant feature - relapses of the disease, which occur quite often; in this case, bone marrow transplantation is used as the most effective treatment.

Complications

Although chemotherapy is highly effective, it has a number of side effects. So, when it is carried out, hematopoiesis is suppressed, the number of a person’s own platelets drops sharply, and bleeding may occur. In order to prevent such problems, transfusions of donor blood and their components - platelets and red blood cells - are performed. Among the side effects, patients often complain of nausea, vomiting, hair loss, and allergic reactions to chemotherapy drugs.

During treatment, the body's resistance to various infections sharply decreases and patients are prevented from infectious diseases with courses of antibiotics, etc. For such patients, any infections are dangerous, as a result of which patients are limited in contact with the outside world.

Forecast

The main questions when diagnosing “Acute blood leukemia” are: How long do people live with this disease? Can it be cured? However, the answer to them is not so simple at first glance. With a diagnosis of “acute leukemia,” the prognosis of life expectancy depends on many reasons: the type of leukemia, the stage of the disease, the patient’s age, the body’s susceptibility to chemotherapy treatment, the presence of concomitant diseases, etc.

For children, the prognosis for treatment is more favorable. Firstly, they are examined more often, which makes it possible to identify signs of the disease in the early stages. Secondly, a young body is more susceptible to chemotherapy and the results of treatment will be much better and, thirdly, the vast majority do not have accumulated diseases.

A characteristic feature of acute leukemia is its rapid development and the longer a person does not take action to treat it, the less likely he is to survive in the future.

In general, the disease is characterized as severe, but currently it has been cured, with about 90% of patients achieving complete remission. However, it is important to understand that during the period of complete remission there may be relapses of the disease, which occur in approximately 25% of cases. If there are no relapses within 5 years, the disease is considered to be completely cured.

Prognosis for leukemia

Leukemia is the most common blood cancer among children. This disease is divided into several types, each with its own course and characteristics. Accordingly, the prognosis for leukemia depends on the type of disease.

Prognosis for acute myeloblastic leukemia

The success of AML treatment largely depends on the patient's age. As a rule, the younger the person, the higher the likelihood of achieving stable remission.

Among adults with acute myeloid leukemia, the prognosis is as follows:

in 25% of cases, the survival rate of older people is 5 years;
young patients have a better chance of complete recovery;
the survival rate of people aged about 45 years is more than 50% of cases, some of them have a chance of complete recovery, for others the disease returns after some time;
in patients over 65 years of age, the five-year survival rate is 12%.

Children with acute myeloid leukemia have a better prognosis than adult patients: the 5-year survival rate for children under 15 years of age is 60-70%.

There are some prognostic factors that can affect the outcome of the disease. The prognosis for leukemia worsens if:

patient over 60 years old;
the level of white blood cells at the time of detection of the disease is very high;
the patient has another type of cancer;
there are specific genetic mutations in the cells;
More than two courses of chemotherapy are needed to control the cancer.

Prognosis for acute lymphoblastic leukemia

In acute lymphoblastic leukemia, the prognosis depends on the patient's age at the time of diagnosis of the disease. Typically, the younger the person, the higher the likelihood of successful treatment. But in general, the disease develops differently in different people.

Older patients have a 5-year survival rate of about 40%, but for some people the disease may return after some time. The prognosis for children with ALL is better than for adults. The five-year survival rate for children is more than 88%.

In the case of diagnosis of acute lymphoblastic leukemia, the prognosis depends on certain prognostic factors, which include:

person’s age – the younger the patient, the higher the likelihood of cure;
gender of the patient - women, as a rule, have a greater chance of recovery;
leukocyte level - the higher the number of white blood cells, the worse the prognosis;
type of leukocytes in leukemia;
the presence of cytogenetic changes in chromosomes reduces the chances of survival.

If leukemia cells are found in the brain or cerebrospinal fluid when acute lymphoblastic leukemia is diagnosed, the prognosis is significantly worse. Some genetic abnormalities in leukemia cells also reduce the likelihood of a successful cure. Leukemia is considered difficult to treat and requires long-term induction chemotherapy to control.

Prognosis for chronic myeloid leukemia

The prognosis for CML treatment depends on a number of different factors, including the stage of the disease at the time of diagnosis and the body's response to treatment. On average, chronic myeloid leukemia has the following prognosis: 5-year survival rate is about 90%. Modern biological methods of therapy, such as imatinib, nilotinib and dasatinib, make it possible to get rid of signs of the disease for many years and achieve stable remission.

If biological treatments do not work, a stem cell transplant may be considered, which usually prolongs patient survival for 15 years or more. If chronic myeloid leukemia is detected in the later stages, the prognosis, unfortunately, is unfavorable.

Prognosis for chronic lymphocytic leukemia

CLL has no cure, but since the disease develops very slowly, therapy can keep the disease under control for many years. Chronic lymphocytic leukemia has the following prognosis: on average, 44% of men and 52% of women live at least 5 years after diagnosis.

CLL has three stages of development (A, B, C). In general, the prognosis depends on the stage at which the disease is detected:

at stage A – survival is 10 years or more,
at stage B – the patient lives from 5 to 8 years;
at stage C – survival is from 1 to 3 years.

Also, the success of treatment for chronic lymphocytic leukemia and its prognosis depend on a number of different factors, such as the timeliness of the diagnosis, the quality of treatment and the response of the disease to chemotherapy and other treatments. Questions about the likelihood of successful disease control are discussed with the doctor conducting diagnosis and drug therapy. In some cases, doctors conduct special tests to determine optimal treatment options and the prospects for achieving stable remission.

Experts continue research to make a prognosis for the development of the disease depending on certain factors. For example, the increase in the number of white blood cells in the blood is monitored over time, and if the number of white cells in the blood does not increase very quickly, then the patient has a good outlook.

Also, the prognosis of the disease is influenced by some genetic changes, which make it possible to determine the prospects and develop an optimal treatment plan.

Prognosis for hairy cell leukemia

The outcome of treatment for hairy cell leukemia depends on a number of different factors, including:

stage of the disease at the time of diagnosis;
reactions of the cancer and the patient's body to treatment.

In most cases, hairy cell leukemia has a good prognosis. The disease usually develops slowly and is controlled with medications for many years, so patients usually live quite a long time. For detailed advice, you should talk to your doctor.

Overall, 96% of people diagnosed with hairy cell leukemia have a good prognosis and live at least 10 years after diagnosis. But it is worth considering that due to the rarity of this type of cancer, statistics are based on a small number of people.

In case of relapse of the disease, subsequent treatment is prescribed to achieve successful remission. As a result of secondary treatment of hairy cell cancer, the prognosis is as follows: 5 years after treatment, the disease returns in 24-33% of patients; after 10 years, the disease recurs in 42-48% of patients.

Usually, after a rapid relapse of the disease, the doctor prescribes another treatment, but if the disease did not manifest itself for a long time after primary therapy, then for secondary cancer the treatment does not change.

In general, the prognosis for leukemia depends on the type of pathogenic cells, the stage of the disease at the stage of diagnosis, the age and health status of the patient, as well as the professionalism of the doctor conducting the therapy. In most cases, after treatment, patients are prescribed a course of drugs that correct hormonal levels, as well as restorative therapy aimed at preventing infectious complications. Such measures can ensure stable remission and improve the prognosis.

Leukemia (leukemia): types, signs, prognosis, treatment, causes

Leukemia is a serious blood disease that is classified as neoplastic (malignant). In medicine, it has two more names - leukemia or leukemia. This disease knows no age restrictions. It affects children of all ages, including infants. It can occur in youth, middle age, and old age. Leukemia affects both men and women equally. Although, according to statistics, people with white skin get it much more often than dark-skinned people.

Types of leukemia

With the development of leukemia, a certain type of blood cell degenerates into malignant one. The classification of the disease is based on this.

When it passes into leukemic cells of lymphocytes (blood cells of the lymph nodes, spleen and liver), it is called LYMPHOLEUKEMIA.
Degeneration of myelocytes (blood cells formed in the bone marrow) leads to MYELOLEUKEMIA.

Degeneration of other types of leukocytes, leading to leukemia, although it occurs, is much less common. Each of these species is divided into subspecies, of which there are quite a lot. Only a specialist who has modern diagnostic equipment and laboratories equipped with everything necessary can understand them.

The division of leukemia into two fundamental types is explained by disturbances in the transformation of different cells - myeloblasts and lymphoblasts. In both cases, instead of healthy leukocytes, leukemia cells appear in the blood.

In addition to classification by type of lesion, acute and chronic leukemia are distinguished. Unlike all other diseases, these two forms of leukemia have nothing to do with the nature of the disease. Their peculiarity is that the chronic form almost never turns into acute and, conversely, the acute form cannot become chronic under any circumstances. Only in isolated cases, chronic leukemia can be complicated by an acute course.

This is due to the fact that acute leukemia occurs during the transformation of immature cells (blasts). At the same time, their rapid reproduction begins and increased growth occurs. This process cannot be controlled, so the likelihood of death with this form of the disease is quite high.

Chronic leukemia develops when the growth of mutated blood cells that are fully mature or in the process of maturation progresses. It differs in the duration of its course. The patient only needs supportive therapy to ensure his condition remains stable.

Causes of leukemia

What exactly causes the mutation of blood cells is currently not fully understood. But it has been proven that one of the factors causing leukemia is radiation exposure. The risk of disease appears even with small doses of radiation. In addition, there are other causes of leukemia:

In particular, leukemia can be caused by leukemic drugs and some chemicals used in everyday life, for example, benzene, pesticides, etc. Leukemia drugs include antibiotics of the penicillin group, cytostatics, butadione, chloramphenicol, as well as drugs used in chemotherapy.
Most infectious viral diseases are accompanied by the invasion of viruses into the body at the cellular level. They cause mutational degeneration of healthy cells into pathological ones. Under certain factors, these mutant cells can transform into malignant ones, leading to leukemia. The largest number of leukemia diseases is observed among HIV-infected people.
One of the causes of chronic leukemia is a hereditary factor that can manifest itself even after several generations. This is the most common cause of leukemia in children.

Etiology and pathogenesis

The main hematological signs of leukemia are changes in blood quality and an increase in the number of young blood cells. In this case, the ESR increases or decreases. Thrombocytopenia, leukopenia and anemia are noted. Leukemia is characterized by abnormalities in the chromosomal composition of cells. Based on them, the doctor can make a prognosis of the disease and choose the optimal treatment method.

Common symptoms of leukemia

With leukemia, a correct diagnosis and timely treatment are of great importance. At the initial stage, the symptoms of blood leukemia of any kind are more reminiscent of colds and some other diseases. Listen to how you feel. The first manifestations of leukemia are manifested by the following signs:

The person experiences weakness and malaise. He constantly wants to sleep or, conversely, sleep disappears.
Brain activity is disrupted: a person has difficulty remembering what is happening around him and cannot concentrate on basic things.
The skin turns pale, bruises appear under the eyes.
The wounds do not heal for a long time. Bleeding from the nose and gums is possible.
The temperature rises for no apparent reason. It can stay at 37.6º for a long time.
There are minor pains in the bones.
Gradually, the liver, spleen and lymph nodes become enlarged.
The disease is accompanied by increased sweating and increased heart rate. Dizziness and fainting are possible.
Colds occur more often and last longer than usual, chronic diseases worsen.
The desire to eat disappears, so the person begins to lose weight sharply.

If you notice the following signs, do not put off visiting a hematologist. It is better to be a little safe than to treat the disease when it is advanced.

These are common symptoms common to all types of leukemia. But, for each type there are characteristic signs, features of the course and treatment. Let's look at them.

Video: presentation about leukemia (eng)

Lymphoblastic acute leukemia

This type of leukemia is most common in children and young people. Acute lymphoblastic leukemia is characterized by a disorder of hematopoiesis. An excessive amount of pathologically altered immature cells - blasts - is produced. They precede the appearance of lymphocytes. The blasts begin to multiply rapidly. They accumulate in the lymph nodes and spleen, preventing the formation and normal functioning of normal blood cells.

The disease begins with a prodromal (latent) period. It can last from one week to several months. The sick person has no specific complaints. He just feels constantly tired. He begins to feel unwell due to his temperature rising to 37.6°. Some people notice that their lymph nodes in the neck, armpits, and groin are enlarged. There are minor pains in the bones. But at the same time, the person continues to perform his work duties. After some time (it is different for everyone), a period of pronounced manifestations begins. It occurs suddenly, with a sharp increase in all manifestations. In this case, various variants of acute leukemia are possible, the occurrence of which is indicated by the following symptoms of acute leukemia:

Anginous (ulcerative-necrotic), accompanied by severe tonsillitis. This is one of the most dangerous manifestations of a malignant disease.
Anemic. With this manifestation, hypochromic anemia begins to progress. The number of leukocytes in the blood increases sharply (from several hundred per mm³ to several hundred thousand per mm³). Leukemia is evidenced by the fact that more than 90% of the blood consists of parent cells: lymphoblasts, hemohistoblasts, myeloblasts, hemocytoblasts. The cells on which the transition to mature neutrophils depends (young, myelocytes, promyelocytes) are absent. As a result, the number of monocytes and lymphocytes is reduced to 1%. The platelet count is also reduced.

Hypochromic anemia in leukemia

Hemorrhagic in the form of hemorrhages on the mucous membrane, open areas of the skin. Bleeding from the gums and nose occurs, and uterine, kidney, gastric and intestinal bleeding is possible. In the last phase, pleurisy and pneumonia with the release of hemorrhagic exudate may occur.
Splenomegalic - a characteristic enlargement of the spleen caused by increased destruction of mutated leukocytes. In this case, the patient experiences a feeling of heaviness in the abdominal area on the left side.
There are frequent cases when the leukemic infiltrate penetrates the bones of the ribs, collarbone, skull, etc. It can affect the bone tissue of the eye socket. This form of acute leukemia is called chlorleukemia.

Clinical manifestations may combine various symptoms. For example, acute myeloblastic leukemia is rarely accompanied by enlarged lymph nodes. This is not typical for acute lymphoblastic leukemia. Lymph nodes acquire increased sensitivity only with ulcerative-necrotic manifestations of chronic lymphoblastic leukemia. But all forms of the disease are characterized by the fact that the spleen becomes larger, blood pressure decreases, and the pulse quickens.

Acute leukemia in childhood

Acute leukemia most often affects children's bodies. The highest percentage of the disease is between the ages of three and six years. Acute leukemia in children is manifested by the following symptoms:

The spleen and liver are enlarged, so the child has a large belly.
The size of the lymph nodes also exceeds the norm. If the enlarged nodes are located in the chest area, the child suffers from a dry, debilitating cough, and shortness of breath occurs when walking.
When the mesenteric nodes are damaged, pain appears in the abdomen and legs.
Moderate leukopenia and normochromic anemia are noted.
The child gets tired quickly, the skin is pale.
Symptoms of acute respiratory viral infection with elevated temperature are pronounced, which may be accompanied by vomiting and severe headache. Seizures often occur.
If leukemia has reached the spinal cord and brain, the child may lose balance while walking and often fall.

Treatment of acute leukemia

Treatment of acute leukemia is carried out in three stages:

Stage 1. A course of intensive therapy (induction) aimed at reducing the number of blast cells in the bone marrow to 5%. In this case, they should be completely absent in the normal bloodstream. This is achieved by chemotherapy using multicomponent cytostatic drugs. Based on the diagnosis, anthracyclines, glucocorticosteroid hormones and other drugs can also be used. Intensive therapy gives remission in children - in 95 cases out of 100, in adults - in 75%.
Stage 2. Consolidation of remission (consolidation). This is done to avoid the possibility of relapse. This stage can last from four to six months. During this procedure, careful monitoring by a hematologist is required. Treatment is carried out in a clinical setting or in a day hospital. Chemotherapy drugs (6-mercaptopurine, methotrexate, prednisone, etc.) are used, which are administered intravenously.
Stage 3. Maintenance therapy. This treatment continues for two to three years, at home. 6-mercaptopurine and methotrexate in tablet form are used. The patient is under outpatient hematology care. He must undergo periodic examinations (the date of visits is determined by the doctor) in order to monitor the quality of his blood composition.

If it is impossible to carry out chemotherapy due to a severe complication of an infectious nature, acute blood leukemia is treated by transfusion of donor red blood cells - from 100 to 200 ml three times every two to three to five days. In critical cases, bone marrow or stem cell transplantation is performed.

Many people try to treat leukemia with folk and homeopathic remedies. They are quite acceptable in chronic forms of the disease, as an additional restorative therapy. But in acute leukemia, the sooner intensive drug therapy is administered, the higher the chance of remission and the more favorable the prognosis.

Forecast

If the start of treatment is very late, the death of a patient with leukemia may occur within a few weeks. This is why the acute form is dangerous. However, modern treatment methods provide a high percentage of improvement in the patient’s condition. At the same time, 40% of adults achieve stable remission, with no relapses for more than 5-7 years. The prognosis for acute leukemia in children is more favorable. Improvement by age 15 is 94%. For teenagers over 15 years of age, this figure is slightly lower - only 80%. Recovery of children occurs in 50 cases out of 100.

An unfavorable prognosis is possible in infants (up to one year) and those who have reached the age of ten (and older) in the following cases:

High degree of spread of the disease at the time of accurate diagnosis.
Severe enlargement of the spleen.
The process has reached the mediastinal nodes.
The functioning of the central nervous system is disrupted.

Chronic lymphoblastic leukemia

Chronic leukemia is divided into two types: lymphoblastic (lymphocytic leukemia, lymphatic leukemia) and myeloblastic (myeloid leukemia). They have different symptoms. In this regard, each of them requires a specific treatment method.

Lymphatic leukemia

Lymphatic leukemia is characterized by the following symptoms:

Loss of appetite, sudden weight loss. Weakness, dizziness, severe headaches. Increased sweating.
Enlarged lymph nodes (from the size of a small pea to a chicken egg). They are not connected to the skin and easily roll during palpation. They can be felt in the groin area, on the neck, armpits, and sometimes in the abdominal cavity.
When the mediastinal lymph nodes enlarge, the veins are compressed and swelling of the face, neck, and arms occurs. They may turn blue.
The enlarged spleen protrudes 2-6 cm from under the ribs. The enlarged liver extends about the same amount beyond the edges of the ribs.
There is frequent heartbeat and sleep disturbance. As chronic lymphoblastic leukemia progresses, it causes decreased sexual function in men and amenorrhea in women.

A blood test for such leukemia shows that the number of lymphocytes in the leukocyte formula is sharply increased. It ranges from 80 to 95%. The number of leukocytes can reach 1 mm³. Blood platelets are normal (or slightly low). The amount of hemoglobin and red blood cells is significantly reduced. The chronic course of the disease can last for a period of three to six to seven years.

Treatment of lymphocytic leukemia

The peculiarity of chronic leukemia of any type is that it can proceed for years, while maintaining stability. In this case, treatment of leukemia in a hospital does not need to be carried out, just periodically check the state of the blood and, if necessary, engage in strengthening therapy at home. The main thing is to follow all the doctor’s instructions and eat right. Regular follow-up is an opportunity to avoid a difficult and unsafe course of intensive care.

Photo: increased number of leukocytes in the blood (in this case, lymphocytes) with leukemia

If there is a sharp increase in leukocytes in the blood and the patient’s condition worsens, then there is a need for chemotherapy using the drugs Chlorambucil (Leukeran), Cyclophosphamide, etc. The treatment course also includes monoclonal antibodies Campas and Rituximab.

The only way to completely cure chronic lymphocytic leukemia is bone marrow transplantation. However, this procedure is very toxic. It is used in rare cases, for example, for people at a young age, if the patient’s sister or brother is the donor. It should be noted that complete recovery can only be achieved by an allogeneic (from another person) bone marrow transplant for leukemia. This method is used to eliminate relapses, which, as a rule, are much more severe and more difficult to treat.

Chronic myeloblastic leukemia

Myeloblastic chronic leukemia is characterized by a gradual development of the disease. In this case, the following signs are observed:

Weight loss, dizziness and weakness, fever and increased sweating.
With this form of the disease, gingival and nosebleeds and pale skin are often observed.
The bones begin to ache.
Lymph nodes are usually not enlarged.
The spleen significantly exceeds its normal size and occupies almost the entire half of the internal cavity of the abdomen on the left side. The liver is also enlarged.

Chronic myeloblastic leukemia is characterized by an increased number of leukocytes - up to 1 mm³, decreased hemoglobin and a reduced number of red blood cells. The disease develops over two to five years.

Treatment of myelosis

Therapeutic therapy for chronic myeloid leukemia is selected depending on the stage of development of the disease. If it is in a stable condition, then only restorative therapy is carried out. The patient is recommended to eat well and undergo regular medical examinations. A course of restorative therapy is carried out with the drug Myelosan.

If leukocytes begin to multiply rapidly, and their number significantly exceeds the norm, radiation therapy is performed. It is aimed at irradiating the spleen. Monochemotherapy is used as primary treatment (treatment with Myelobromol, Dopan, Hexaphosphamide). They are administered intravenously. Polychemotherapy according to one of the CVAMP or AVAMP programs gives a good effect. The most effective treatment for leukemia today remains bone marrow and stem cell transplantation.

Juvenile myelomonocytic leukemia

Children between the ages of two and four often develop a special form of chronic leukemia called juvenile myelomonocytic leukemia. It is one of the rarest types of leukemia. Most often boys get it. The cause of its occurrence is considered to be hereditary diseases: Noonan syndrome and neurofibromatosis type I.

The development of the disease is indicated by:

Anemia (pallor of the skin, increased fatigue);
Thrombocytopenia, manifested by nasal and gingival bleeding;
The child is not gaining weight and is stunted.

Unlike all other types of leukemia, this type occurs suddenly and requires immediate medical attention. Myelomonocytic juvenile leukemia is practically not curable with conventional therapeutic agents. The only way to give hope for recovery is an allogeneic bone marrow transplant, which should preferably be performed as soon as possible after diagnosis. Before this procedure, the child undergoes chemotherapy. In some cases, there is a need for splenectomy.

Myeloid nonlymphoblastic leukemia

The ancestors of blood cells that are formed in the bone marrow are stem cells. Under certain conditions, the process of stem cell maturation is disrupted. They begin to divide uncontrollably. This process is called myeloid leukemia. Most often, adults are susceptible to this disease. It is extremely rare in children. Myeloid leukemia is caused by a chromosomal defect (mutation of one chromosome) called the Philadelphia Rh chromosome.

The disease progresses slowly. The symptoms are unclear. Most often, the disease is diagnosed accidentally when a blood test is performed during a regular medical examination, etc. If leukemia in adults is suspected, a referral is issued for a bone marrow biopsy.

Photo: biopsy to diagnose leukemia

There are several stages of the disease:

Stable (chronic). At this stage, the number of blast cells in the bone marrow and general bloodstream does not exceed 5%. In most cases, the patient does not require hospitalization. He can continue to work while receiving maintenance treatment with anti-cancer pills at home.
Acceleration of the development of the disease, during which the number of blast cells increases to 30%. Symptoms manifest themselves in the form of increased fatigue. The patient experiences nosebleeds and gum bleeding. Treatment is carried out in a hospital setting with intravenous administration of anticancer drugs.
Blast crisis. The onset of this stage is characterized by a sharp increase in blast cells. Intensive therapy is required to destroy them.

After treatment, remission is observed - a period during which the number of blast cells returns to normal. PCR diagnostics show that the “Philadelphia” chromosome no longer exists.

Most types of chronic leukemia can now be successfully treated. For this purpose, a group of experts from Israel, the USA, Russia and Germany developed special treatment protocols (programs), including radiation therapy, chemotherapy treatment, stem cell treatment and bone marrow transplantation. People diagnosed with chronic leukemia can live quite a long time. But people with acute leukemia live very little. But even in this case, everything depends on when the treatment course began, its effectiveness, the individual characteristics of the body and other factors. There are many cases where people “burned out” within a few weeks. In recent years, with correct, timely treatment and subsequent maintenance therapy, life expectancy in acute forms of leukemia has been increasing.

Video: lecture on myeloid leukemia in children

Hairy cell lymphocytic leukemia

A cancer of the blood in which the bone marrow produces an excessive amount of lymphocyte cells is called hairy cell leukemia. It occurs in very rare cases. It is characterized by a slow development and course of the disease. Leukemia cells in this disease, when magnified many times, look like small bodies overgrown with “hair.” Hence the name of the disease. This form of leukemia occurs mainly in older men (after 50 years). According to statistics, women make up only 25% of the total number of cases.

There are three types of hairy cell leukemia: refractory, progressive and untreated. Progressive and untreated forms are the most common, since the main symptoms of the disease are associated by most patients with signs of advancing old age. For this reason, they go to the doctor very late, when the disease has already progressed. The refractory form of hairy cell leukemia is the most difficult. It occurs as a relapse after remission and is practically untreatable.

White blood cell with “hairs” in hairy cell leukemia

The symptoms of this disease do not differ from other types of leukemia. This form can only be identified by performing a biopsy, blood test, immunophenotyping, computed tomography and bone marrow aspiration. A blood test for leukemia shows that leukocytes are tens (hundreds) times higher than normal. At the same time, the number of platelets and red blood cells, as well as hemoglobin, are reduced to a minimum. All these are criteria that are characteristic of this disease.

Chemotherapy treatments using cladribine and pentosatin (anti-cancer drugs);
Biological therapy (immunotherapy) with Interferon alfa and Rituximab;
Surgical method (splenectomy) - excision of the spleen;
Stem cell transplant;
General restorative therapy.

The effect of leukemia in cows on humans

Leukosis is a common disease in cattle. There is an assumption that the leukemic virus can be transmitted through milk. This is evidenced by experiments conducted on lambs. However, no studies have been conducted on the effects of milk from leukemia-infected animals on humans. It is not the causative agent of bovine leukemia itself that is considered dangerous (it dies when milk is heated to 80°C), but carcinogenic substances that cannot be destroyed by boiling. In addition, the milk of an animal with leukemia helps to reduce human immunity and causes allergic reactions.

Milk from cows with leukemia is strictly forbidden to be given to children, even after heat treatment. Adults can eat milk and meat from animals with leukemia only after treatment at high temperatures. Only the internal organs (liver), in which leukemia cells mainly multiply, are utilized.

In fact, leukemia has recently begun to increasingly affect the adult population. And now about 75% of all cases are over 40 years of age. Every year, more than 280,000 people worldwide suffer from this disease, and approximately 190,000 die. Every year, new methods and types of treatment appear that have reduced the mortality rate.

Blood leukemia, or leukemia as it is also called, is an oncological disease, the pathological process of which affects the hematopoietic system located in the bone marrow. At the same time, the number of immature and mutated leukocytes in the blood begins to increase. In common parlance, this disease is also called leukemia. Acute and chronic leukemia are divided.

Typically, the incidence of this disease increases in older people over 55-60 years of age. Most often, older people suffer from acute myeloblastic leukemia. Younger ones, 10-20 years old, already suffer from chronic lymphoblastic pathology. For people over 70 years of age, another form of blood cancer is usually characteristic - myeloblastic leukemia.

If we take children, then they have one of the most dangerous types of blood oncology - acute lymphoblastic leukemia, and more often it affects boys from 2 to 5 years old. The acute form of myeloblastic leukemia already accounts for 27% of all cancers among children and affects children from 1 to 3 years old. And most often the prognosis is very disappointing, since the disease is very aggressive and progresses quickly.

Chronic

Causes

Scientists and doctors are still arguing about what exactly influences the occurrence of cancerous and malignant cells. But most doctors are already on the path to discovery, since most believe that both acute and chronic forms of leukemia arise as a result of pathology at the level of chromosomes within cells.

Recently, scientists discovered the so-called “Philadelphia chromosome”, which is located in the bone marrow and can lead to blood cancer - a mutation of red bone marrow cells. But as studies have shown, this chromosome becomes acquired during a person’s life, that is, it cannot be obtained from parents.

Acute myeloid leukemia occurs in people with Bloom syndrome, Down syndrome, Fanconi anemia, and in patients with Wiskott-Aldrich syndrome. Let's take a closer look at all the other factors that may influence the occurrence of this disease:

Smoking. Cigarette smoke contains a huge amount of chemicals that directly affect blood cells when inhaled.
Alcohol and nutrition. One of the endogenous factors that affect the entire body and every cell. In people with poor nutrition and problems with alcohol, the risk of developing cancer of any class increases by one and a half times.
Working with hazardous chemicals. People who work in factories, laboratories, or with plastic, gasoline, or other petroleum products have an increased chance of getting sick.
Chemotherapy and Radiotherapy. It happens that when treating a tumor, complications arise and another cancer appears.
Immune deficiency. Any disease that weakens the immune system can lead to cancer.
Genetics. Children whose parents had leukemia have a higher chance of getting the disease than the average child. Such people are usually included in the risk group, and they must undergo the necessary examinations annually.

To put it simply, first there is some external or internal effect on the cell. Then inside at the chromosomal level, it changes and mutates. After this cell divides, there are more of them. When a mutation occurs, the division program breaks down, and the cells themselves begin to divide faster. The death program also breaks down, and as a result they become immortal. And all this happens in tissues in the red bone marrow, which reproduce blood cells.

As a result, the tumor itself begins to produce underdeveloped leukocytes, which simply fill all the blood. They interfere with the work of red blood cells and platelets. And later there are many times fewer red blood cells.

Symptoms primarily depend on the type of leukemia and the stage of the cancer itself. It is clear that in later stages the symptoms are more vivid and more pronounced. Plus, other symptoms of the disease may appear. General signs of leukemia in adults:

Pain in bones and muscles.
Lymph nodes throughout the body become very enlarged and hurt when pressed.
The patient more often begins to suffer from common colds and viral diseases - due to the deterioration of the immune system.
Due to infection, fever and chills appear.
Sharp weight loss of up to 10-15 kg in an adult.
Loss of appetite.
Weakness and rapid fatigue.
I constantly want to sleep.
Bleeding does not stop for a long time and wounds on the body do not heal well.
Leg pain.
Bruises on the body.
Adult women may experience bleeding from the vagina.

First symptoms

The problem is that at the initial stage the disease manifests itself poorly, and the patient thinks that it is a common disease. Because of this there is a loss of time. The first symptoms of leukemia in adults:

Increased size of the liver and spleen.
You may notice slight bloating in the abdomen.
The appearance of a rash, red spots on the body.
Bruising may occur.
The symptoms are similar to a cold.
Slight dizziness.
Joint pain.
General malaise.

The first signs of leukemia are not so bright, so first of all you need to pay attention to a sharp decline in immunity and frequent illnesses. A patient can get sick, recover, and then start getting sick again a couple of days later. This is due to the fact that there are many immature mutant leukocytes in the blood that do not perform their function.

A decrease in the number of platelets leads to bleeding, rashes, stars appearing on the skin or subcutaneous bleeding. In the acute form of leukemia, chills and fever first appear, and then bones and muscles begin to ache.

Symptoms of acute leukemia

Acute leukemia usually progresses rapidly and aggressively. Often, up to stage 4, the disease can develop within 6-8 months, which is why the mortality rate for this pathology is higher than for the chronic form. But at the same time, cancer begins to manifest itself earlier, so in this case you need to see a doctor in time and diagnose cancer. Symptoms of acute leukemia in adults:

Weakness, nausea, vomiting.
Dizziness
Body cramps
Memory impairment
Frequent headaches
Diarrhea and diarrhea
Pale skin
Heavy sweating
Cardiopalmus. Heart rate 80 -100

Symptoms of chronic leukemia

It is a slow and non-aggressive cancer that develops over several years. In the first stages it is almost impossible to recognize it.

Frequent colds
A hard and enlarged abdomen is due to an enlarged spleen and liver.
The patient quickly loses weight, without any diets.

Symptoms of chronic lymphoblastic leukemia

Lymphocytic leukemia occurs more often in adulthood after 50 years. At the same time, there is an increase in lymphocytes in the blood. With an increase in -lymphocytes, it has the form of lymphocytic leukemia.

Disruption of the entire lymphatic system.
Anemia.
Long-term colds.
Pain in the spleen.
Visual impairment.
Noise in ears.
May lead to stroke.
Jaundice.
Bleeding from the nose.

Diagnostics

Usually, with any cancer, the level of platelets and red blood cells in the blood drops significantly. And this is clearly visible on a general blood test. Plus, an additional biochemistry test is usually taken, and there you can see abnormalities with an enlarged liver and spleen.

Further, when diagnosing, the doctor usually prescribes an MRI and x-ray of all bones to identify the source of the disease itself. Once cancer is found, the nature of the malignancy needs to be determined. To do this, a spinal or bone marrow puncture is performed.

A very painful procedure where a thick needle is pierced into the bone and a sample of bone tissue is taken. Next, the tissues themselves go for a biopsy, where they look at the degree of differentiation of the cancer - that is, how much different the cancer cells are from normal cells. The more differences, the more aggressive and dangerous the cancer. And only then treatment is prescribed.

Therapy

The treatment itself is mainly aimed at destroying cancer cells, as well as reducing the level of immature white blood cells in the blood. The treatment itself may depend on the stage of the cancer, the type and classification of leukemia, and the size of the bone marrow lesion.

The most basic treatments are: chemotherapy, immunotherapy, radiation and bone marrow transplantation. If the spleen is completely damaged, it can be completely removed.

First of all, the patient undergoes a complete diagnosis in order to find out the extent of the lesion and the stage of the disease. Nevertheless, the most basic method is chemotherapy, when a substance is introduced into the patient’s body aimed at destroying only pathological cancer cells.

Chemotherapy

Before this, the doctor performs a biopsy and tests the tissues and cells themselves for sensitivity to various reagents. But this is not always done; sometimes the doctor initially tries to introduce some type of chemical substance, and then looks at the reaction of the cancer itself.

Patients are prescribed medications that reduce vomiting and painkillers for severe symptoms. Several medications are usually prescribed, both as tablets and as injections.

If the spinal cord is damaged, a spinal puncture is used, when the drug itself is injected into the lower back into the spinal canal. Ommaya reservoir is a similar procedure that places a catheter in the same area and the end is secured to the head.

Chemotherapy itself is done in courses over a long period of 6-8 months. Between injections there is usually a recovery period when the patient is allowed to rest. The patient may be sent home if he does not have a severe decrease in immunity, otherwise he may be placed in a sterile ward with constant observation.

Side effects

Decreased immunity. The result is infectious complications.
Risk of internal bleeding.
Anemia.
Hair and nail loss. Later they grow up.
Nausea, vomiting, diarrhea.
Weight loss.

Immunotherapy

Aimed at boosting the patient's immune system to fight cancer cells. A mandatory procedure after chemotherapy, since after it the patient’s immunity drops significantly. They use monoclonal antibodies that attack cancer tissue and Interferon - it already inhibits growth and reduces cancer aggression.

Side effects

The appearance of fungus
Seizures on the lips, palate and mucous membranes

Radiotherapy

Irradiation of the patient leads to the destruction and death of leukemoid cells. It is often used before a bone marrow transplant to kill off any remaining tumor tissue. Typically, this type of treatment is used only as an auxiliary method, as it has little power in the fight against leukemia.

Fatigue
Drowsiness
Dry skin, mucous membranes.

Bone transplant

First, doctors need to completely destroy cancerous tissue in the bone marrow; for this they use chemicals. reagents. After which the remains are destroyed by radiation therapy. Later a bone marrow transplant occurs.

After this, peripheral blood stem cell transplantation is also used, through any of the large veins. Once the cells enter the blood, after a short period of time they turn into regular blood cells.

Side effects

Rejection of donor cells
Damage to the liver, gastrointestinal tract and skin.

Subsequent treatment

Doctors prescribe: Diet.

Painkillers.
Antiemetic drugs.
Complex of vitamins.
Antianemic therapy.
Antiviral, antifungal drugs, antibiotics, for low immunity.

Prognosis and survival

Five-year survival rate is the period during which a patient lives after the disease is detected.

Doctors do not use the concept of “cure”, since the disease can always return again. That is why, after complete therapy, the patient undergoes a biochemical, general and window marker blood test every six months.

NOTE! Adults are much less susceptible to treatment than children with leukemia. This is due to the fact that a young body adapts and regenerates faster. Also, recovery during chemotherapy occurs much faster, this is especially important in the acute form, since the frequency of courses is higher due to the high rate of development of the disease.

Nutrition for leukemia

Cannot be consumed

Fast food
Fried, smoked food
Alcohol
Highly salted food
Coffee and caffeinated products and food

Must be consumed

Fruits: apples, oranges, pears.
Carrots, tomatoes
Garlic, onion
Berries: strawberries, blueberries, currants
Sea kale
Mussels
Nuts
Buckwheat, oatmeal
Selenium
Legumes

Acute leukemia (acute leukemia) is a severe malignant disease that affects the bone marrow. The pathology is based on a mutation of hematopoietic stem cells - the precursors of blood cells. As a result of the mutation, the cells do not mature, and the bone marrow is filled with immature cells - blasts. Changes also occur in the peripheral blood - the number of basic formed elements (erythrocytes, leukocytes, platelets) in it decreases.

As the disease progresses, tumor cells move beyond the bone marrow and penetrate other tissues, resulting in the development of so-called leukemic infiltration of the liver, spleen, lymph nodes, mucous membranes, skin, lungs, brain, and other tissues and organs. The peak incidence of acute leukemia occurs at the age of 2-5 years, then there is a slight increase at 10-13 years; boys are affected more often than girls. In adults, the dangerous period for the development of acute leukemia is the age after 60 years.

Depending on which cells are affected (myelopoietic or lymphopoietic lineages), there are two main types of acute leukemia:

ALL– acute lymphoblastic leukemia.
AML– acute myeloblastic leukemia.

ALL develops more often in children (80% of all acute leukemias), and AML- in older people.

There is also a more detailed classification of acute leukemia, which takes into account the morphological and cytological features of blasts. An accurate determination of the type and subtype of leukemia is necessary for doctors to choose treatment tactics and make a prognosis for the patient.

Causes of acute leukemia

Studying the problem of acute leukemia is one of the priority areas of modern medical science. But, despite numerous studies, the exact causes of leukemia have not yet been established. What is clear is that the development of the disease is closely related to factors that can cause cell mutation. These factors include:

Hereditary tendency. Some variants of ALL develop in both twins in almost 100% of cases. In addition, it is not uncommon for several family members to develop acute leukemia.
Exposure to chemicals(in particular benzene). AML can develop after chemotherapy for another disease.
Radioactive exposure.
Hematological diseases– aplastic anemia, myelodysplasia, etc.
Viral infections, and most likely an abnormal immune response to them.

However, in most cases of acute leukemia, doctors are unable to identify the factors that provoked cell mutation.

There are five stages during acute leukemia:

Preleukemia, which often goes undetected.
The first attack is the acute stage.
Remission (complete or incomplete).
Relapse (first, repeated).
Terminal stage.

From the moment of mutation of the first stem cell (namely, everything begins with one cell) until the appearance of symptoms of acute leukemia, on average, 2 months pass. During this time, blast cells accumulate in the bone marrow, preventing normal blood cells from maturing and entering the bloodstream, as a result of which characteristic clinical symptoms of the disease appear.

The first signs of acute leukemia may be:

Fever.
Decreased appetite.
Pain in bones and joints.
Pale skin.
Increased bleeding (hemorrhages on the skin and mucous membranes, nosebleeds).
Painless enlargement of lymph nodes.

These signs are very reminiscent of an acute viral infection, so patients are often treated for it, and during the examination (including a general blood test), a number of changes characteristic of acute leukemia are discovered.

In general, the disease picture in acute leukemia is determined by the dominant syndrome; there are several of them:

Anemic (weakness, shortness of breath, pallor).
Intoxication (decreased appetite, fever, weight loss, sweating, drowsiness).
Hemorrhagic (hematomas, petechial rash on the skin, bleeding, bleeding gums).
Osteoarticular (infiltration of the periosteum and articular capsule, osteoporosis, aseptic necrosis).
Proliferative (enlarged lymph nodes, spleen, liver).

In addition, very often, in acute leukemia, infectious complications develop, the cause of which is immunodeficiency (there are insufficient mature lymphocytes and leukocytes in the blood), and less often, neuroleukemia (metastasis of leukemia cells to the brain, which occurs as meningitis or encephalitis).

The symptoms described above cannot be ignored, since timely detection of acute leukemia significantly increases the effectiveness of antitumor treatment and gives the patient a chance for a full recovery.

Diagnosis of acute leukemia consists of several stages:

There are two methods of treating acute leukemia: multicomponent chemotherapy and bone marrow transplantation. Treatment protocols (drug regimens) for ALL and AML are different.

The first stage of chemotherapy is the induction of remission, the main goal of which is to reduce the number of blast cells to a level undetectable by available diagnostic methods. The second stage is consolidation, aimed at eliminating the remaining leukemia cells. This stage is followed by re-induction - a repetition of the induction stage. In addition, maintenance therapy with oral cytostatics is a mandatory element of treatment.

The choice of protocol in each specific clinical case depends on which risk group the patient belongs to (the person’s age, genetic characteristics of the disease, the number of leukocytes in the blood, response to previous treatment, etc. play a role). The total duration of chemotherapy for acute leukemia is about 2 years.

Criteria for complete remission of acute leukemia (all of them must be present at the same time):

absence of clinical symptoms of the disease;
detection in the bone marrow of no more than 5% of blast cells and a normal ratio of cells of other hematopoietic germs;
absence of blasts in peripheral blood;
the absence of extramedullary (that is, located outside the bone marrow) lesions.

Chemotherapy, although aimed at curing the patient, has a very negative effect on the body because it is toxic. Therefore, against its background, patients begin to lose hair, experience nausea, vomiting, and disturbances in the functioning of the heart, kidneys, and liver. In order to promptly identify side effects of treatment and monitor the effectiveness of therapy, all patients must regularly undergo blood tests, undergo bone marrow tests, biochemical blood tests, ECG, EchoCG, etc. After completion of treatment, patients should also remain under medical supervision (outpatient).

Of no small importance in the treatment of acute leukemia is concomitant therapy, which is prescribed depending on the symptoms that appear in the patient. Patients may require blood transfusions, antibiotics, and detoxification treatment to reduce intoxication caused by the disease and the chemotherapy drugs used. In addition, if indicated, prophylactic irradiation of the brain and endolumbar administration of cytostatics are performed to prevent neurological complications.

Proper patient care is also very important. They must be protected from infections by creating living conditions that are as close to sterile as possible, excluding contact with potentially infectious people, etc.

Patients with acute leukemia undergo bone marrow transplantation, because only it contains stem cells that can become the ancestors of blood cells. Transplantation performed in such patients must be allogeneic, that is, from a related or unrelated compatible donor. This treatment procedure is indicated for both ALL and AML, and it is advisable to perform a transplant during the first remission, especially if there is a high risk of relapse - return of the disease.

At the first relapse of AML, transplantation is generally the only salvation, since the choice of conservative treatment in such cases is very limited and often comes down to palliative therapy (aimed at improving the quality of life and alleviating the condition of a dying person).

The main condition for transplantation is complete remission (so that the “empty” bone marrow can be filled with normal cells). To prepare the patient for the transplant procedure, conditioning is also required - immunosuppressive therapy designed to destroy the remaining leukemia cells and create a deep depression of the immune system, which is necessary to prevent transplant rejection.

Contraindications for bone marrow transplantation:

Serious dysfunction of internal organs.
Acute infectious diseases.
Relapse of leukemia that is untreatable.
Elderly age.

Prognosis for leukemia

The following factors influence the forecast:

age of the patient;
type and subtype of leukemia;
cytogenetic features of the disease (for example, the presence of the Philadelphia chromosome);
the body's reaction to chemotherapy.

The prognosis for children with acute leukemia is much better than for adults. This is due, firstly, to the higher reactogenicity of the child’s body to treatment, and secondly, to the presence in elderly patients of a mass of concomitant diseases that do not allow full-fledged chemotherapy. In addition, adult patients often turn to doctors when the disease is already advanced, while parents usually take a more responsible approach to the health of children.

If we use numbers, then the five-year survival rate for ALL in children, according to various sources, ranges from 65 to 85%, in adults – from 20 to 40%. In AML, the prognosis is somewhat different: five-year survival is observed in 40-60% of patients under 55 years of age, and in only 20% of older patients.

To summarize, I would like to note that acute leukemia is a serious disease, but it is curable. The effectiveness of modern protocols for its treatment is quite high, and relapses of the disease after a five-year remission almost never occur.

Zubkova Olga Sergeevna, medical observer, epidemiologist

Chronic leukemia is a malignant tumor that develops in the circulatory system. Mature and young cells from the myeloid or lymphoid series participate in its formation. The disease mainly affects adults over 50 years of age. But recently, doctors have noticed a rejuvenation of the disease - the pathology is increasingly being diagnosed in children. Symptoms appear depending on the type of leukemia. To clarify the diagnosis, an extensive examination of the patient is required. Based on the test results, a decision on therapy is made.

The circulatory system is capable of performing a specific function - saturating tissues with organs with oxygen, beneficial microelements and vitamins. Reversely removes waste products, carbon dioxide and other substances. Oncological disease affecting the blood is considered one of the most dangerous.

Leukemia develops in the blood-forming organs. The disease is provoked by an increase in the main cells of the blood supply, which retain the ability to differentiate. Chronic leukemia is a lymphoproliferative or myeloproliferative pathology characterized by an increase in differentiated blood cells. It differs from the acute form in that a mature or maturing cell is involved in the formation. Acute leukemia is formed from poorly differentiated blood cells.

At the first stage, a benign tumor forms. The neoplasm can be present in a person’s body for several years without causing discomfort or other side effects. During development, transformation into a malignant form occurs. Development is slow.

This type of leukemia is diagnosed in adults over 40 years of age and in older people. Men are more susceptible to the disease than women. Children are also susceptible to chronic leukemia, but less frequently - it occurs in 2% of patients.

Reasons for the development of pathology

Doctors do not know the exact cause of chronic leukemia. The disease is being studied, new theories of development are emerging. Scientists have identified a number of factors that can trigger the development of a tumor:

It can develop due to the presence in the body of a virus that affects the genome of cells - Epstein-Barr virus, retrovirus, papillomas and others.
Hereditary predisposition.
Chronic myeloid leukemia provokes disturbances in the chromosomal sequence (mutation of chromosome 22 and a fragment of the long arm).
The oncological process can provoke exposure to high doses of radioactive radiation on the body.
Interaction with toxic chemical compounds and carcinogenic substances - paints, petroleum products, benzene and others.
The influence of specific drugs - from the group of cytostatics and antibiotics, gold salts.
Nicotine and alcohol abuse.

Chronic lymphocytic leukemia causes interaction with toxic herbicides and pesticides over a long period of time. Chronic myeloid leukemia often develops when the body is exposed to high doses of radiation exposure.

The clinical picture of the disease is associated with immune disorders in the hematological structure - anemia, decreased platelet levels, collagenosis.

There are examples in medical practice when it was not possible to establish the cause of tumor development. Several precipitating factors were present.

Types of chronic leukemia

The tumor process that affects hematopoiesis is studied by hematology. Chronic leukemia is formed by a mature appearance of cells and a number of maturing elements. Chronic leukemia is divided into two large groups - chronic lymphocytic leukemia and chronic myeloid leukemia.

The shape of the tumor depends on the substrate cell that formed the pathology - lymphoblastic, myeloid and monocytic.

Chronic lymphocytic cancer includes the following types of diseases:

Lymphomatosis of the skin, or Sezary's disease;
Chronic lymphocytic leukemia;
Various types of paraproteinemic hemoblastosis - pathologies of light or heavy chains with Waldenström macroglobulinemia, myeloma;
Hairy cell leukemia.

The myeloid form includes chronic myeloid leukemia, polycythemia vera with erythromyelosis, and others.

The monocytic group is divided into histiocytosis and myelomonocytic leukemia.

The course of the pathology goes through two stages:

The first is a benign form (monoclonal).
The second is malignant (polyclonal).

The development of the oncological process is conventionally divided into three stages:

At the initial stage, the malignant process occurs in the affected area without going beyond the boundaries - there are no symptoms of the disease.
The advanced stage can be characterized by an increase in tumor size, damage to neighboring tissues - the first signs of pathology appear.
At the terminal stage, the tumor process spreads to the entire body, metastases are present in distant areas - the clinical picture of oncology is observed.

Symptoms of the myeloid form of the disease

At the initial stage, myeloid leukemia is asymptomatic. Sometimes signs that are not characteristic of pathology may be observed. There are structural changes in the blood, but they can only be identified through analysis. Patients complain of muscle weakness, increased sweating, body temperature ranges from 37 to 38 degrees, pain in the area of the right rib.

The advanced stage may have more pronounced symptoms:

The spleen and liver increase in size;
The victim begins to lose weight sharply;
There is pain in bone tissues and joints;
Leukemic infiltrates are present on the skin and mucous membranes;
There are blood impurities in the stool and urine;
Women experience severe blood loss during menstruation;
Vaginal bleeding not associated with the menstrual cycle;
Tooth extraction is accompanied by severe bleeding.

At the last stage, the symptoms become acute with signs of intoxication of the body. The symptoms resemble an acute form of leukemia - skin lesions, severe blood loss, infectious lesions of the body, body temperature rises to 40 degrees. In severe form, splenic rupture may occur.

Symptoms of the lymphoid form of the disease

The main sign of this form of disease is considered to be enlarged lymph nodes. This happens during the advanced period of the disease. The initial stage occurs without pronounced symptoms. At the second stage, the affected lymph nodes enlarge and gradually spread to other types of lymph nodes. Leukocytosis provokes an enlargement of the spleen and liver. Lymph nodes that exceed normal sizes put pressure on the bile ducts and vena cava. Externally, there are signs of jaundice, swelling of the soft tissues of the face, neck and arms. The patient complains of pain in the joints, an itchy effect on the skin and secondary infection.

Intoxication symptoms are manifested by muscle weakness, increased sweating, fever, lack of urge to urinate, an increase in heart rate is accompanied by dizziness and shortness of breath, deep fainting may be present.

The terminal stage is characterized by hemorrhagic and immunodeficiency syndromes. In the upper layers of the dermis and mucous membranes, pinpoint hemorrhages are observed, the patient has nosebleeds, gums bleed, and in women there is prolonged uterine bleeding. The immune system, affected by the tumor process, is not able to protect the body, which is manifested by frequent infectious complications - bronchitis, pneumonia, tuberculosis, skin fungus, inflammatory processes in tissues, kidney disease and herpes.

Internal organs undergo serious structural changes. The body suffers severe exhaustion. Kidney failure develops. Prolonged bleeding, infections and hemoglobin deficiency can cause the death of the patient. Chronic lymphocytic leukemia can transform into acute leukemia with lymphosarcoma.

Diagnosis of the disease

The doctor will be able to make an accurate diagnosis after a thorough examination of the patient. Diagnosis of lymphocytic leukemia includes the following procedures:

A physical examination of the patient is performed and a complete verbal history of the course of the disease is collected.
Blood must be taken for a general analysis and tumor markers - the characteristics of cancer are anemia, the presence of myelocytes with granulocytes, blast crisis, leukocytosis with lymphocytosis, lymphoblasts and Botkin-Gumprecht cells are detected.
A procedure is performed for sternal puncture of the bone marrow, which will show the state of the cellular series of blood and adipose tissue.
Trephine biopsy with lymph node biopsy will show the degree of malignancy of the tumor and the stage of the disease.
An ultrasound examination will show the extent of damage to the lymph nodes of the liver, kidneys and spleen.
The chest organs are studied using radiography.
Additionally, to clarify the patient's condition, lymphoscintigraphy and MSCT of the abdominal organs are prescribed.

Once all the test results are received, the doctor will be able to determine the type of tumor and the extent of organ damage. Based on this, a decision will be made on the course of therapy and the duration of the measures.

Treatment and prognosis of patient survival

At the initial stage, conservative treatment is usually not used. The patient is under the supervision of a doctor. At this stage, the patient is recommended to exclude physical activity, stressful situations, exposure to direct sunlight, and medical procedures associated with electrical heating and heat therapy. A balanced diet, rich in vitamins and microelements, and daily walks in the fresh air for a long time are prescribed.

At the second (advanced) stage of the disease, chemotherapy and radiation are used. For chemotherapy, drugs from the group of cytostatics are used - Busulfan, Mitobronitol, Hydroxyurea and others. Gamma ray irradiation is used to block the enlargement of the spleen. Sometimes doctors use leukapheresis. The dosage and timing are selected individually for each patient. These procedures help stop tumor development and prevent blast crisis. Bone marrow transplantation is an effective method in the fight against blood cancer. To perform the operation, one’s own stem cells or donor ones are used. Depends on the patient's condition.

At the terminal stage of the disease, polychemotherapy using high doses of drugs is used. Symptomatic treatment and palliative medicine methods are also used to relieve pain syndromes.

The doctor will not be able to accurately predict the prognosis of treatment - it depends on the form of cancer, the physical condition of the patient and the degree of damage to the body. On average, the life expectancy of patients with this diagnosis ranges from 3 to 5 years. There are examples in medical practice of living for more than 15 years. It is recommended to follow the clinical recommendations of your doctor, follow a diet and walks in the fresh air. This will increase your chance of living longer with minimal complications.