myeloid leukemia - a chronic disease of the hematopoietic system tumor, referring to the group of leukemia, characterized by a sufficiently large number of education in the blood of immature granulocytes.Myeloid leukemia at the beginning of its development is the increased number of white blood cells almost 20,000 l, and in expanded phase progression - up to 400,000 per ml.The myelogram and hemogram marked predominance of cells with varying degrees of maturity, such as myelocytes, stab, promyelocytes and metamyelocytes.
When myeloid leukemia revealed changes in the twenty-first and twenty-second chromosome that distinguish these cells from others.Very often it is a pathological condition characterized by a significant increase in blood eosinophils and basophils, suggesting a more severe course of myeloid leukemia.In this oncological disease is a common symptom of splenomegaly and blood and bone marrow - myeloblasts in large quantities.The main methods of treatment are considered
myeloid leukemia causes
Etiology of myeloid leukemia to date remains unclear.But there are suggestions that the occurrence of both acute and chronic myeloid leukemia form disorders play a role in the structure and composition of the chromosome apparatus, which are caused by inherited or acquired under the influence of some mutagenic agents.
The reasons for the development of myeloid leukemia may include action of chemical carcinogens.There is evidence that more frequent acute myeloid leukemia among people who were exposed to benzene or received cytostatic drugs (Azathioprine, Mustargen, Sarkozolin, Leykeran, cyclophosphamide).The frequency of this pathology of the disease among these patients is increased several times.There are cases that myeloid leukemia develops in the long term treatment of other cancers with radiation exposure.Thus, the ionizing radiation is considered to be one of the contributing factors in the development of myeloid leukemia.
addition, myeloid leukemia begins to develop as a result of not congenital chromosomal damage in a single stem cell.What triggers it to such changes is not yet known.Perhaps the occasional exchanges occur at the genetic level between chromosomes, which are located very close to each other at a certain stage of life of the cell.Applied analysis of chromosomes revealed that when myeloid leukemia throughout the body are distributed clonal tumor cell leukemia - are descendants of a single cell, which initially undergone mutations.Unstable genotype pathological cells in myeloid leukemia contributes to the appearance in the original clone such clones, and in addition under the influence of medicines are selected for the independent clones.This phenomenon suggests progressive course myeloid leukemia, and his departure from the monitoring cytotoxic drugs.
also do not rule out the disease in the event of the involvement of some viruses.
myelogenous leukemia symptoms
This disease refers to a chronic form of leukemia.When myeloid leukemia tumor process affects many sprouts bone marrow, such as red blood cells, platelets, and granulocytes.The tumor is considered to be the ancestor of myelopoiesis, which is the progenitor cells.Malignant process extends to the major blood-forming organs, and in the final stage of the tumor can be affected any tissue.
for clinical disease characterized by such stage myeloid leukemia, as the Unfolded and terminal.In the early stages of the disease the patient has no specific pathology complaints, spleen remains normal or may be slightly increased, and are not marked changes in the peripheral blood.
myeloid leukemia diagnosis in the early stages is carried out based on the analysis of the elevated leukocyte shift to promyelocytes and myelocytes.In addition, they exhibit a significant increase in the ratio between erythrocytes and leukocytes in the bone marrow, as well as the Philadelphia chromosome, which is localized in granulocytes.However, bone marrow trepanata this period is characterized by the replacement of the absolute fat myeloid cells.Continued deployed stages can be observed for 4 years.When you assign the correct treatment, the condition of patients with myeloid leukemia may be satisfactory.They continue to work, maintain their usual lifestyle, while on an out-patient treatment and observation.
End-stage malignant myeloid leukemia manifested all features.Appears irregular fever with high temperature, patients begin to rapidly lose weight, feel constant pain in the bones, there is a weakness throughout the body.On palpation in these patients have splenomegaly and hepatomegaly, sometimes increased lymph nodes.For this stage of myeloid leukemia characterized by certain changes in the blood.It is characterized by the emergence and rapid growth characteristics, which suppress normal hematopoiesis germs, such as granulocytopenia complicated by infection and necrosis of mucous, thrombocytopenia with complications in the form of hemorrhagic syndrome and anemia.
most important characteristic of the nature of hematological myeloid leukemia is a terminal stage of an increased amount of tumor cells (blasts).Based karyological analysis in the final stage of almost 75% of aneuploid defined clonal cell - a blood-forming cells that contain the wrong number of chromosomes.
Chronic myelogenous leukemia
This disease is considered a common type of leukemia, which accounts for nearly 20% of all leukemia pathologies.Annually myeloid leukemia in chronic ill at a ratio of 1.5: 100,000, with uniformly in all countries and is stable for fifty years.The disease affects mainly people 30 to 50 years, with a large percentage of men.Children suffer from this type of myeloid leukemia is rare, about 2%.
first reports of chronic myeloid leukemia occur in 1845, when the increase in the spleen were found with the presence of a significant amount of blood neutrophils.Already Virchow described the histology myeloid leukemia, where the related changes in the composition of the blood and the internal organs, giving him the name "splenic leukemia."
Today, when the diagnosis is not only used cytogenetic studies, and molecular, there is no evidence of the family of chronic myeloid leukemia.But ionizing radiation and certain carcinogens play a unique role in causing the disease.
Chronic myelogenous leukemia occurs in three stages such as chronic, advanced (acceleration) and acute (terminal).
for chronic myeloid leukemia stage characterized by a gradual increase in leukocytosis, increased platelets, granulocytes and spleen.First myelogenous leukemia is asymptomatic period that ends in the range of one to three years.During this period, there is sweating, the severity of the left edge and under the constant fatigue.Patients can consult a specialist after the onset of shortness of breath and heaviness in the epigastrium after eating, forcing them to limit the use of a one-time amount of food.In this case, the X-ray examination reveals highly elevated dome of the diaphragm, muffled and relegated lung, stomach and strangled the huge size of the spleen.At palpation, it is very dense, but painless.But at a fairly significant increase in this body develops infarction of the spleen, which is the signal for the treatment of a qualified installer.
Clinically infarction of the spleen characterized as a sharp pain under the ribs on the left, which radiates to the back, to the rise in temperature 38˚S with symptoms of intoxication.At this point, the spleen is very painful, noise is in the form of friction over the infarcted area due perisplenitom.
in 35% of patients with severe hepatomegaly splenomegaly form.In some cases, causing excruciating hyperleukocytosis priapism, and in rare moments - blurred vision and confusion, with pain in his head.
increased viscosity of the blood can cause the development of venooklyuzivnogo liver damage.At this stage myeloid leukemia using cytogenetic study revealed only Ph-chromosome (9 and 22), which is not typical for incremental changes.
Stage acceleration occurs without specific symptoms or they may not be very pronounced.As a rule, the patient is in satisfactory condition, but sometimes may experience unreasonable rises in temperature, fatigue will appear after any work, palpable spleen, which had previously defied palpation.
main picture of the transition from chronic myeloid leukemia in the acceleration stage is to change the composition of blood.Observed increase of leukocytes, that it was possible to monitor the treatment, increased myelocytes, metamyelocytes, promyelocytes and appear and blast cells in an amount of up to 2%.Also, up to 30% increase basophils.Therefore, patients with such a large number of basophils complain of itchy skin, the appearance of a feeling of heat and with the periodic occurrence of diarrhea, which is caused by a significant amount of blood histamine, which is produced by basophils.
If after increasing the dose of the chemotherapeutic drug is not reduced the percentage of basophils, this indicates a poor prognosis and a short onset of end-stage myeloid leukemia.For the later period are characterized by an acceleration of bone pain or aching in the joints, susceptibility to infectious diseases and weight loss.
step possible to determine the acceleration of almost 70% of patients.A sudden shift in its terminal stage was observed in patients with a prolonged first stage more than eight years (chronic).
End-stage chronic myeloid leukemia begins with the appearance of severe weakness, aching lengthy and sometimes very severe joint pain and bone pain with intermittent fever to 39˚S, often accompanied by chills, drenching sweat and weight loss.
Very often diagnosed with splenomegaly fast developing further heart attack spleen.Furthermore, there is an increase of liver to protrude from the edge of the rib 35 cm. Also symptoms of a hemorrhagic syndrome.Patients in this stage are in a very serious condition.Most patients develop blast crisis, characteristic of blood cells and bone marrow.Almost 50% of bone marrow revealed fibrosis.Many at this time point normochromic anemia and thrombocytopenia of varying depth.At 5-10% there are local extramedullary blast infiltrates that promote mieloblastomy.Quite often affects peripheral or mediastinal limfouzy.Basically it increases and becomes painful one lymph node, but then he's joined by other lymph nodes and organs.
Very rarely observed CNS with neuroleukemia or infiltration of the nerves in the peripheral system to the development of pain and paresis.
myeloid leukemia in children is more common in the juvenile form of the disease.In this case, there is a low hemoglobin, decreased platelet and erythrocyte increase monocyte blast cells with the presence and absence of basophils and eosinophils.For bone marrow characterized by an increased content of monocytes and blasts.Characterized lymphadenopathy with splenomegaly and hepatomegaly.At present, this option is considered as a chronic myelomonocytic leukemia in children.
Acute myeloid leukemia
This disease refers to malignant diseases of myeloid cells, as a result of which they are a quick process of reproduction and replacement, thus inhibiting the growth of healthy blood cells.Symptomatology acute myeloid leukemia develops substitution processes of bone marrow cells on leukemia, and this causes reduction of normal leukocytes, erythrocytes and platelets.
myelogenous leukemia acute form is characterized by the appearance of signs of fatigue, shortness of breath, small skin lesions with bleeding disorders, and infectious complications.
Today is not fully known cause of the disease.But some factors have been identified that contribute to the development of acute myeloid leukemia.These include ionizing radiation, exposure to harmful substances and mutation at the genetic level.
Many symptoms of acute myelogenous leukemia are caused by replacement of normal processes of hematopoietic tumor.Insufficient number of leukocytes leads to a reduction of the immune defense of patients and increases susceptibility to infection.The reduction of red blood cells causes anemia, which is expressed in fatigue, pale skin, and difficulty breathing.The decline in platelets leads to easy damage to the skin and to increase bleeding.
At the beginning of acute myeloid leukemia may occur as a sign of the state of influenza with fever, fatigue, weight loss or loss of appetite, shortness of breath, anemia, bruising, pain in the joints and bones, with the accession of infections.
In acute myeloid leukemia, and there is a small asymptomatic splenomegaly.Also noted is not of the increase in the lymph nodes.Sometimes this form of myeloid leukemia changes appear on the skin, and Sweet's syndrome.
addition, patients diagnosed with swelling in the gum as a result of infiltration of leukemic cells in the tissue.In some cases, detected the first signs of the disease chlorine - dense tumor mass is bone marrow.
In rare cases acute miieloleykoz detected at routine inspection due to the general analysis of blood on the background of asymptomatic disease.
Typically, acute myelogenous leukemia in developing very rapidly and without proper treatment can result in a fatal outcome for the patient for a few months or even weeks.
prognosis of acute myeloid leukemia with five-year survival rate can range from 15 to 70%, and remission - up to 78%.And it will depend on the subtype of malignant disease.
myeloid leukemia treatment
When choosing a primary treatment myeloid leukemia based pose stage.For the chronic stage, when mild clinical and hematological manifestations appointed restorative therapy, high-grade food fortified with regular medical observation.Interferon is used, which has a positive effect on the course of malignant disease.
main method of therapeutic treatment of myeloid leukemia is considered to be the use of cytotoxic drugs that block the growth of all cells, especially cancer.However, these drugs cause of side effects, manifested by inflammation of the mucosa of the gastrointestinal tract, hair loss, nausea and others. In addition, the irradiation beam is used, transfusion of blood substitutes and stem cell transplantation.
use self-therapy for the treatment of myeloid leukemia is unacceptable.Typically, the disease begin to cure during the progression of the pathological process.Considered effective chemotherapeutic agent Mielosan (6-8 mg per day) for more than a hundred thousand leukocytes in 1 l with simultaneous use of alkali drink significant quantities.And assign Allopurin 0.3 twice a day.Once normalized blood counts and reduced white blood cell count, Mielosan apply to 2 mg per day or every other day, and then used by maintenance therapy - once a week for 4 mg.Be sure to pass the control of the blood once every two weeks, and then move on once a month.
myeloid leukemia patients can also benefit from outpatient treatment.If there is resistance to Mielosanu and celebrated trombotsitemichesky syndrome, then resorted to the appointment Mielobromola 250 mg daily or hydroxyurea to 6 grams daily, too.