Leukemia - the disease is related to gemablastozu, in which bone marrow cells are replaced throughout malignant.The blood leukemia tumor appear not only leukocytes but also erythrokaryocytes and megakaryocytes.In addition, the formation of blood excessive number of leukocytes with such pathology is optional.Malignant tumor is actively growing and virtually controlled by the body.
Leukemia is not the result of inflammation or accumulation of unmetabolized cells.Thus, for increased production of abnormal blasts is suppressed healthy blood cells, which causes susceptibility to infections and the development of anemia and bleeding.There are two forms of malignant disease: chronic and acute, which are classified according to the type of white blood cells involved.Typically, a child suffer from acute lymphoblastic leukemia, and in older age - acute myeloid leukemia.
mainly leukemia potentially curable, but the chronic form of the elderly forecasts are not very favorable.However, the path
Today credible reasons that cause the development of leukemia is unknown.However, it has been suggested that several factors may contribute to this pathological neoplasms in humans.First of all it refers to ionizing radiation.With its exposure to frequent cases of acute myeloid leukemia, which affects people of all ages, and acute lymphoblastic leukemia, which is usually diagnosed in children from two to nineteen.The dose dependence is characterized by a high frequency of leukemia in those who were at a distance of 1,500 meters from the hypocenter.Very high incidence of acute leukemia in patients with spondylosis, who previously received analgesia as radiotherapy.There are also numerous cases of myeloblastic leukemia and myelomonoblastic, erythremic myelosis after irradiation with chlamydia and other tumor diseases of different localization.
also in the event of the presumed role for leukemia viruses.There are viral oncogenes, which are capable of forcing the cell to the continuous division after falling in her genome.It was proved the identity of the viral genes with malignant cell, and this is evidence of leukemia due to certain viruses.
hereditary factor plays an important role in the development of this disease.Leukemia is often diagnosed in families where there were sick similar forms of pathology.Registered defects at the genetic level, which are characterized by changes in the chromosomes.Thus, we can assume that the leukemia develops from a single cell mutant, which is beginning to be activated and leads to the formation of cancer cells.Thereafter, there are repeated the mutations that contribute to autonomous subclones which provokes malignant progression of leukemia.
Symptoms of cancer consists of increasing weakness, malaise, dyspnea (in some cases), dizziness (as a consequence of anemia).When nelimfoblastnyh acute leukemia toxicity observed with the rise in temperature.
Not all forms of leukemia in extensive stage proceed with enlarged lymph nodes and liver, and spleen, but all that may develop in the terminal stage of leukemia, regardless of the form of the disease.The skin shows signs of hemorrhagic syndrome, which is caused by thrombocytopenia.This is manifested in the form of mucosal bleeding, petechial rash, especially on the shins.Sometimes power generated tumor infiltration in the myocardium and lung, as well as other systems and tissues.
debut in pathological diseases in the blood expressed characteristic cytopenia.For bone marrow characterized by increased number of blasts in all forms of leukopenia, unlike maloprotsentnoy acute pathology.When this form is marked below 15% blasts, and in their blood greater than in bone marrow.Form acute leucopenia set based on histochemical studies.
The most common forms in adults are myelomonoblastic leukopenia, and myelogenous.
clinical picture onset of the disease is expressed in normal amounts of the principal organs of hematopoiesis with no increase in lymph nodes.At the same time it marked a profound form of granulocytopenia, anemia and thrombocytopenia.Often there is an intoxication, and the rise in temperature.
promivpotsitarnoy In acute leucopenia, which is considered a rare disease, there is a strong intoxication, gipofibrinogenemia and bleeding.The spleen, lymph nodes and liver are normal.But in the blood anemia, thrombocytopenia strongly expressed.For bone marrow characterized by a high content of modified blasts.Generally, bleeding in the brain leads to the death.
also not as common acute leukemia monoblastic.Starting with this form of practice, as in the myeloblast, but with more pronounced symptoms of intoxication and subfebrile body temperature.A common symptom of the disease appears hyperplasia of the gums, which is caused by tumor proliferative them.Blood tests show saved the germ of granulocytes, monocytes found power cells, and the amount of lysozyme in the urine reaches a high level.
plazmoblastnoy Leukemia acute form is characterized by the formation of blood and bone marrow plasma cells and plazmoblastov and blasts are not amenable to differentiation.Sometimes there foci of extramedullary leukemia, such as splenomegaly, enlarged liver and lymph nodes, skin leykemidy.
In acute leukemia megacaryoblastic blood found megakaryoblasts and undifferentiated blasts with characteristic tromotsitozom.
For acute erythremic myelosis characteristic progression of anemia, such as normochromic and hyperchromic.And without reticulocytosis, unsharp icteric eritrokariotsitarnogo a result of the collapse, raising thrombocytopenia and leukopenia.In the bone marrow erythroblasts identified with undifferentiated blast cells.
is often complicated by acute leukemia neuroleukemia.In this case, it affects the nervous system.This form of injury caused by the proliferation of leukemic cancer cells in the meninges or its agent.Clinically neuroleukemia characterized hypertensive and meningeal syndromes.There persistent headache, repeated vomiting, irritability, weakness, swelling of the optic nerve, strabismus, nystagmus, and meningeal signs.In the study of fluid from the spinal canal exhibit high levels of powerful cell count.Metastases in the brain - the clinical picture presented without cytosis.
Among chronic leukemia distinguish common forms, such as erythremia, lymphocytic leukemia, multiple myeloma, myeloid leukemia, and less - Waldenstrom macroglobulinemia, myelofibrosis, osteomieloskleroz and chronic monocytic leukemia.
clinically chronic leukemia occur in several stages, including a special role belongs to such as The developed and the terminal stage.
deployed to stage leukemia peculiar absence of complaints from patients, the spleen is normal in size and composition of the blood is not changed.Diagnosed with leukemia at this stage on the basis of leukocytosis, a significant increase in white blood cells of red blood cells in the bone marrow.The developed stage can occur up to four years.With proper patient management are in satisfactory condition, they retain the ability to work, they are at the outpatient follow-up.
End-stage flows from the high rise in temperature, the progressive depletion of nature, severe weakness, bone pain, fast splenomegaly, enlargement of the liver and sometimes the lymph nodes.Very quickly anemia with thrombocytopenia, which is complicated by the symptoms of hemorrhagic syndrome, granulocytopenia and mucosal necrosis.In the hematopoietic system of patients with marked increase in the number of blast cells.Typically, patients in this stage are living up to twelve months.
Chronic limfoleykemiyu at the beginning of its development, it is very difficult to identify.Only laboratory studies that show increasing leukocytosis, may be a signal in the diagnosis of leukemia.However, a characteristic symptom is lymph node enlargement.Splenomegaly refers to the most common symptom, but not always the liver increases.In the blood, there is an increase of lymphocytes, and sometimes prolymphocytes lymphoblasts.With the development of the disease reduced the overall level of gamma globulins.This in turn leads to frequent infectious complications, pneumonia, cytopenia, anemia and thrombocytopenia.In the terminal stage of chronic limfoleykemii growth occurs sarcomas or blast crisis occurs.
When hairy cell leukemia increased spleen and peripheral lymph nodes, as well as significantly expressed cytopenia.
Clinical symptoms in hereditary neyrotropenii is characterized by a tendency to staphylococcal infections, severe alveolar pyorrhea.For intermittent form of the disease is characterized by fever, but the infection is strictly joined by day neutropenia.
Signs of Leukemia
When leukemia can be distinguished characteristic features of cancer general and local manifestations.These signs of leukemia include: fatigue and weakness;insomnia or constant desire to sleep;the deterioration of memory and concentration;pale skin and dark circles under the eyes;unhealed wounds;the formation of various bruises on the body, without apparent reason;nosebleeds;often occurring SARS and infection;splenomegaly and an increase in lymph nodes and liver, the rise in temperature.
In laboratory blood tests reveal an increase or decrease in ESR, various types of leukocytosis, thrombocytopenia and anemia.
having one or more of these symptoms may not indicate leukemia.And in order to exclude or confirm the diagnosis it is advisable to be tested in a specialized clinic and consult with professionals.
Leukemia in children
This disease refers to tumors, which are characterized by uncontrolled growth and division of hematopoietic cells.Leukaemia is a clonal pathologies.This disease occurs in children in acute and chronic forms, which differ in the ability of cancer cells to differentiate.If tumor cells after primary differentiation mutation not tested, but only reproduce themselves, this acute form of leukemia.In children, they act as two major groups: acute lymphoblastic leukemia (80%) and acute nonlymphoblastic leukemia.
For many years studied the causes of childhood leukemia.But accurate data on this issue has not yet been established.It has been suggested that the majority of acute leukemia in children can be programmed even in utero.But for the implementation of the pathological process requires exposure to certain factors.The risk of acute leukemia in children whose pregnant mothers shifted X-ray examination is much higher.In addition, if one identical twin develops leukemia before the year is almost 100% can be argued that the second twin is sick of the same acute form of leukemia.
Also, many medical scientists argue that children with congenital abnormalities in the chromosomes of higher risk of leukemia.This particularly applies to diseases such as Fanconi anemia (the risk increases to 200 times), Down's syndrome (20 times), Louis-Bar syndrome (70 times) and Bloom's syndrome (200 times).
So far, continue to study the role of viral factors in the formation of acute lymphoblastic leukemia.In addition to infections being actively discussed the impact of physical, social and economic factors on the development of acute leukemia.
Acute lymphoblastic leukemia in children is presented in the form of clonal division, multiplication and accumulation of immature blast cells (lymph cells).The disease is most often diagnosed in boys and can occur at any age.Very often, acute lymphoblastic leukemia affects children two to four years (nearly 50%).About 15% is for ten years, and 2% - it is up to a year.
clinical picture of the disease is made up of the complaints of parents of children on the weakness of their malaise, decreased appetite and irrational rise in temperature.Almost 60% of children have pale skin.All this indicates the growing intoxication and anemia.Many children complain of pain in the bones, and in some cases, there are very intense and arthralgia ossalgia, which leads to restriction of movement.
In addition, there are pains in the spine and limbs, especially the lower ones.Developing osteoporosis and proliferative podnakostnichnye pathological character.On radiographs are changes in the vertebral bodies, osteoporosis and abscess.Also, the child is determined proliferative syndrome, which is expressed in hepatosplenomegaly (80%) increase in peripheral lymph nodes (50%) and mediastinal (10%).Sometimes the upper vena Vienna squeezed by increasing the mediastinal lymph nodes.Almost 50% of children have hemorrhagic syndrome, which manifests itself in the form of a nasal, kidney, uterine bleeding, and bleeding from the gums;petenhialnoy rash on the skin and mucous membranes;hematomas and ecchymosis.Some patients in early lesions appear leukemia extramedullary character.These include neuroleukemia (5-8%).It may be asymptomatic, in the form of specific meningitis with nausea, vomiting, pain in the head, with elevated CSF cell count;encephalitic meningo-encephalitic and.
CNS involvement occurs diapedetic way (through the vessels of the soft lining of the brain) and a contact (from the bones of the skull on a solid shell of the brain).The other area of extramedullary lesions are testicles.In 2% of boys marked infiltration of leukemia in the testicles.Clinically observe their increase as a dense, painless material.If a tumor is suspected, do a biopsy analysis.Very rarely, leukemic infiltration detect the syndrome of Mikulic in the heart, kidneys and lungs.Laboratory diagnosis
shows normochromic anemia (85% of children), leukopenia (20%), leukocytosis (50%), thrombocytopenia (80%).Almost 98% of affected children are identified in peripheral blood blast cells.The bone marrow was observed "leukemic hiatus."
nelimfoblastnyh Acute leukemia in children is basically the same clinical manifestations of acute lymphoblastic leukemia.It is characterized by the occurrence of anemia, hemorrhagic and proliferative syndrome, and symptoms of intoxication.Very often children developing DIC as a result of development of thromboplastin.This feature leads to profuse bleeding nature.15% of children diagnosed granulocytic sarcoma, which is mainly localized on the skin and periorbital region.Neuroleukemia at the beginning of the disease is detected in 20% of children.Acute leukemia nelimfoblastnyh proceeds with considerable variability in hematological parameters.
Chronic myeloid leukemia in children - a clonal abnormality of blood, which refers to the chronic myeloproliferative diseases, including such as idiopathic myelofibrosis, essential thrombocytopenia, and polycythemia vera.Chronic myeloid leukemia develops after a change in the genetic nature of stem cells.These lesions begin to proliferate and produce hematopoietic cells, and they are gradually replacing the healthy cells of the hematopoietic system.
flow of this type of leukemia is characterized by progressive character.As a result of the disease occurs in three phases, such as chronic, acceleration and blast crisis.