lymphocytic leukemia - a form of leukemia, malignant tumors of hematopoietic tissue, which originate in the bone marrow, then in propagating organs of the immune system and blood.Lymphocytic leukemia is characterized by pathological changes in malignant cells.
lymphocytic leukemia classified according to cells that have undergone abnormal changes in the acute and chronic.In acute diseases affected young undifferentiated cells (blasts).The chronic process involved more mature cells.Acute lymphocytic leukemia in the vast majority of cases occur in children, chronic lymphocytic leukemia is more common in men in the age range 50-60 years.In women, this damage occurs twice as often.
lymphocytic leukemia causes
most often determine exactly what might cause the beginning of lymphocytic leukemia, is not possible.But long-term studies in this area have allowed to identify the main factors that contribute to the development of the disease.
There is evidence of cases of famil
viruses can trigger a number of hematologic malignancies, including lymphocytic leukemia.Studies on cows, primates have confirmed that cause disease can both RNA and DNA viruses.Exact confirmation of received data on the virus triggering T-cell lymphomas.Epstein-Barr virus promotes B-cell acute lymphocytic leukemia.
Low doses of ionizing radiation does not lead to disease of the hematopoietic system, but lymphocytic leukemia occur at high doses, as one of the manifestations of radiation sickness.Radiation therapy of cancer in 10 percent of cases leads to lymphocytic leukemia.
Chemotherapy with cancer can also be the cause of malignant hematological diseases.
benzene, pesticides and other chemicals at times increased risk of lymphocytic leukemia.
In some editions published data on the effects of smoking on the process oknogeneza lymphocytic leukemia.
As a result, combinations of these factors mutations occur in cells of the lymphoid tissues.Subsequently, these cells have uncontrolled growth and reproduction.The cells lose their ability to move to a more mature forms.The immune system can not destroy malignant changes blood cells.The modified cells go into the blood from the bone marrow and colonize tissues and organs: spleen, lymph nodes, liver, and others. At this time the eviction of other cells of the hematopoietic system in the bone marrow.The predominant becomes malignant germ.Under these conditions, immune system depression, a person suffers from a variety of infectious diseases that can be fatal.
lymphocytic leukemia symptoms
What or specific symptoms and signs of lymphocytic leukemia has not.Most often, the person feels good, while the disease is already gaining momentum.Access to a doctor is usually associated with infectious diseases that accompany immunosuppression.General malaise that is manifested by increased weakness, reduced work capacity, increased sweating, drowsiness, and low-grade fever, a person is treated as a common cold, which will take place by itself.
symptoms begin lymphocytic leukemia can also be aches in bones and joints, weight loss and various skin rashes.But we must remember that all this is not specific symptoms and lymphocytic leukemia is characterized by a number of other pathological processes.Reduced immune function leads to fungal, parasitic, bacterial and viral diseases.
chronic lymphocytic leukemia
Chronic lymphocytic leukemia is characterized by the presence in the blood of a large number of mature forms of lymphocytes, as well as the infiltration of these cells of various organs.In 95% of all cases of lymphocytic pathological change was subjected to B cells, and only 5% is in the T-cell population.The incidence of 2.7 cases per 100 thousand. Population.
disease in chronic lymphocytic leukemia role of external factors has not been proved.Of great importance in triggering the disease, many authors give heredity, chromosomal anomalies, viruses, and electromagnetic waves.
Changed lymphocytes accumulate in the lymph nodes, liver, spleen, bone marrow, gradually displacing other progenitor cells hematopoiesis.Thus, slowing the development of red blood cells, platelets, granulocytes.
Depending on the clinical manifestations of the following types of lymphocytic leukemia: good, progressive, spleen, abdominal, tumor, bone marrow, prolymphocytic, hairy, T-cell.
Stage lymphocytic leukemia
initial stage.The patient had no complaints.The condition is satisfactory.Most often, this stage lymphocytic leukemia is detected on prophylactic examinations or treatment for infectious diseases.On examination, the doctor reveals swollen lymph nodes, there is an increase in blood cells and white blood cells.The size of the lymph nodes can vary to a very large, but it is not painful on palpation.
Period bright symptoms.Extreme weakness, profuse night sweats, weight loss, fever - these are the main symptoms.All groups of lymph nodes are enlarged.There may be non-specific skin rashes, infiltrates.In this step, lymphocytic actively align fungal, herpes, bacterial infections.The liver and spleen are enlarged.Sometimes it may be jaundice.Involvement of the gastrointestinal tract manifested gastritis, peptic ulcer disease, which is the risk of bleeding.The defeat of the respiratory system can lead to respiratory failure.The defeat of the cardiovascular system is manifested by shortness of breath, arrhythmia, ECG changes.The kidneys at this stage almost never affected.
End-stage lymphocytic leukemia.Serious opportunistic infections, and internal organ involvement without treatment will be lethal.
Each form has its own characteristics lymphocytic leukemia in clinical manifestations.Clinic progressive forms such as in benign, but the symptoms are increasing much faster.
form of lymphocytic leukemia tumor differs significantly enlarged lymph nodes and other lymphoid tissues.Lymph nodes in this form conglomerates and can compress the surrounding tissue.
have medullary forms of lymphocytic leukemia rapidly progressive course in which, without proper treatment, after 2 years can occur death.
prolymphocytic form of lymphocytic leukemia can only be distinguished in the study of blood smear.
hairy form of lymphocytic leukemia gets its name due to the shape of abnormal lymphocytes, and it is characterized by cytopenia varying severity and lymph nodes of normal size.
leukemic infiltration in the T-cell form affects deeper layers of skin and tissue, occurs in people older than 25 years.
lymphocytic leukemia blood
for lymphocytic leukemia at different stages of the disease is characterized by a specific pattern of blood tests.Big increase in lymphocytes, or lymphocytosis, is the most characteristic feature.
About the beginning of the disease is the presence in the blood of more than 5 * 109 / L leukocytes (rate of 4.5 * 109 / L).Sometimes figures can reach 100 * 109 / L.Among all leukocytes predominate lymphocytes (80-90%).All lymphocytes mature forms are presented.
peripheral blood is an important feature is the presence of anemia, which progresses with the passage of the disease.Thrombocytopenia is characteristic of the later period lymphocytic leukemia where the bone marrow is almost filled by the tumor cells.During all stages of the erythrocyte sedimentation rate improved.
lymphocytic leukemia treatment
in benign lymphocytic leukemia during the use of drugs is not necessary.But a prerequisite for this is a monthly survey.
With the progression of disease in patients older than 55 years should be administered chlorambucil and cyclophosphamide therapy.Supportive therapy chlorobutynyl is 10-15 mg 1-2 times a week.Cyclophosphamide prescribed for resistance to chlorambucil and progression lymphocytosis, enlarged lymph nodes and spleen at a dose of 2 mg / kg per day.It is also possible, and pulse therapy with cyclophosphamide - 600 mg / m2.
great importance in the treatment of lymphocytic leukemia are steroids.They eliminate a number of symptoms: the lymph nodes and spleen are less removed intoxication, the patient's state of health improves.But we must remember that the immune system is already depressed, and prednisone exacerbate infectious complications.In addition, after stopping hormone withdrawal occurs, so the hormones need to be lifted gradually.The course of drug therapy lasts 4-6 weeks.
very effective radiotherapy.And in the case of increasing intrathoracic, abdominal lymph nodes and the increasing leukocytosis and thrombocytopenia, infiltration of nerve trunks needed.A single dose of 1.5-2 Gy.For spleen total dose of 6-9 Gy.At local irradiation vertebra total dose of 25 Gy.Local effects gives, usually lasting effect and acute lymphocytic leukemia long.If unable to use medical treatment possible appointment of a system of radiation exposure.
With the progression of cytopenia unrelated to cytostatics, and do not respond to hormone therapy, recourse to remove the spleen.The rapid growth of the body, constant pain in the left upper quadrant are also indications for removal of the spleen.
When lymphocytic leukemia ineffective drug therapy, application of methods of extracorporeal blood purification.These include plasmapheresis and leukophoresis.Last effective in thrombocytopenia.
for the treatment of progressive forms of lymphocytic leukemia using chlorambucil (Leykeran) - 5.10 mg / Cyclophosphamide - 200 mg / day.Also, a program M-2: Day 1 - vincristine 2 mg / in, cyclophosphamide -600-800 mg, Carmustine per 0.5 mg / kg, Alkeran - 0.25 mg / kg orally (Sarkolizin - 03 mg / kg) once a day for 4 days.Prednisolone - 1 mg / kg per day for seven days, half the dose for the next 7 days, a quarter of the initial dose the next 7 days.This scheme is effective and results in remission.
tumorous form of lymphocytic leukemia is treated under the following schemes: CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) for 6 courses.This scheme tolerated difficult and requires long-term administration of prednisolone.M-2 program leads to remission only during treatment.Effective in this form of the disease with the total radiation therapy with a total dose of 0.12 Gy.
Treatment medullary forms lymphocytic carried program VAMP (vincristine 2 mg twice a week, 6-Mercaptopurine - 60 mg per day, Methotrexate - 20 mg once every 4 days, prednisolone - 40 mg / m2 per day. Duration of the course -8 days of reception, 9 days break. And so at least 8-10 courses, despite the improvement.
prolymphocytic form of the disease can not be cured with standard schemes. In this case, use Cytosar and rubomycin.
When hairy form used chlorobutynyl -2-4 mg per day.
When the disease chronic lymphocytic leukemia prognosis is favorable. Despite the fact that there is no cure, life expectancy is often equated to the general population. In benign variant current life expectancy can reach 20 years since the discovery of tumors. When progressingform may be only a few months.