Acute leukemia symptoms in adults prognosis treatment. Acute leukemia: life prognosis. Myeloid non-lymphoblastic leukemia

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

What determines patient survival?

More recently, the prognosis for blood cancer in the vast majority of cases was disappointing. This is not surprising: oppression 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 leukemia patients live cannot even be roughly answered: the prognosis depends on the thoroughness of care, the possibility of using intensive polychemotherapeutic 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;
the minimum duration of the diagnostic period (the time interval between the initial stage of the disease and the introduction of the first dose of chemotherapy);
absence of other oncological diseases;
achievement of complete remission after 1-2 courses of chemotherapy;
age and gender of the patient (the least favorable prognosis for male patients younger than 2 and older than 60 years);
careful care (observance of the prescribed diet and sterility in the room where the patient is located);
timely appointment of antimicrobial and antifungal therapy, blood transfusions (transfusions of blood components) to exclude complications of leukemia;
the possibility of transplantation of bone marrow tissue from a related or suitable unrelated donor and successful engraftment of the transplant.

Also, the survival of the patient 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 prognosis is most favorable in patients with a tumor B-lymphocyte clone.

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

Characteristic disorders at the gene level allow not only to suggest a prognosis, but also to improve it through the use of compensatory drugs. In the case of translocation (9;22), the so-called "Philadelphia chromosome", the action 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 bone marrow and blood tests, complete and incomplete remission are distinguished.

Complete remission occurs in the absence of immature (blast) cells and a decrease in their concentration in the hematopoietic tissue to 5% or less. With incomplete remission, the proportion of blasts in the bone marrow tissue is up to 20%. In fact, this condition characterizes the positive dynamics against the background of the treatment, and not the final result of the 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 a complete remission, doctors cannot diagnose a complete recovery, because. there is a possibility of recurrence of signs of leukemia. Only patients who have not relapsed within five years after the end of the main stage of chemotherapy are considered to be cured. To prolong remission and destroy possible abnormal blasts, the second stage of therapy is prescribed - maintenance treatment.

Supportive treatment includes taking cytostatic tablets, diet and daily routine and hygiene. The absence of this stage of treatment greatly increases the risk of recurrence of the disease. With each subsequent manifestation of leukemia, the remission period is reduced, and the chances of a five-year survival rate fall sharply.

How long do patients with various types of leukemia live

In 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 peak in the incidence of leukemia.

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

In acute lymphoblastic leukemia, the prognosis is highly dependent on 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 are at high risk of relapse.

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

With myeloid blood 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 the end of treatment in 12% of cases.

The worst prognosis is observed in megakaryoblastic blood leukemia, in which platelet progenitor cells undergo mutations. This diagnosis is fixed 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. Complete recovery, according to statistics, occurs in about 10% of all clinical cases of myeloid leukemia. The use of TCM allows you to increase the chances of long-term (more than 10 years) survival up to 80%.
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Effect of Leukemia Complications and Cytostatic Therapy on Survival of Patients

Any oncological process can negatively affect not only the organ in which the tumor develops, but also the entire body of the patient. In particular, this applies to neoplasia in the endocrine, lymphatic and hematopoietic systems. How long a patient will live after the end of treatment is determined not only by the anticancer efficacy of drugs, but also by the presence of complications of the tumor process itself and chemotherapy.

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

An excess of blasts in the blood increases its viscosity, which contributes to the deterioration of the organs. Due to the formation of leukemic and myeloid thrombi 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 classes of cytotoxic drugs, as well as the nausea and vomiting that accompanies chemotherapy, may force the patient to abandon potentially curative courses in favor of less effective ones. The use of setrons and corticosteroids can stop the negative effects of the gastrointestinal tract.

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

Leukemia is a malignant pathology that affects the circulatory system. Its primary focus of localization is bone marrow tissue.

The disease has no age restrictions, but in more than 90% of detected cases, the disease affects adults. In the past few years, the statistics of leukemia cases has been steadily increasing.

Pathology can proceed both in acute and have a chronic form of the course. In the first case, its clinical manifestations will be more pronounced, in the second case, the symptoms are extremely blurred and it is not always possible to diagnose the disease in time.

The acute form of leukemia is characteristic of the elderly, while the chronic manifestation of blood cancer affects young and middle-aged people. It is in this situation that it is extremely important to carefully monitor the slightest manifestations of the disease.

First symptoms

In the vast majority of patients with this diagnosis at the initial stages of its progression, the process proceeds differently. The intensity of the manifesting signs is determined by the state of the body's immune forces and the general physical health of a person.

This symptom is considered one of the most non-specific and therefore almost always ignored up to a certain point. This condition is very close to the manifestations of a cold at the stage when nothing hurts yet, but the person understands that something is wrong with him.

There is muscle weakness, drowsiness, lethargy. Often this "set" is accompanied by swelling of the mucosa, headache, ocular tearing, characteristic of viral diseases.

The patient begins to take anti-cold drugs, due to their orientation they give some result, eliminating physical discomfort, which blurs the symptoms for an indefinite time, and the person continues to not notice a serious threat.

Anemia

Leukemia, especially its myeloid form, provokes a tendency to bleeding, the appearance of hematomas, bruises, even with a slight mechanical impact, which should not be normal.

The phenomenon is considered a consequence of a violation of the cellular structure of platelets, in which blood cells lose their natural coagulability. During this state, the number of red blood cells reaches an extremely low level. This is how anemia occurs. It is because of her that the skin becomes paler than usual, which directly indicates serious problems with hematopoiesis.

sweating

One of the main early signs of the development of a malignant anomaly of the blood. This is especially true in cases where, due to physiological and anatomical features, a person was previously not prone to sweating.

The phenomenon occurs spontaneously, cannot be corrected. Basically, it happens at night during sleep. Such sweating in oncological practice is interpreted as profuse and is the result of damaging processes in the central nervous system.

Patients with leukemia tissue fragments - the cause of infiltration of the outer epithelial integuments and glands that produce sweat secretion.

Enlarged lymph nodes

Submandibular, clavicular, axillary and inguinal nodal joints, that is, those areas where there are skin folds, fall under the damaging effect of progressive pathology. However, they are quite easy to spot.

Since cancer-affected leukocytes actively accumulate and develop further in the lymph nodes, their increase is an inevitable process. Abnormal tissues gradually fill immature forms, and the nodes increase many times in diameter.

They are characterized by an elastic and soft internal content, while mechanical pressure on the tumor is accompanied by pain of varying degrees of intensity, which cannot but alert a person and requires consultation of a specialized specialist.

If the lymph node is larger than 2 cm, this is far from the norm, but most likely a developing oncological pathology.

Enlargement of the liver and spleen

It is worth noting that these signs are quite specific and may have a completely different background. It is important to understand the borderline conditions of enlargement of these organs in order to adequately judge the possible risks of oncology.

As for the liver, its increase is not too pronounced and critical. With such a diagnosis, it almost never reaches large sizes. The spleen somewhat dominates in this regard - it begins to grow actively already at the initial stages of the course of the disease and gradually spreads to the entire area of the left peritoneal zone.

At the same time, the organ changes its structure - it becomes dense in the center, and softer at the edges. It does not cause discomfort and pain, which makes it difficult to diagnose this anomaly, especially in overweight patients.

Main symptoms

As the disease progresses, the symptoms of its course become brighter. At this stage, it is extremely important to pay attention to secondary signs of leukemia, since untimely seeking medical help is the main cause of death in adults from the considered malignant pathology.

Bleeding

Blood leukemia in adults, regardless of its form, disrupts the normal processes of platelet production, which directly determine the quality of blood clotting. As the disease progresses, this condition worsens, as a result of which fibrin clots that can stop bleeding simply do not have time to form.

In this state, even shallow cuts and scratches are very dangerous. And nosebleeds are fraught with serious losses of blood mass.

Women on the background of the disease are characterized by heavy menstruation, cycle disorders and spontaneous uterine bleeding.

bruising

Bruises and bruises appear suddenly, and their nature of occurrence is not mechanical trauma to the affected tissue fragment. This is the specificity of the symptom, and the inexplicability of their appearance is the result of a low content of platelets in the blood plasma and the resulting low blood clotting.

Bruises can appear in any part of the patient's body, but their predominant number is in the upper and lower extremities.

Joint pain

Pain in the joints differs in varying degrees of intensity and is a consequence of a large concentration of diseased cells in the brain, in particular in those areas where their maximum density is concentrated - in the area of the sternum and pelvic bone at the ilium.

As the stage of leukemia increases in an adult, cancer cells grow into the cerebral fluid, enter the nerve endings and cause local pain.

chronic fever

Many associate a chronic increase in the temperature of the patient's body with internal inflammatory processes, however, if this phenomenon does not have obvious symptoms, then malignant oncological lesions of organs can be suspected with a high degree of probability.

A chaotic increase in the number of leukocytes will inevitably cause biochemical processes with the releasing action of components that activate the activity of the hypothalamus, which, in turn, is responsible for an increase in the patient's body temperature.

Frequent infectious diseases

Chronic cough, nasal congestion, become almost regular, especially in the acute form of the disease in adults.

The reason for this phenomenon is the low functional ability of leukocytes, which are responsible for the immunomodeling of cells. The body affected by leukemia can no longer qualitatively and quickly fight the pathogens of viral and catarrhal infections penetrating from the environment, and the disease becomes regular.

In this condition, the patient's microflora is disturbed, which further reduces susceptibility to SARS and colds.

Constant malaise

A constant feeling of fatigue and physical weakness even after a good rest, a feeling of indifference and depression associated with this state, are directly a consequence of the fall in the level of erythrocytes. This process occurs at lightning speed and progresses just as rapidly.

Often, against the background of this, appetite decreases, a person begins to lose body weight, since the tumor transformation of cancerous blood cells in an adult organism requires large energy resources. As a result, the patient becomes weak and exhausted.

Distinguishing symptoms by type

The clinical manifestations of leukemia in an adult may differ somewhat and have more non-standard manifestations depending on the type of disease. In addition to the general signs characteristic of the pathology, the following specific symptoms of the development of tumor processes in the blood were revealed.

Chronic myeloid leukemia

Manifestations of myeloid oncology in the chronic stage of the course in addition to the general signs of the disease are fraught with:

palpitations or vice versa, slow heart rate;
fungal infections of the oral cavity - stomatitis, tonsillitis;
renal failure - manifests itself, starting from the 3rd stage of the course of the disease;

Chronic lymphoblastic leukemia

It belongs to the group of non-Hodgkin manifestations of lymphoma, the main cause of which is a genetic factor. Against the background of the disease develop:

severe impairment of immune function- entail a sharp deterioration in the state of health and dysfunction of a number of important systems and departments of the body's vital activity;
urinary tract pathology- cystitis, urethritis are most often diagnosed, and only in the process of their therapy is the true cause of their appearance revealed;
tendency to fester- purulent masses accumulate in the area of subcutaneous adipose tissue;
lung lesions- often they lead to death against the background of the main diagnosis - leukemia;
shingles- proceeds hard, quickly affects large areas of tissue, often passes to mucous fragments.

Acute lymphoblastic leukemia

The course of the disease is accompanied by the following distinctive features:

severe intoxication of the body- manifests itself in various kinds of viral, bacterial infections and inflammatory processes;
vomiting reflex-accompanied by an uncontrolled course. The composition of the vomit contains a large number of blood fragments;
respiratory failure and as a result, the development of heart failure.

Acute myeloid leukemia

The disease, unlike other types of leukemia, in adult patients develops extremely rapidly and already at the stage of tumor formation, symptoms associated with a particular type of cancer may be characteristic:

sharp, more than 10% of the total body weight, weight loss- weight loss occurs very quickly, the patient spontaneously loses fat mass after a couple of months;
pain in the abdomen- caused by the growth of parenchymal departments;
tarry stools- their cause is bleeding of the gastrointestinal tract;
high intracranial pressure- occurs due to swelling of the optic nerve and acute headache.

Informative and educational video about the symptoms of the disease:

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In the mind of an ordinary person, cancer is closely related to the formation of a primary focus of a tumor in the body, which directly threatens his life and its duration. However, in a number of cases, pathological processes do not manifest themselves clearly, even if they are already widely spreading through tissues and organs. For example, myeloblastic leukemia of the blood is dangerous precisely for this.

The pathology of hematopoietic structures is characterized by the difficulty of diagnosing, as well as an uncontrolled increase in the number of mutated cells. Gradually, the number of healthy elements decreases, and the infection affects more and more new tissues and organs.

Main reasons

To date, the root causes of the formation of AML have not been finally established by specialists. Therefore, it is rather difficult to judge unambiguously what exactly prompted the failure, and how this will affect the survival time.

However, negative predisposing factors have been identified that can significantly reduce the remaining years. The latter should include:

the person has myelodysplastic or myeloproliferative syndromes;
courses of chemotherapy transferred by a person;
exposure to ionizing radiation;
congenital genetic mutations;
the presence of biological mutagens in a woman at the time of her childbearing.

Of great importance is the hereditary predisposition to myeloid leukemia, the prognosis in this case is significantly worse. If a blood relative had a similar oncological disease, it is highly likely to manifest itself in subsequent generations.

Myeloid leukemia types and prognosis

In most cases, when using the terms "chronic" and "acute", we are talking about the stages of the same pathology. Based on this, experts judge the forecast. However, this is not possible in the case of myeloid leukemia. These are 2 different types of oncoprocesses in the blood system, with their own causes, formation mechanisms, symptoms and prognosis.

So, an acute form of myeloid leukemia is a lesion of a myeloid blood germ by a malignant oncological process. It is characterized by uncontrolled and very rapid division of mutated cells. This has an extremely negative effect on the well-being of a cancer patient, quickly exhausting his ability to resist cancer. A lethal outcome can occur literally in 1-2 months.

Such a lesion can occur in people of different age categories and social security. However, the disease is more often diagnosed in older people.

The main difference between the chronic variant of myeloid leukemia is that after uncontrolled division in the bone marrow structures, mutated cells enter the bloodstream. It is this fact that determines a more favorable course of the pathology, and the prognosis of survival is somewhat improved. The age category of cancer patients is also different - the disease is diagnosed more often at 35-55 years.

Symptoms versus prognosis

Pathology has many clinical manifestations. In this case, there are no specific symptoms, as such. This aggravates the situation, since late diagnosis does not allow us to talk about recovery. Symptoms directly depend on at what age and at what stage of the oncological process the pathology was detected.

In most cases, patients complain that they are concerned about the increase in temperature parameters and persistent pain impulses in the bones. In addition, there are:

increasing weakness and increased fatigue;
skin becomes cyanotic;
appetite is practically absent;
severe shortness of breath is formed;
dyspeptic disorders - urge for nausea, vomiting, alternating constipation with diarrhea, increased flatulence;
unpleasant discomfort, heaviness in the hypochondrium;
an increase in the parameters of the spleen and liver;
pain impulses in all groups of joints.

All of the above undermines a person's reserves of strength, he has no desire to fight a tumor, the survival time is many times reduced. And since, against the background of damage to blood sprouts, the number of platelets also decreases sharply, cancer patients will have a tendency to prolonged bleeding up to a diffuse variant, leading to death.

Such a diverse symptomatology is due to the fact that all tissues and organs receive blood with mutated cells contained in it. Their infiltration into healthy tissues occurs, followed by the formation of multiple tumor foci.

Modern diagnostic methods help to put everything in its place and conduct an adequate differential diagnosis, as well as decide whether it is possible to cure myeloid leukemia.

What is the forecast

Pathology can successfully disguise itself as a variety of other diseases, which makes it very difficult to detect it in a timely manner. And this, of course, worsens the prognosis for the life of a cancer patient.

Acute myeloid leukemia and its life prognosis are influenced by such practically uncontrollable factors as the age of the cancer patient and the stage at which the disease was detected.

By itself, such a pathology never goes away. But adequate therapeutic measures can significantly prolong a person's life, as well as significantly improve the prognosis.

Among the additional prognostically unfavorable factors, the following should be indicated:

formed splenomegaly;
failure in the activities of the structures of the central nervous system;
multiple lesions of the lymph nodes;
the age category of the patient is more than 65-75 years;
significant inhibition of blood parameters;
a person has other oncopathologies;
lack of a positive response to ongoing therapeutic measures.

No oncologist can give an accurate prediction of life expectancy in case of diagnosed myeloid leukemia. Malignant lesions of the hematopoietic system are quite unpredictable. They can recur even with an established long-term remission.

If the pathology is amenable to chemotherapy, then complications or relapse can be delayed by 5-7 years. Therefore, it is so important to contact specialists at the slightest deterioration in well-being for early diagnosis of cancer. With a significant number of mature blood elements and well-designed therapy, the chances of achieving a long period of remission increase.

How to prolong life with acute myeloid leukemia

If after the courses of chemotherapy (at least 3-5 sessions) more than two years have passed, we are talking about stable remission. If more than 5 years have passed and there are no signs of a return of the symptoms of oncopathology, then there is every chance to cure the disease.

Timely bone marrow replacement helps to achieve the most positive prognosis of survival. After such a procedure, a cancer patient can live for more than 10-15 years. However, among the shortcomings of the technique, it is necessary to point out the high cost and complexity of its implementation. Not all cancer patients have such opportunities.

Additional strength to fight such a terrible pathology for every person is given to the patient by his close relatives and friends. Psychological assistance throughout the treatment is also provided by the medical staff of specialized clinics. Psychologists help a person accept his diagnosis and understand that life does not end there, that it is necessary to gather all your strength and fight hard.

A person's lifestyle and the general initial state of his immune barriers have a huge impact on the rate of oncology.

To help your body overcome the disease, it is recommended to adhere to the following principles:

between courses of chemotherapy, strive for the most healthy lifestyle - give up all existing negative habits, for example, the use of tobacco and alcohol products;
try to spend more time in the fresh air, for example, walk twice a day for several hours in the nearest forest park;
adjust your diet - it should be dominated by plant foods, necessarily a variety of vegetables and fruits;
take modern vitamin complexes - the attending physician will recommend the best option;
to activate your own immune barriers, you will also need to take immunomodulators, as well as hepatoprotectors - to protect against the negative effects of cytostatics;
follow all the recommendations of your doctor - an independent change in the frequency or duration of pharmacotherapy is absolutely unacceptable.

If the course of myeloid leukemia is not accompanied by severe complications, and the diagnosis was made at an early stage in the formation of oncopathology, recovery can be predicted in a person.

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

Blood leukemia, or as it is also called leukemia, 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 begins to increase in the blood. In the common people, this disease is also called leukemia. Separate acute and chronic leukemia.

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

If you take children, then they have one of the most dangerous types of blood cancer - acute lymphoblastic leukemia, and more often boys from 2 to 5 years old turn white with it. The acute form of myeloid leukemia already has 27% of all oncological diseases among children and children from 1 to 3 years old suffer from them. And most often the prognosis is very disappointing, since the disease is very aggressive and proceeds quickly.

Chronic

Causes

Scientists, doctors are still arguing what exactly affects the emergence of cancerous and malignant cells. But most doctors are already on the path to discovery, as most believe that both acute and chronic forms of leukemia result from 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 can affect the occurrence of this disease:

Smoking. Cigarette smoke contains a huge amount of chemicals that directly affect blood cells when inhaled.
Alcohol and food. One of the endogenous factors that affect the entire body and every cell. People with poor nutrition and alcohol problems have a one and a half times higher risk of developing cancer of any class.
Working with hazardous chemicals. People who work in factories, laboratories, or with plastic, gasoline, or other petroleum products are more likely to get sick.
Chemotherapy and Radiotherapy. It happens that during the treatment of 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 sick than a normal 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 influence on the cell. Then inside at the chromosomal level, it changes and mutates. After the division of this cell, there are more of them. During mutation, the division program breaks down, the cells themselves begin to divide faster. The program of death is also broken, and as a result they become immortal. And it all takes place in the tissues in the red bone marrow, which are produced by 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, red blood cells become many times smaller.

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

Pain in bones and muscles.
Lymph nodes throughout the body are greatly enlarged and hurt when pressed.
The patient often begins to get sick with the usual colds, viral diseases - due to the deterioration of the immune system.
Due to infection - fever, chills appear.
Sudden weight loss up to 10-15 kg in an adult.
Loss of appetite.
Weakness and rapid fatigue.
Always want to sleep.
Bleeding does not stop for a long time and wounds on the body do not heal well.
Pain in the legs.
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 weakly, and the patient thinks that this is a common disease. Because of what there is a loss of time. The first symptoms of leukemia in adults:

Enlargement of the liver and spleen.
You may notice a slight bloating.
The appearance of a rash, red spots on the body.
Bruising may appear.
The symptoms are similar to those of a cold.
Slight dizziness.
Pain in the joints.
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. The patient can get sick, recover, and after a couple of days start to get sick again. This is due to the fact that there are many immature mutant leukocytes in the blood that do not fulfill their function.

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

Symptoms of acute leukemia

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

Weakness, nausea, vomiting.
Dizziness
Cramps in the body
Memory impairment
Frequent headaches
Diarrhea and diarrhoea
Pale skin
Strong 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 early stages, it is almost impossible to recognize it.

Frequent colds
Hard and enlarged abdomen due to 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.

Violation of the entire lymphatic system.
Anemia.
Long colds.
Pain in the spleen.
Violation of vision.
Noise in ears.
May lead to stroke.
Jaundice.
Bleeding from the nose.

Diagnostics

Usually, with any cancer in the blood, the level of platelets and red blood cells drops dramatically. And this is clearly seen in the general blood test. Plus, an additional biochemistry test is usually given, and there you can see deviations with an enlarged liver and spleen.

Further, when diagnosing, the doctor usually prescribes an MRI and an x-ray of all bones in order to identify the focus of the disease itself. Once the cancer is found, the nature of the malignant neoplasm needs to be determined. For this, a puncture of the spinal or bone marrow is performed.

A very painful procedure, when a thick needle is pierced through the bone and a bone sample is taken. Next, the tissues themselves go for a biopsy, where they look at the degree of cancer differentiation - that is, how much cancer cells differ from ordinary ones. The more differences, the more aggressive and dangerous cancer. And then there is the treatment.

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 very nature of the treatment may depend on the stage of 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 there is a complete lesion of the spleen, then it can be completely removed.

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

Chemotherapy

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

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

With damage to the spinal cord, a lumbar puncture is used, when the drug itself is injected into the lower back of the spinal canal. The 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 for a long time of 6-8 months. There is usually a recovery period between injections, when the patient is allowed to rest. The patient can be allowed to go home if he does not have a strong decrease in immunity, otherwise he can be placed in a sterile ward with constant monitoring.

Side effects

Decreased immunity. The result is infectious complications.
Risk of internal bleeding.
Anemia.
Loss of hair and nails. They grow up later.
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 dramatically. They use monoclinal antibodies that attack cancerous tissues and Interferon - it already inhibits growth and reduces cancer aggression.

Side effects

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

Radiotherapy

Irradiation of the patient leads to the destruction and death of leukemoid cells. Often used before bone marrow transplantation to finish off the remnants of tumor tissue. Usually this type of treatment is used only as an auxiliary method, as it has little effect in the fight against leukemia.

Fatigue
Drowsiness
Dry skin, mucous membranes.

Bone graft

To begin with, doctors need to completely destroy cancerous tissue in the bone marrow, for this they use chem. reagents. After that, the remnants are destroyed by radiation therapy. Later, a bone marrow transplant occurs.

After that, peripheral blood stem cell transplantation is also used, through any of the large veins. As soon as the cells enter the blood, after a short period of time they turn into ordinary blood cells.

Side effects

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

Follow-up treatment

Doctors prescribe: Dieting.

Painkillers.
Antiemetic drugs.
Complex of vitamins.
Antianemic therapy.
Antiviral, antifungal drugs, antibiotics, with a decrease in immunity.

Prognosis and survival

The five-year survival rate is the length of time a patient lives after the discovery of a disease.

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

NOTE! Adults respond much worse to treatment than children with leukemia. This is due to the fact that the young body adapts faster, regenerates. Also, recovery during chemotherapy is 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
High salt food
Coffee and caffeinated foods and foods

Need to consume

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 - 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 falls.

With the progression of the disease, tumor cells go beyond the bone marrow and penetrate into other tissues, resulting in the development of the 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 falls at the age of 2-5 years, then there is a slight rise at 10-13 years, boys get sick more often than girls. In adults, a dangerous period in terms of the development of acute leukemia is the age after 60 years.

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

ALL- Acute lymphoblastic leukemia.
AML- Acute myeloid leukemia.

ALL more often develops 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 definition of the type and subspecies of leukemia is necessary for doctors to choose treatment tactics and make a prognosis for the patient.

Causes of acute leukemia

The study of 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. It is only clear that the development of the disease is closely related to factors that can cause cell mutation. These factors include:

hereditary propensity. Some variants of ALL develop in almost 100% of cases in both twins. In addition, cases of acute leukemia in several family members are not uncommon.
Exposure to chemicals(particularly benzene). AML can develop after chemotherapy for another condition.
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 fail to identify the factors that triggered the cell mutation.

During acute leukemia, five stages are distinguished:

Preleukemia, which often goes unnoticed.
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 starts with one cell) until the onset of symptoms of acute leukemia, an average of 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 "swallows" of acute leukemia can be:

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

These signs are very reminiscent of an acute viral infection, so it is not uncommon for patients to be treated for it, and during the examination (including a complete blood count) a number of changes characteristic of acute leukemia are detected.

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

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

In addition, very often with acute leukemia, infectious complications develop, the cause of which is immunodeficiency (inadequately mature lymphocytes and leukocytes in the blood), less often - neuroleukemia (metastasis of leukemia cells to the brain, which proceeds like meningitis or encephalitis).

The symptoms described above cannot be ignored, since the 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 treatment for 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 purpose 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 reinduction - a repetition of the induction stage. In addition, maintenance therapy with oral cytostatics is an obligatory element of treatment.

The choice of protocol in each specific clinical case depends on which risk group the patient belongs to (the age of the person, the genetic characteristics of the disease, the number of leukocytes in the blood, the 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 lineages;
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, since it is toxic. Therefore, against its background, patients begin to lose hair, nausea, vomiting, dysfunction of the heart, kidneys, and liver appear. In order to timely detect side effects of treatment and monitor the effectiveness of therapy, all patients need to regularly take blood tests, undergo bone marrow studies, biochemical blood tests, ECG, echocardiography, 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 patient's symptoms. Patients may require transfusion of blood products, antibiotics, and detoxification treatment to reduce the toxicity caused by the disease and the chemotherapy drugs used. In addition, if indicated, prophylactic brain irradiation 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 as possible to sterile, excluding contact with potentially infectious people, etc.

Patients with acute leukemia are transplanted with bone marrow, because only it contains stem cells that can become the ancestors of blood cells. Transplantation performed on 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 transplant during the first remission, especially if there is a high risk of relapse - the return of the disease.

In the first recurrence 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 transplantation procedure, conditioning is also mandatory - immunosuppressive therapy designed to destroy the remaining leukemic cells and create a deep depression of immunity, which is necessary to prevent transplant rejection.

Contraindications for bone marrow transplantation:

Serious dysfunction of internal organs.
Acute infectious diseases.
Recurrent leukemia, refractory to treatment.
Elderly age.

Prognosis for leukemia

The following factors influence the prognosis:

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

The prognosis for children with acute leukemia is much better than for adults. This is due, firstly, to the higher responsiveness 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 for full-fledged chemotherapy. In addition, adult patients often turn to doctors when the disease is already advanced, while parents are usually more responsible for the health of children.

If we operate with 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 younger than 55 years, and only 20% of older patients.

Summing up, I would like to note that acute leukemia is a serious disease, but 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 commentator, epidemiologist