And whether you know...
January 3, 2012
The acute lymphoid leukosis (other name — acute lymphoblastoid leukemia) is an illness of malignant character which is most often shown at children whose age — from 2 to 4 years.
Symptoms of an acute lymphoid leukosis
At manifestation of a lymphoid leukosis patients first of all complain of feelings of weakness, an indisposition. At them appetite strongly decreases, body temperature nemotivirovanno increases, integuments turn pale in view of anemia and the general condition of intoxication. Pain is most often shown in a backbone and extremities. In development of an illness also mediastinal lymph nodes increase peripheral, and in certain cases. Development of a hemorrhagic syndrome of which petechias and hemorrhages are characteristic is characteristic of about a half of cases.
Because of emergence of the extramedullary centers of defeat of TsNS neuroleukaemia can develop. Correctly to establish the diagnosis in this case, the computer tomography of a brain, EEG, MRT, and also liquor research is carried out. The leukemic infiltration of testicles is more seldom observed. In this case the diagnosis is based on research of the samples received as a result of a biopsy
Diagnosis of an acute lymphoid leukosis
As a rule, inspection of patients is begun with carrying out the analysis of peripheral blood. Its results almost in each case (98%) existence will be exclusive blasts and mature cells without intermediate stages. In case of an acute lymphoid leukosis normokhromny anemia and thrombocytopenia will be revealed. A number of other signs is characteristic already of smaller number of cases: approximately the leukopenia, in half of cases – a leukocytosis develops in 20% of cases. The specialist can suspect this disease already on the basis of complaints of the patient, and also an overall picture of blood. However it is impossible to establish the exact diagnosis without detailed research of red marrow. First of all at such research the attention addresses on the histologic, cytochemical and cytogenetic characteristic of blasts of marrow. Rather informatively identification of the Philadelphian chromosome (Ph-chromosome). To make the most exact diagnosis and to plan the correct course of treatment, it is necessary to conduct a number of additional examinations to establish whether defeats of other bodies take place. For this patient the otolaryngologist, the urologist, the neuropathologist in addition examines, researches of an abdominal cavity are conducted.
At statement of the diagnosis as factors of the bad forecast the age of the patient is considered 10 years, existence of a high leukocytosis, V-OLL morphology, a male, leukemic defeat of TsNS are more senior.
Treatment of an acute lymphoid leukosis
Generally at the correct treatment the illness recovers completely.
In most cases it is possible to achieve full treatment. In the course of treatment of an acute lymphoid leukosis certain principles which are important for successful treatment are applied.
The principle of a wide range of influence which essence consists in use of the himiopreparat having different mechanisms of influence is important. Use of the principle of adjusted dosage is not less important, at sharp decrease in doses of medicine the palindromia is possible, and at too high doses the risk of manifestation of complications of a lymphoid leukosis increases. At appointment to the patient of himiopreparat the doctor adheres to the principle of staging, and also succession.
However the defining principle in the course of therapy is the continuity of treatment for the beginning before end. Emergence of palindromias strongly reduces chance of final recovery of the patient. At emergence of recurrence several short blocks of chemotherapy in high doses are used to treatment.
Symptoms of a chronic lymphoid leukosis
It is an oncological illness of lymphatic fabric of which accumulation of tumoral lymphocytes in peripheral blood, lymph nodes and marrow is characteristic. If to compare this form of a lymphoid leukosis to an acute state, then in this case growth of a tumor happens more slowly, and disturbances of a hemopoiesis happen only at a late stage of an illness.
Symptoms of a chronic lymphoid leukosis is the general weakness, heavy feeling in a stomach, especially in the field of the left hypochondrium, the increased perspiration. At the patient body weight sharply decreases, lymph nodes strongly increase. The hyperadenosis is, as a rule, observed as the first symptom of a chronic form of a lymphoid leukosis. Because in development of an illness the spleen increases, there is a feeling of the expressed weight in a stomach. Often patients become more susceptible to any infections. However development of symptoms happens rather slowly and gradually.
Diagnosis of a chronic lymphoid leukosis
According to the available data, approximately in a quarter of cases the illness accidentally is found during blood test which is appointed to the person in other occasion. For statement of the diagnosis "the chronic lymphoid leukosis" to the patient is appointed by a number of researches. However first of all the doctor examines the patient. Clinical blood test in the course of which calculation of a leukocytic formula is made is without fail carried out. The defeat picture which is characteristic of this disease comes to light in the course of research of marrow. Also during full inspection of the patient with suspicion on a chronic lymphoid leukosis immunophenotyping of cells of marrow and peripheral blood, a biopsy of the increased lymph node is carried out.
The cytogenetic analysis allows to study tumor cells. And it is possible to predict risk level of development of infectious complications of a disease, having determined the level of immunoglobulins.
In the course of diagnosis the stage of a chronic lymphoid leukosis is also defined. Being guided by this information, the doctor makes the decision on tactics and features of its treatment.
Stages of a chronic lymphoid leukosis
Today there is specially developed system of a stadirovaniye of a chronic lymphoid leukosis by which it is accepted to determine three stages of a disease.
Defeat is characteristic of a stage And no more than two groups of lymph nodes or defeats of lymph nodes are not present at all. Also at this stage the patient has no anemia and thrombocytopenia.
At a stage In chronic a lymphoid leukosis defeat of three and more groups of lymph nodes takes place. The patient has no anemia and thrombocytopenia.
Existence of thrombocytopenia or anemia is characteristic of a stage With. At the same time these manifestations do not depend on the number of the affected groups of lymph nodes.
Also at statement of the diagnosis letters add the Roman figures designating a certain symptom to designation of a stage of a lymphoid leukosis:
I \existence of a lymphadenopathy
II \the increased spleen (splenomegaly)
III \existence of anemia
IV \existence of thrombocytopenia
Treatment of a chronic lymphoid leukosis
The fact that specialists define inexpedient therapy at early stages of a zvbolevaniye is considered feature of treatment of this illness. Treatment is not carried out in view of the fact that at most of patients at initial stages of a chronic form of this illness the so-called "smoldering" course of a disease takes place. Respectively, rather long period people can do without drugs, lead a usual life and it is rather good to feel. Therapy of a chronic lymphoid leukosis is begun only in case of manifestation of a number of symptoms.
So, treatment is reasonable if in the patient's blood the quantity of lymphocytes very quickly increases, increase in lymph nodes progresses, the spleen increases very strongly, anemia and thrombocytopenia accrues. Also treatment is required if the patient has symptoms of tumoral intoxication: the increased sweating at night, fast loss of body weight, fever, constant strong weakness.
Today allocate a number of approaches to therapy of a disease.
The chemotherapy is actively applied to treatment. However if till rather recent time for carrying out this procedure used drug Chlorbutinum, then at the moment more effective remedy the group of drugs — purine analogs is considered. Also apply a bioimmunotherapy method with use of monoclones to treatment of a chronic lymphoid leukosis. After administration of such drugs tumor cells are selektivno destroyed, and healthy fabrics in the patient's organism at the same time are not damaged.
If the applied methods of treatment have no desirable effect, then the attending physician the method of high-dose chemotherapy with the subsequent change of stem hemopoietic cells is used for designated purpose. If the patient has a big tumoral weight, then the method of radiation therapy as an auxiliary course of treatment is applied.
At strong increase in a spleen full removal of this body can be shown to the patient.
At selection of tactics of treatment of the patient with a chronic lymphoid leukosis the doctor without fail is guided by extensive data of all researches and considers specific features of the specific patient and the course of a disease.
Prevention of a lymphoid leukosis
As the reasons which can provoke manifestation of a lymphoid leukosis, define influence of a number of chemicals. Therefore it is necessary to treat contact with similar substances very carefully.
Patients who have an immunodeficiency in the anamnesis hereditary chromosomal defects, people for whose family the chronic lymphoid leukosis was diagnosed have to pass regularly routine inspections and visit specialists. Patients who completed a chemotherapy course should treat prevention of infections very seriously. So patients after chemotherapy need to stay a certain period in isolation, to observe the sanitary and hygienic mode, to avoid contacts with sick infectious diseases by people. Also for the purpose of prevention in certain cases by the patient appoint reception of antiviral means, antibiotics.
Persons for whom the lymphoid leukosis in a chronic form is diagnosed should eat dishes rich with proteins, to constantly take a blood test on the analysis, without fail in time to use all means which are appointed by the doctor. It is impossible to use aspirin, and also aspirinosoderzhashchy drugs which can provoke bleedings.
At display of tumors of lymph nodes, discomfortable feelings in a stomach the patient should see the attending physician at once.